On Monday, November 29, 2021, the United States District Court for the Eastern District of Missouri – Eastern Division has issued a preliminary injunction staying the Centers for Medicare and Medicaid Services (CMS) Mandatory Vaccination Emergency Temporary Standards (ETS) which were set to take effect on January 4, 2022. This preliminary injunction currently only applies to healthcare providers in the plaintiff states.
On November 10, 2021, the States of Missouri, Nebraska, Arkansas, Kansas, Iowa, Wyoming, Alaska, South Dakota, and New Hampshire filed a nine (9) count complaint in the United States Court for the Eastern District of Missouri seeking relief from the CMS Emergency Temporary Standard (ETS) which requires certain certified healthcare facilities to mandate COVID-19 vaccination of all employees, contractors, and those performing services “under arrangement.” The complaint alleged that the ETS violates numerous provisions of the Administrative Procedures Act (APA), the Social Security Act (SSA), that CMS failed to consult with the state agencies that would be charged with enforcing such a mandate, failure to perform an impact analysis of the new rules, and several other Constitutional violations.
In the ruling, U.S. District Judge Matthew T. Schelp, agreed with the plaintiffs that a preliminary injunction was warranted because it posed an irreparable harm and that the plaintiffs demonstrated a likelihood of success on the merits of their complaint. The thirty-two (32) page ruling cites that Congress did not give CMS the authority to enact the mandatory vaccination regulations, nor authorized CMS to issue regulations that pre-empt validly enacted state legislation that contradict these new rules. The court believed that the plaintiffs would likely be able to show that CMS violated numerous administrative and rulemaking procedures.
Throughout the ruling the court cited the likelihood of significant harm to state sovereignty and how the implementation of the rule’s requirements would cause substantial economic harm to both the states and the healthcare facilities. Not only through the cost of implementation but also through the impact to a healthcare facility’s ability to provide care due to employees who refuse to get vaccinated.
This ruling is only applicable to covered healthcare facilities in the states of Missouri, Nebraska, Arkansas, Kansas, Iowa, Wyoming, Alaska, South Dakota, and New Hampshire. It is unknown if the stay will be expanded to other jurisdictions. Additionally, the OSHA Vaccination & Testing ETS is currently enjoined and OHSA has announced that they will halt implementation and enforcement associated with those rules. Despite these rulings, many EMS employers are subject to the mandatory vaccination requirements under the Safer Federal Workforce Task Force COVID-19 Workplace Safety: Guidance for Federal Contractors and Subcontractors.
I advise employers to take the initial steps toward compliance while these cases proceed through the legal system. EMS employers are already required to have policies and procedures to determine and maintain a log of their employee’s vaccination status. Additionally, many EMS employers have already been contacted by their contracted healthcare facilities who have enacted a vaccine mandate, either prior to, or in response to the CMS ETS. These facilities may still independently require your staff to be vaccinated.
I recognize that these are incredibly challenging times. If your organization has questions or need assistance deciphering or preparing for these requirements, please contact the AAA by emailing firstname.lastname@example.org.
Governor Kay Ivey recently signed into law Alabama’s REPLICA legislation, HB250. Alabama joins ten other states—Colorado, Texas, Virginia, Idaho, Kansas, Tennessee, Utah, Wyoming, Mississippi, and Georgia—in this forward-thinking interstate compact.
REPLICA, the Recognition of EMS Personnel Licensure Interstate Compact, recognizes the day-to-day movement of EMS personnel across state lines. It extends the privilege to practice under authorized circumstances to EMS personnel based on their home state license, as well as allows for the rapid exchange of licensure history between Compact member states..
Learn more about how REPLICA participation can help your state at http://www.emsreplica.org.
May 8, 2017
For Immediate Release
May 8, 2017 (Falls Church, VA). With the 10th member state enactment, the Recognition of
Emergency Medical Services Licensure Interstate Compact (REPLICA) has become official.
Governor Nathan Deal of Georgia signed Senate Bill 109 on today activating the nation’s first EMS
licensure compact. States that have passed REPLICA to date include: Colorado, Texas, Kansas,
Virginia, Tennessee, Idaho, Utah, Mississippi, Wyoming and Georgia.
Released in 2014, REPLICA’s model legislation creates a formal pathway for the licensed individual
to provide pre-hospital care across state lines under authorized circumstances. According to Keith
Wages, president of the National Association of State EMS Officials (NASEMSO), “REPLICA
represents a collective, nationwide effort to address the problems faced by responders when needing
to cross state borders in the line of their duties.” Wages highlighted the compact’s abilities to
“increase access to healthcare, reduce regulatory barriers for EMS responders, and place an
umbrella of quality over cross border practice not previously seen in the EMS profession.” Wages
also noted that the partnership with the National Registry of Emergency Medical Technicians
(NREMT) has been essential during the advocacy and implementation phases. “We are grateful for
their continued support and contributions.”
Through funding provided by the Department of Homeland Security (DHS), NASEMSO led 23 EMS,
fire, law enforcement organizations and associations as well as key federal partners in the design and
drafting of REPLICA. The National Registry of EMTs (NREMT) currently provides funding to finalize
the development of the Commission.
The compact calls for establishment of an Interstate Commission with each state that has passed
REPLICA holding a seat, as well as a national EMS personnel coordinated database. Member states
will be able to rapidly share personnel licensure information, develop policy focused only on cross
border EMS practice, and hold EMS personnel originating in other states accountable in an
unprecedented way. The National Registry of EMT’s (NREMT) has committed to the development
and hosting of the coordinated database.
Twelve national associations and organizations support REPLICA. Three states have REPLICA bills
under consideration in their legislative sessions. Learn more at www.emsreplica.org.
FOR IMMEDIATE RELEASE
Washington, D.C.– The American Ambulance Association (AAA) has selected Senator Pat Roberts of Kansas as recipient of an AAA Legislative Recognition Award in honor of his strong advocacy for emergency medical services. Senator Roberts received his award during EMS on the Hill Day events on April 25.
AAA President Mark Postma notes, “We would like to thank Senator Roberts for his commitment to sustainable reimbursement for ambulance services in Kansas and across our nation.”
Senator Roberts was recognized for championing the Medicare Ambulance Access, Fraud Prevention and Reform Act, which would make permanent the current temporary Medicare ambulance add-on increases and the super rural bonus payment. The legislation would also treat ambulance services more like providers of health care services, and require CMS to collect cost data utilizing a methodology that would likely result in usable information and not be an unnecessary burden on rural ambulance services.
Senator Roberts was presented the award by Brandon Beck, President of the Kansas EMS Association (KEMSA), and other KEMSA representatives as well as Shawn Baird of Woodburn Ambulance (OR) AAA Treasurer and Vice Chair of the AAA Government Affairs Committee.
In appreciation of his ongoing service to the ambulance services of the United States, AAA is proud to honor Senator Roberts with a Legislative Recognition Award.
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Founded in 1979, the AAA represents hundreds of ambulance services across the United States that participate in emergency and nonemergency care and medical transportation. The Association serves as a voice and clearinghouse for ambulance services, and views prehospital care not only as a public service, but also as an essential part of the total public health care system.
The mission of the American Ambulance Association is to promote health care policies that ensure excellence in the ambulance services industry and provide research, education, and communications programs to enable its members to effectively address the needs of the communities they serve.
The American Ambulance Association is proud to announce the winners of the 2017 AAA Legislative Awards, in recognition of their strong advocacy for emergency medical services. Each legislator was chosen for their ongoing service to the ambulance services of the United States.
Senator Susan Collins (R-ME) – Press Release, Facebook Post, Twitter Post