Tag: Louisiana

AAA Comments on Pandemic and All-Hazards Preparedness Act (PAHPA)

March 28, 2023

The Honorable Bernie Sanders
Chair
Health, Education, Labor, & Pensions Committee
United States Senate
Washington, DC 20510

The Honorable Bob Casey
Health, Education, Labor, & Pensions Committee
United States Senate
Washington, DC 20510

The Honorable Bill Cassidy
Ranking Member
Health, Education, Labor, & Pensions Committee
United States Senate
Washington, DC 20510

The Honorable Mitt Romney
Health, Education, Labor, & Pensions Committee
United States Senate
Washington, DC 20510

Dear Chair Sanders, Ranking Member Cassidy, Senator Casey, and Senate Romney,

I am writing on behalf of the American Ambulance Association (AAA) to provide comments on policies the Committee should consider during the reauthorization of the Pandemic and All- Hazards Preparedness Act (PAHPA).

The members of the AAA provide mobile health care services to more than 75 percent of Americans. These essential mobile health care services include the local operation of the 9-1- 1 emergency medical services (EMS) system, as well as both emergent and non-emergency interfacility care transition ambulance services and transportation. Often ground ambulance service organizations are the first medical professionals to interact with individuals in need of a health care encounter. These organizations also serve as the health care safety net for many small communities, especially those located in rural areas where other providers and suppliers have reduced their hours of operation or left the community altogether. As such, these organizations play a critical and unique role in the country’s health care infrastructure.

Ground ambulance services are essential to our nation’s emergency medical response system, whether they are needed for a pandemic, natural disaster, or terrorist attack. The country’s EMS system requires federal support to ensure the availability of a well-trained workforce to provide these ground ambulance services. Ground ambulance services are also essential to protecting patient access to the right level of facility-based treatment options.

I.                    Support for Jurisdictional Preparedness and Response Capacity: Hospital Preparedness Program / ASPR activities financed through the general HHP budget

The AAA supports continued funding for the Hospital Preparedness Program (HPP). Our members have been working closely with the Assistant Secretary for Planning and Evaluation (ASPR) to find ways to direct some of the currently allocated HPP dollars to support ground ambulance services, particularly to address the workforce crisis and support expanded recruitment and training for emergency medical technicians (EMTs) and paramedics. During these discussions, it has become clear that more direct language authorizing the use of a specified portion of the HPP funds to support non-governmental and governmental ground ambulance services would allow ASPR to tackle this issue in a timelier manner.

Ground ambulance service organizations are facing crippling staffing challenges that threaten the provision of crucial emergency healthcare services at a time of maximum need. As we face a pandemic that waxes and wanes but does not end, our 9-1-1 infrastructure remains at risk due to these severe workforce shortages. The 2022 Ambulance Employee Workforce Turnover Study by the American Ambulance Association (AAA) and Newton 360 – the most sweeping survey of its kind involving nearly 20,000 employees working at 258 EMS organizations — found that overall turnover among paramedics and EMTs ranges from 20 to 30 percent annually with organizations on average having 30% of their paramedic positions open and 29% of their EMT positions.

The Congress and the President recognized the crisis and the FY23 Consolidated Appropriations called on ASRP to address this shortage by implementing a grant program to support non- governmental and governmental ground ambulance suppliers and providers through the HPP to address emergency medical services preparedness and response in light of the workforce shortage. While this language is helpful, the AAA recognizes that authorizing authority would provide a more sustainable approach to support an EMS workforce grant program.

Such a program would be consistent with the goals of ASRP. The FY24 HHS Budget in Brief highlights to goal of making “transformative investments in pandemic preparedness and biodefense across HHS public health agencies to enable an agile, coordinated, and comprehensive public health response to future threats and protect American lives, families, and the economy.” (HHS Budget in Brief 142). Ground ambulance medical services are an essential part of this preparedness and response goal.

Our nation’s ground ambulance service organizations, EMTs, and paramedics need Congress to address the EMS workforce challenges facing these front-line health care workers by including direct authority to use $50 million of the HPP funding to establish an EMS workforce grant program to address the crippling EMS workforce shortage, including in underserved, rural, and tribal areas and/or address health disparities related to accessing prehospital ground ambulance healthcare services, including critical care transport. The grants would be available to governmental and non-governmental EMS organizations to support the recruitment and training of emergency medical technicians and paramedics. The program would emphasize ensuring a well-trained and adequate ground ambulance services workforce in underserved, rural, and tribal areas and/or addressing health disparities related to accessing prehospital ground ambulance health care services.

This program is critically important to supporting the non-governmental and governmental ground ambulance service organizations that are the backbone of the country’s first emergency medical response system. The dollars would be used to provide grants directly to non- governmental and governmental ground ambulance service organizations to support training and retention programs, such as paying for initial training; providing tuition for community colleges EMT/ paramedic training courses; paying for required continuing education courses; supporting costs related to licensure and certification; and supporting individuals in underserved areas with transportation, child care, or similar services to promote accessing training.

II.                  Gaps in Current Activities and Capabilities: Gaps in HHS’ capabilities and what activities or authorities needed to fulfill intent of PAHPA and related laws

The most significant gap in PAHPA and HHS on preparedness and readiness activities is the exclusion of non-governmental entities from many of the federal programs targeted to first responders and EMS. This oversight results in more than one-third of local communities and their citizens not being able to access or benefit from the programs and funding that Congress intended be provided to support them. The AAA requests that the Committee recognize the decision-making authority to rely on non-governmental ground ambulance service organizations and provide access to programs that are currently available to governmental organizations.

During the pandemic, non-governmental local community ground ambulance organizations were not permitted to apply for or participant in many of the federal grant programs in place during the pandemic. As a result, these programs fell short of the goal of supporting preparedness and response activities at the local level.

The distinction between governmental and non-governmental appears to be based on outdated assumptions that first responders are only governmental or not-for-profit entities. This assumption ignores the decisions of state and local governments to contract with private ground ambulance service providers and suppliers to provide 911 or equivalent services. The federal government should respect these local decisions and support all ground ambulance services as first-responders and EMS.

One example of this problem is the FEMA public assistance grant program that reimbursed “first responders” for PPE and other expenses related to the response to COVID-19. When non- governmental (including not-for-profit) emergency ambulance service organizations sought direct reimbursement under the program, they were turned away. This differential treatment impacts communities across the United States, including those in Arkansas, California, Colorado, Florida, Georgia, Indiana, Louisiana, Massachusetts, Mississippi, Nevada, New York, Oregon, Texas, and Wisconsin, among others.

Appendix A includes list of some of the program the AAA has identified that should reviewed and updated to include non-governmental entities.

The solution to this problem is to use the more inclusive language that the Congress adopted in the Homeland Security Act of 2002 (6 U.S.C. § 101) on non-governmental and governmental entities within the definition of “emergency response providers.” This language provides access to all ground ambulance services and the communities they serve to funding when available to support preparedness and response activities.

 

III.               Conclusion

On behalf of ground ambulance service organizations of the AAA, I want to thank you for the opportunity to provide comments on the PAHPA. We look forward to working with your team as you continue develop these policies.

 

Sincerely,

Randy Strozyk President

Appendix A: Grant Program for Review

ASSISTANCE TO FIREFIGHTERS GRANT (AFG)

http://www.firegrantsupport.com/afg/faq/08/faq_emer.aspx#q1

The grant program prohibits “for-profit” organizations from applying for grant funding.

STAFFING FOR ADEQUATE FIRE AND EMERGENCY RESPONSE (SAFER)

Retrieved from http://www.firegrantsupport.com/safer/faq/08/faq_elig.aspx#q1

Only fire departments and volunteer firefighter interest organizations are eligible for SAFER grants.

FEDERAL DISASTER RELIEF FUNDS

$45B to reimburse activities such as medical response, procurement of PPE National Guard deployment, coordination of logistics, implementation of safety measures, and provision of community services. According to FEMA, these funds will cover overtime and backfill costs; the costs of supplies, such as disinfectants, medical supplies and PPE; and apparatus usage. (The federal government will cover 75% of these costs.) NAEMT recommends FEMA’s new sheet on FEMA’s Simplified Public Assistance Application. In addition, you should consult with their state emergency managers to begin the process of being reimbursed. Eligible to apply: Public and some non-profit services.

Emergency Management Baseline Assessment Grant Program

The Emergency Management Baseline Assessment Grant (EMBAG) program provides non- disaster funding to support developing, maintaining, and revising voluntary national-level standards and peer-review assessment processes for emergency management and using these standards and processes to assess state, local, tribal, and territorial emergency management programs and professionals.

Nonprofit Security Grant Program

The Nonprofit Security Grant Program (NSGP) provides funding support for target hardening and other physical security enhancements and activities to nonprofit organizations that are at high risk of terrorist attack.

SIREN ACT

The Siren Act supports public and non-profit rural EMS agencies through grants to train and recruit staff, fund continuing education, and purchase equipment and supplies from naloxone and first aid kits to power stretchers or new ambulances.

ASPR – NATIONAL BIOTERRORISM HOSPITAL PREPAREDNESS PROGRAM

Eligibility requirements exclude for-profit private EMS.

PUBLIC SAFETY OFFICERS’ DEATH BENEFIT

Public Safety Officers’ Benefits Improvements Act of 2011 (S. 1696).

Added non-profits (but still excluded for profits) in the Public Safety Officers’ Benefit (PSOB) program. This legislation extended the federal death benefit coverage to paramedics and emergency medical technicians (EMTs) who work for a private non-profit emergency medical

services (EMS) agency and die in the line of duty and thank you for including the language of the Dale Long Emergency Medical Service Providers Protection Act (S. 385) in this new bill. Congress established the Public Safety Officer Benefit program to provide assistance to the survivors of police officers, firefighters and paramedics and emergency medical technicians in the event of their death in the line of duty. The benefit, however, currently only applies to those public safety officers employed by a federal, state, or local government entity and non-profits.

URBAN AREA SECURITY INITIATIVE (UASI) & METROPOLITAN MEDICAL RESPONSE SYSTEM (MMRS)

Retrieved from http://www.iowahomelandsecurity.org/Portals/0/CountyCoordinators/Grants/FFY09HSGPguida nce.pdf

Inclusion of Emergency Medical Services (EMS) Providers

DHS requires State and local governments to include emergency medical services (EMS) providers in their State and Urban Area homeland security plans. In accordance with this requirement, and as States, territories, localities, and tribes complete their application materials for the FY 2009 HSGP, DHS reminds our homeland security partners of the importance for proactive inclusion of various State, regional, and local response disciplines who have important roles and responsibilities in prevention, deterrence, protection, and response activities. Inclusion should take place with respect to planning, organization, equipment, training, and exercise efforts. Response disciplines include, but are not limited to: governmental and nongovernmental emergency medical, firefighting, and law enforcement services; public health; hospitals; emergency management; hazardous materials; public safety communications; public works; and governmental leadership and administration personnel.

INTEROPERABLE COMMUNICATIONS GRANTS

Retrieved from http://www.fema.gov/government/grant/iecgp/index.shtm

Eligibility and Funding

The Governor of each State and territory has designated a State Administrative Agency (SAA), which can apply for and administer the funds under IECGP. The SAA is the only agency eligible to apply for IECGP funds.

TECHNOLOGY TRANSFER PROGRAM (CEDAP)

Retrieved from http://ojp.usdoj.gov/odp/docs/cedap_factsheet_2008.pdf

Eligibility

Eligible applicants include law enforcement agencies, fire, and other emergency responders who demonstrate that the equipment will be used to improve their ability and capacity to respond to a major critical incident or work with other first responders. Awardees must not have received technology funding under the Urban Areas Security Initiative, or the Assistance to Firefighters Grants program since Oct. 1, 2006. Organizations must submit applications through the Responder Knowledge Base (RKB) website at www.rkb.us.

Medicare Ambulance Relief Bill introduced in Senate

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.

East Baton Rouge EMS | 2021 EMS Week Featured Service

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

Senate Passes Ambulance Treatment in Place Language

On Saturday, the U.S. Senate passed language for Medicare coverage of emergency treatment in place of lower acuity patients by ground ambulance services providers and suppliers during the COVID-19 public health emergency (PHE). The language is from S. 149 by Senators Cortez Masto (D-NV) and Cassidy (R-LA) and passed as part of the $1.9 Trillion American Rescue Plan (H.R. 1319). The House is scheduled to vote and expected to pass the package tomorrow.

The American Ambulance Association along with the International Association of Fire Chiefs, International Association of Firefighters, National Association of EMTs and National Volunteer Fire Council pushed for passage of the bill language.

S. 149 would authorize the Centers for Medicare and Medicaid Services (CMS) to waive the transport requirement under Medicare for treatment in place for 9-1-1 or equivalent ambulance responses in which community EMS protocols dictate that the patient not be transported to a facility. The waiver would apply during the public health emergency.

Similar to other waivers provided by Congress for Medicare coverage during the pandemic, CMS would not be required to implement the policy. However, CMS has done so in all other situations and has also made the coverage retroactive to the beginning of the PHE. Upon passage of the language, the AAA will strongly advocate for CMS to implement the waiver and make it retroactive.

The AAA will be offering educational services to our members on the requirements of the proposed new policy and how to bill for covered services.

Treatment In Place in Senate Draft

Ambulance Treatment in Place Bill Included in Senate Draft Budget Reconciliation Package

The draft bill by Senate Democrats on a Budget Reconciliation package includes the language of S. 149 which would waive the transport requirement under Medicare for certain 9-1-1 ground ambulance services during the public health emergency. The Senate is expected to consider the package as soon as tomorrow.

Senators Catherine Cortez Masto (D-NV) and Bill Cassidy, M.D. (R-LA) introduced S. 149 on February 3 which is supported by the AAA, International Association of Fire Chiefs, International Association of Firefighters, National Volunteer Fire Council and National Association of EMTs.

Under S. 149, the Centers for Medicare and Medicaid Services (CMS) would have the authority to waive the requirement that a patient must be transported to a medical facility in order for a ground ambulance service organization responding to a 9-1-1 emergency call to be reimbursed by Medicare when there is a community-wide EMS protocol restricting the transport of the patient.  Ground ambulance service organizations whose paramedics and EMTs are on the frontlines of this pandemic are struggling financially due to the reduction in ambulance transports and higher costs such associated with responding to medical emergencies that cannot be reimbursed because of the transportation requirement. S. 149would greatly help address part of that problem and recognizes the critical role that ground ambulance service organizations are playing in controlling hospital surges and reducing the spread of COVID-19 .”

The House has already passed their version of Budget Reconciliation and would still need to pass a Senate version before sending to the President. S. 149 would provide CMS with the authority and, if passed, the AAA would advocate for the agency to exercise that authority and follow through with the waiver starting at the beginning of the public health emergency.

Senators Cortez Masto and Cassidy Introduce Bill on Ambulance Treatment in Place

Yesterday, Senators Catherine Cortez Masto (D- NV) and Bill Cassidy, MD (R-LA) introduced legislation (S. 149) to allow for Medicare reimbursement under certain circumstances of treatment in place by ground ambulance service organizations during the COVID-19 public health emergency. The AAA applauds the efforts of Senators Cortez Masto and Bill Cassidy as well as the Senate Finance Committee and Leadership.

S. 149 would provide the Centers for Medicare and Medicaid Services (CMS) with the authority to waive the requirement that a patient be transported to a medical facility in order for the ground ambulance service provider or supplier to receive Medicare reimbursement. The waiver would apply to 9-1-1 emergency ambulance services in which the transport did not occur as a result of “community-wide EMS protocols” due to the public health emergency. While the bill would not apply to situations in which a patient declines transport due to COVID-19 exposure concerns as advocated by the AAA, S. 149 is a significant step in the right direction to recognize ground ambulance services not being reimbursed during the pandemic.

The American Ambulance Association (AAA) along with the International Association of Fire Chiefs (IAFC), International Association of Firefighters (IAFF) and National Association of Emergency Medical Technicians (NAEMT) have spearheaded efforts for the Congress to provide CMS with waiver authority for treatment in place. We will be pushing to include the language of S. 149 in the COVID-19 stimulus package currently being negotiated between the White House and the Congress.

For the official statement of the AAA on the introduction of S. 149, please click here.

S.149 Treatment In Place

The American Ambulance Association Urges Immediate Passage of  S. 149 to Allow CMS to Support Local Ground Ambulance Service Responses to the Public Health Emergency

Treatment in Place Supports Patients and Sustains 9-1-1 EMS Providers During the COVID-19 Pandemic

Washington, DC, February 2, 2021 – The American Ambulance Association (AAA), our nation’s voice for ground ambulance service organizations commends Senators Catherine Cortez Masto (D-NV) and Bill Cassidy, M.D. (R-LA) for the introduction of S. 149 and urges its immediate passage. This legislation would remove a statutory barrier that has stopped ground ambulance service organizations from being reimbursed for health care services they provide consistent with local emergency medical service (EMS) protocols.

“S. 149 will empower ground ambulance service organizations to better meet the emergency medical needs of their communities, which are struggling during the pandemic,” stated AAA President Shawn Baird. “I applaud Senators Cortez Masto and Cassidy for their leadership on introducing this vital piece of legislation, as well as the Senate Finance Committee and Leadership for their support of these efforts.”

Under S. 149, the Centers for Medicare and Medicaid Services (CMS) would have the authority to waive the requirement that a patient must be transported to a medical facility in order for a ground ambulance service organization responding to a 9-1-1 emergency call to be reimbursed by Medicare when there is a community-wide EMS protocol restricting the transport of the patient.  “Ground ambulance service organizations whose paramedics and EMTs are on the frontlines of this pandemic are struggling financially due to the reduction in ambulance transports and higher costs such associated with responding to medical emergencies that cannot be reimbursed because of this transportation requirement,” said Baird. “This bill would greatly help address part of that problem and recognizes the critical role that ground ambulance service organizations are playing in controlling hospital surges and reducing the spread of COVID-19 .”

The legislation would benefit patients by reducing their risk of exposure to the virus, which is often the focus of the local protocols requiring them to remain at home. It would also help hospitals experiencing surges during the pandemic by allowing hospital beds to be reserved for higher acuity patients.

The AAA will help push for swift passage of the bill. President Baird called on the Congress to address the legislation as part of negotiations on a new COVID-19 economic relief package. “The American Ambulance Association fully endorses S. 149 and we ask for all members of Congress to help their ground ambulance service organizations, their patients, and the communities they serve by supporting passage of this bill.”

About the American Ambulance Association

The American Ambulance Association safeguards the future of mobile healthcare through advocacy, thought leadership, and education. AAA advances sustainable EMS policy, empowering our members to serve their communities with high-quality on-demand healthcare. For more than 40 years, we have proudly represented those who care for people first. For more information about the AAA visit our website at www.ambulance.org.

Acadian Ambulance Service in 2020

Acadian Ambulance Service
Lafayette, Louisiana
5,000 Staff | 750 Quarantined in 2020

Since 1971, Acadian Ambulance Service has earned a reputation as one of the nation’s most respected and largest privately held medical transportation companies.

Acadian was founded in response to a sudden crisis, as communities around the country found themselves without emergency medical transportation when federal regulations caused funeral homes to stop using hearses for emergency transport.

We began Louisiana operations on September 1, 1971, with three young cofounders, two ambulances and eight medics covering 279 square miles.

We have steadily added parishes and states to our service area over the years, addressing challenges along the way. Our fleet currently contains more than 600 ground ambulances, helicopters and fixed-wing airplanes.

Acadian currently covers more than 70 parishes and counties that are home to more than 24 million residents in Louisiana, Mississippi, Tennessee, and Texas.

Our company is one of a very select few agencies in the United States to achieve accreditation with both the Commission on the Accreditation of Ambulance Services for our ground operations and the Commission on Accreditation of Medical Transport Systems for our air operations.

The COVID-19 pandemic and seven tropical cyclones that impacted our service area have presented operational and economic challenges to Acadian Ambulance. Our team has responded by working together, finding solutions and taking care of our patients and communities, while ensuring the health of our employees.

When cases began rising in the spring and stay-at-home orders were enacted, we saw patient volume drop and costs escalate.

Throughout the pandemic, we have worked hand-in-hand with other EMS agencies and first responders, working under state contracts and staffing surge units.

Our four-state service area was also impacted by a very active hurricane season, enduring effects from Cristobal, Marco, Laura, Sally, Beta, Delta and Zeta.

Hurricane Laura made landfall in the heart of our SE Texas and SW Louisiana service areas and impacted Central and North Louisiana. More than 100 of our employee-owners suffered substantial or total loss of their homes and property, and some of our company facilities saw severe damage.

We have faced many challenges over the years, and each one has helped us to adapt and continue living out our mission of Knowing Life Matters.

Pafford Medical Services in 2020

Pafford Medical Services
Hope, Arkansas
1,500 Staff | 98 Quarantined in 2020

Founded in 1967, Pafford Medical Services provides over 80 communities across 8 states and the U.S. Virgin Islands with the latest, most sophisticated level of pre-hospital care. As a family-owned and operated company, Pafford is staffed 24/7/365. Over 1500 members of Team Pafford can be found operating the fleet of 200 ambulances, 4 communications centers, 3 medical fixed-wing aircraft, 3 rotor-wing aircraft to provide communities with proper 911 ambulance coverage.

In addition to the day-to-day operations, the company has become known nationwide for its Special Response Taskforce which assists during national disasters. As the company evolves to cater to the citizens it serves, Pafford took notice of the needs of industries and businesses during the global pandemic and now operates OnSite Healthcare Services in order to safeguard workforces as the world resumes operation amidst COVID-19. Another pillar of the company’s mission is its promise as a contributive community partner by providing educational resources, medical equipment, and scholarships along with medical standby for special events.

With the novel Coronavirus, EMS personnel would need to be properly trained to combat the transmission of the virus. Along with obtaining PPE for their medics, Pafford Medical Services provided additional training while increasing health surveillance, screening, and tracking of employees with the activation of their Emergency Operations Center.

Pafford remained a leader in community discussions and decisions related to COVID-19. Thanks to the diligent work and daily communications with their leadership teams, all of Pafford’s systems remained fully operational.

As the world stopped turning due to COVID-19, Mother Nature did not as hurricane season came out in full force. With 8 named storms and 2 major hurricanes, Pafford’s Special Response Taskforce deployed along the Gulf Coast to provide relief to the affected communities for 75 days.

“We’ll never be able to fully express our gratitude to not only our management teams, but to our boots on the ground who have been in the trenches remaining strong and vigilant,” says CEO, Jamie Pafford-Gresham. “Our men and women have gone beyond the call of duty–– suiting up, serving others, and their communities on the frontlines of healthcare.”

A-MED Ambulance Service in 2020

A-MED Ambulance Service
Gretna, Louisiana
55 Staff | 3 Quarantined in 2020

Founded in 1996 by Frank Macera Jr. and Joseph Jaeger Sr., A-MED has grown from a two-vehicle transport service into one of Louisiana’s premier private ambulance agencies. New Orleans is a unique city whose people have clear expectations when it comes to caring for family. We are thankful that our community continues to trust us to deliver essential care at their most crucial time.

Frank and Joe’s vision was to be the best, not the biggest, and positively impact every life entrusted to us. Nearly 25 years later, we preserve that vision by keeping our patients’ and clients’ needs as our primary focus; and keeping our promise always to be there when they need us.

The COVID-19 pandemic created unprecedented challenges for our team, on both a personal and professional level. At the organizational level, we worked tirelessly to provide access to top-of-the-line PPE and decontamination systems at all times to ensure the safety of our team and their patients. As we experienced this most challenging and uncertain time, we also experienced an incredible outpouring of love and support from our community. Our team regularly received coffee, meals, thank you notes, and sometimes even applause!

Our team faced a very active hurricane season in addition to the pandemic response, completing several facility evacuations and deployments to other impacted areas. No matter what the obstacle, every challenge was met head-on and overcome.

We are truly thankful to each team member for the strength, courage, and compassion you continue to demonstrate every day. Thank you for being a shining example of the EMS spirit!

East Baton Rouge Parish EMS in 2020

East Baton Rouge Parish EMS
Baton Rouge, Louisiana
200 Staff | 35 Quarantined in 2020

The East Baton Rouge Parish Department of Emergency Medical Services was founded as the first municipal third service EMS system in the State of Louisiana on August 6th,1982. At its inception, there was no advanced life support pre-hospital care in the capital area. EMS was initially supported by Federal Revenue Sharing Funds. In 1985 a tax election was held, and the citizens voted for a $3 million property tax dedicated to the funding of their EMS System. This year the Department has an operating budget of $24,000,000 which is also supplemented by third-party insurance billing. EBR EMS is the primary provider of pre-hospital emergency medical care in EBR Parish and runs about 65,000 calls annually. EBR Parish is 456 square miles with a population of over 440,000 residents. EBR EMS operates 12 stations throughout the parish with 14 ALS ambulances and a minimum of 2 supervisor sprint vehicles. Baton Rouge is home to LSU and Southern University, as well as a community college. The Department’s special events fleet is comprised of a medical rehab trailer, bicycle teams, ASAP brand 4×4 vehicles, and a mass casualty triage deployment truck.

In January 2020, East Baton Rouge EMS was requested to provide mutual aid to New Orleans EMS for the College Football National Championship game. The Department provided NOEMS an ASAP cart, a bicycle team along with medics to work the event. EBR EMS medics were once again sent to New Orleans in February for Mardi Gras coverage and provided 2 ASAP carts, 2 bicycle teams and medics for an entire week’s coverage. There were multiple Mardi Gras parades in Baton Rouge that EBR EMS also medics covered.

March 2020 was when COVID began to affect our community. We quickly mobilized specialized COVID units to respond solely to these types of calls based on dispatcher screening. Increased protective measures were placed on these units. As the number of COVID calls increased, it was decided to outfit every unit and medic with these extra protective measures.

The 2020 hurricane season was very active for our area. We had several back to back storms that required us to activate our disaster plans. Thankfully the capital area was spared direct hits, but our neighboring communities weren’t so lucky. EBR EMS provided USAR medics and an ambulance to the badly damaged Lake Charles area.

EMS Week Featured Service | Pafford Medical Services

Pafford Medical Services
Hope, Arkansas
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Meet Pafford Medical Services

Founded in 1967, Pafford Medical Services continues to provide over 80 communities with the latest, most sophisticated level of pre-hospital care. As a family-owned and operated company, Pafford serves communities across Arkansas, Louisiana, Mississippi, Oklahoma, Pennsylvania, and the U.S. Virgin Islands. With over 1200 members of Team Pafford, over 180 ambulances, 3 medical fixed-wing aircraft, 3 rotor-wing aircraft, 2 communications centers, and our corporate billing office, Pafford is staffed 24/7.

It is Pafford’s mission to provide its communities, healthcare partners, and facilities they serve with the highest standards of mobile healthcare. While providing communities with proper 911 ambulance coverage, the company has become known nationwide for its Special Response Taskforce which assists during national disasters. As the company evolves to cater to the citizens it serves, Pafford took notice of the needs of industries and businesses during the global pandemic and now operates OnSite Healthcare Services in order to safeguard workforces as the world resumes operation amidst COVID-19.  Another pillar of the company’s mission is its promise as a contributive community partner by providing educational resources, medical equipment, and scholarships along with medical standby for special events.

Pafford is fully equipped to provide the following services:

  • ALS/BLS Ground Ambulance Transportation
  • 911 Paramedic Ambulance
  • Mobile Integrated Healthcare Services
  • OnSite Healthcare Services
  • Air Medical Fixed-WingTransporation
  • Air Medical Rotor-Wing Transportation
  • Government and Industrial OnSite Services
  • Event Standby Services
  • Domestic and International Special Response Taskforce
  • Community Education Resources
  • Medical Billing

The Pafford Medical Services COVID-19 Response

It was evident that with the novel coronavirus, crew members would need to be properly trained to combat the transmission of the virus. Along with obtaining PPE for their medics, Pafford Medical Services provided additional, in-depth training and education to crew members all while increasing health surveillance, screening, and tracking of employees. Due to Pafford spanning across 5 states and the U.S. Virgin Islands, the company activated its Emergency Operations Center to provide support to its primary 911 PSAPS.

In these unprecedented times, Pafford Medical Services remained a leader in community discussions and decisions related to COVID-19. To better serve its communities, Pafford dedicated ambulances in their regions to coordinate the transport of COVID cases or suspected COVID cases. All of Pafford’s systems were able to remain fully operational thanks to the diligent work and daily communications with their leadership teams to keep all team members up to date on the latest information for their communities.

“We will never be able to fully express our gratitude to not only our management teams but to our boots on the ground who have been in the trenches remaining strong and vigilant over the past 10 weeks,” says CEO, Jamie Pafford-Gresham. “These men and women have gone above and beyond the call of duty, serving others, their communities, and their country during this global health crisis.”

The Pafford Medical Services Leadership Perspective

“As a rural EMS provider, our challenges on a day-to-day basis require our medics to be prepared to care for our communities, many of which do not have hospitals and with clinics working limited hours, our medics are always there 24/7/365.  We are the Healthcare Safety Net and our team does a wonderful, compassionate job. They don’t back down and provide a vital service to our citizens. During this outbreak, I am proud of not only our EMS team members but the entire EMS system across America for stepping up in such a critical time in our Country.”—Jamie Pafford-Gresham, CEO, Pafford Medical Services

Frontline Voices from Pafford Medical Services

“It takes a servant’s heart and a strong mind. But I count it as pure joy to help those in need.”-Alvin Short, Pafford EMS, Paramedic, Canadian County, OK

EMS is important because even when things get rough, the world keeps getting scarier and sickness continues to rise…we never quit.”—Meghann Jones EMT Pafford EMS, Canadian County, Oklahoma

“EMS is important because it provides immediate medical care to people who need it– bringing the ER to the patient in a timely manner.” Jarlicia Scott FTO/ Paramedic

“EMS is an extremely important part of community safety, doctors don’t make house calls anymore so EMS practitioners stand readily available to provide that extension of care while treating and managing acute illnesses and trauma.”—Randy Murry, EMS Operations Manager, Coahoma County, Mississippi,  Star of Life 2020

How Pafford Medical Services Celebrates EMS Week

Most people that know the Pafford Family, know that celebration is normally in the form of passing the plate, sharing in a meal, and most importantly, fellowship. Pafford Medical Services makes it a point to take a step back and bring families together, to recognize and honor the sacrifices made from all members of the families that have a loved one on the front-lines. This year, team gifts will be given out, but most importantly, Pafford realizes that the ultimate gifts are its people.

PEW Stateline | Many Health Providers on Brink of Insolvency

Thank you to PEW Stateline journalist Michael Ollove for taking the time to learn about EMS economics from AAA Payment Reform Chair Asbel Montes and Professional Ambulance Association of Wisconsin President Chris Anderson.

Stay-at-home orders have paused many activities that resulted in emergency calls, such as traffic accidents and shootings, said Chris Anderson, director of operations for Bell Ambulance in Wisconsin. As for non-emergency transportation, many people want to avoid health facilities now if they can, he said.

Asbel Montes, a senior vice president with Acadian Companies, a Louisiana-based firm operating 500 ambulances in Louisiana, Mississippi, Tennessee and Texas, said emergency calls have dropped by 30% and non-emergency calls by 70%.

Read the full article►

NBC Nightly News | EMS workers speak out from front lines of coronavirus crisis

On April 15, NBC nightly news profiled the front line COVID-19 response in a segment featuring members Acadian Ambulance, Empress EMS, Medstar (MI), and the Fire Department of New York. Thank you to Lester Holt and Stephanie Gosk for sharing mobile healthcare’s value and perspective during the pandemic.


Emergency responders, used to trauma and danger, say it’s impossible to get used to their new reality during the coronavirus pandemic. “You’re coming to work to deal with death all day,” one New York EMS worker says.

40 Under 40: Corey Chapman (Acadian Ambulance Service – Lafayette, LA)

40 Under 40 nominees were selected based on their contributions to the American Ambulance Association, their employer, state ambulance association, other professional associations, and/or the EMS profession.
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Corey Chapman
Director of Revenue Cycle
Acadian Ambulance Service
Lafayette, LA

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Nominated by: Rachel Harracksingh

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Biography:

Corey Chapman has worked at Acadian Ambulance Service since 2013. Corey has a Bachelor’s Degree in Behavioral Science and a Master’s Degree in Business Administration from the University of Louisiana Lafayette. In addition to his work at Acadian, Corey is also a Board Member for the American Cancer Society of Louisiana and the Junior Achievement of Louisiana. Coey is passionate about patient care and moving the EMS industry forward.
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Reason for Nomination:

Corey Chapman is passionate about process re-engineering and improvements. During his tenure at Acadian Ambulance Service over the past six years, Corey has provided project management leadership around contracts, membership and corporate compliance initiatives. Corey was promoted in January to Director of Revenue Cycle where he leads a team of approximately 200 employees.

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View all of the 2020 Mobile Healthcare 40 Under 40 Honorees

2019 AMBY Award Winners Announced

The American Ambulance Association is proud to announce the recipients of the 2019 AMBY Awards. The AMBYs highlight excellence in EMS and the ingenuity and entrepreneurial spirit that epitomize  mobile healthcare. The mission of the awards is to showcase creativity and innovation in the ambulance industry by fostering a culture of collaboration, cooperation, and a passion for excellence in patient care. This year’s awards will be presented at the Annual Conference & Trade Show Awards Reception on November 5 in Nashville. Please join us in congratulating our 2019 winners!

Clinical Outcome Program

Medic Ambulance Service Inc.
CPR Initiative

Community Impact Program

Advanced Medical Transport
CPR Race to the Top

American Medical Response (Manchester/Nashua, NH)
Safe Station Project

Sunstar Paramedics
Health & Safety Fair

Employee Programs

American Medical Response (Buffalo, NY)
Recruitment/Training Program

Northstar EMS, Inc
Medical Director Engagement Through Technology

Public Relations Campaign

Acadian Ambulance Service
Hometown Hero Initiative

Mecklenburg EMS Agency
Bystander CPR Initiative With Pulsepoint

Once again, join us in celebrating the 2019 winners! Learn more about the AMBYs.

Debut of Unit 68 Film Ft. Acadian Ambulance

Unit 68 premiered worldwide on YouTube today. The short film was written and directed by David K. Jarreau, a Paramedic with Acadian Ambulance Service, and features an Acadian ambulance. The film depicts a young boy, Mack, and his experience with a mysterious ambulance that forever changes his life. The film is loosely based on real-life experiences faced by Unit 68 In Baton Rouge, LA. Jarreau stated on Baton Rouge’s Local 33 news that part his motivation to create this film was to address today’s shortage of EMS personnel. He hopes that the film will inspire young viewers to aspire to careers in EMS.

Watch the video above, or on YouTube.

Senator Bill Cassidy Receives AAA Legislative Honor

Senator Bill Cassidy to Receive
2017 AAA Legislative Recognition Award

For Immediate Release
Contact:
Amanda Riordan
ariordan@ambulance.org
703-610-0264

Washington, DC– The American Ambulance Association (AAA) will honor Senator Bill Cassidy of Louisiana with a Legislative Recognition Award in appreciation of his advocacy for emergency medical services.

Senator Cassidy will be presented this award in June in Washington, DC by AAA’s Louisiana Stars of Life—EMS personnel selected for their excellence and dedication. This year’s Stars from the Bayou State are Tyler Niblett, and Coty M. Peardon, of Acadian Ambulance Service.

Senator Cassidy was selected for the Legislative Recognition Award for championing the Protecting Patient Access to Emergency Medications Act. This legislation is intended to ensure that Paramedics and EMTs can continue to administer life-saving drugs to patients.

AAA President Mark Postma notes, “Senator Cassidy has been a trusted advocate for health care and emergency medical services, both in Louisiana and across our country. The AAA is proud to present him with a Legislative Recognition Award.”
Elected to the Senate in 2014, Senator Cassidy serves on the Health, Education, Labor & Pensions (HELP), Energy and Natural Resources, Finance, Veterans Affairs, and Joint Economic Committees. In addition to his service in the Senate, for nearly three decades Senator Cassidy has provided care for uninsured and underinsured patients in Louisiana’s charity hospital system in his capacity as a medical doctor.

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About the American Ambulance Association

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.

AAA Stars of Life

The Stars of Life program celebrates the contributions of ambulance professionals who have gone above and beyond the call of duty in service to their communities or the EMS profession. Stars of Life honors the dedication of these heroes while shining light on the critical role EMS plays in our healthcare infrastructure. This year, 101 EMS professionals will be honored as the 2017 Stars of Life. Meet the stars at www.stars.ambulance.org.

AAA Mission Statement

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.

2017 AAA Legislative Awards

Status of the American Health Care Act

Today, citing “growing pains” of his Republican majority, Speaker Paul Ryan (R-WI), in consultation with President Donald Trump, determined not to proceed with a planned vote on the American Health Care Act (AHCA), which repealed and replaced important elements of the Affordable Care Act (ACA).  The Speaker indicated that the House Republican Caucus “came up short” in the number of votes needed for the bill.  House Republican Leadership had been moving AHCA through the Chamber at a rapid pace.  The bill was officially released on March 6, and had been changed several times to try to appease various conservative and moderate voting blocs within the Republican Caucus.  The Congressional Budget Office (CBO) originally estimated the bill would reduce federal deficits by $337 billion, and subsequently downgraded the deficit reduction to $150 billion based on additional substantive policy changes to the bill.  The CBO estimates the bill would have increased the country’s number of uninsured by about 24 million people.

In negotiating the provisions of AHCA, the House Republican Leadership had faced a constant seesaw, as efforts to appease one ideological bloc upset the other.  Ultimately, throughout the day in advance of the scheduled vote, an increasing number of moderate Republicans, including Appropriations Committee Chairman Rodney Frelinghuysen (R-NJ), announced they would vote against the bill.  As the moderates disappeared, not enough members of the conservative Freedom Caucus decided to support the bill.

As disarray in the House Republican Caucus occurred, there appeared to be a similar lack of consensus amongst their Republican colleagues on the Senate side.  While Senate Leadership had planned to move the bill directly to the Senate floor as fast as within a week of receipt from the House, there were a number of Senators from a range of political perspectives with serious concerns about the bill.  On one side of the Republican spectrum, Senators Rand Paul (KY), Mike Lee (UT) and Ted Cruz (TX) had planned to push the limits of what can be included in a reconciliation bill to make it more conservative. Senator Paul had advocated for repealing the ACA in full and dealing with the replacement later on. On the other side, more moderate or “purple state” Members like Senators Susan Collins (ME), Lisa Murkowski (AK), Rob Portman (OH), Cory Gardner (CO) and Dean Heller (NV) raised concerns about insurance affordability and the expedited rollback of Medicaid expansion in the House version of the bill. Other Senators who will likely play a prominent role in any further health reform developments include physician Senator Bill Cassidy (LA), and Senator Tom Cotton (AR), who advocated all along to slow the process down. Republicans can only lose two Senators and still pass any health reform bill, with the vote of Vice President Mike Pence breaking the tie.

As a next step, House and Senate Republican Leadership plan to take more time to develop consensus in any future approach to health reform.  How much time is unclear – but it seems unlikely the bill will be the legislative focus in the short term.  Instead, there will likely be a cooling-off period on health reform legislative activity, since the fundamental disagreements within the caucus are not easily fixed.  There will continue to be significant messaging against ACA from conservatives, and there is the potential that the idea of “repeal and delay” may gain more traction.  Nonetheless, in the short term, the Speaker indicated he would move on to other items on his conference’s agenda – including tax reform.  Keep in mind, however, that since health-related tax provisions are a major component of the tax code, it would not be surprising to see some health issues resurface in tax reform.

The Speaker indicated that he expects the ACA marketplace to get worse – specifically citing rising premium costs.  In his own remarks on the failure to pass AHCA, the President suggested the Democrats will own any rising premiums, and provided a rare moment of optimism for the day when he indicated that a bipartisan health care reform bill may be achievable in the future when that happens.   As the Legislative Branch takes time to develop consensus, more focus will be placed on the Executive Branch.

We expect HHS Secretary Tom Price and White House Budget Director Mick Mulvaney to take an increasingly important role in driving the health agenda.  It is unclear at this point whether the Trump Administration will let ACA drift in the wind, take administrative actions to try to improve the marketplace, or even actively work to derail it further.  A likely bellwether as to the Administration’s intent is how it approaches the pending litigation over cost-sharing reduction (CSR) subsidies.  The House had sued the Obama Administration over the program, which funnels federal dollars to insurers to help keep out-of-pocket costs manageable for lower-income individuals, saying the funding had to be appropriated.  But after the inauguration, the House and Trump Administration sought a stay of the case until May 22 to allow time to resolve the issue.  If the Administration agrees to fold, the subsidies would be cut off, leading to further market instability.  If the House folds, the CSR payments would continue into the indefinite future.

From a health care legislative perspective, 2017 will still be far from a quiet year.  The President has proposed significant changes in the funding levels of important discretionary health programs.  Those budget battles will now move more front and center on the legislative agenda.  Furthermore, there continue to be “must pass” pieces of health care legislation, including CHIP reauthorization, FDA User Fee legislation, and certain Medicare extenders legislation.

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