Tag: Washington (state)

Letter to Senate HELP Committee Leadership on Provider-Type Equity

The Honorable Patty Murray
Chair, United States Senate Committee on Health, Education, Labor and Pensions

The Honorable Richard Burr
Ranking Member
United States Senate Committee on Health, Education, Labor and Pensions

Dear Chairwoman Murray and Ranking Member Burr:

The American Ambulance Association (AAA) appreciates the opportunity to provide suggestions for bipartisan legislation to improve medical preparedness and response programs. The AAA is the primary association for ground ambulance service suppliers/providers, including governmental entities, volunteer services, private for-profit, private not-for-profit, and hospital-based ambulance services. Our members provide emergency and non-emergency medical transportation services to more than 75 percent of the U.S. population. AAA members serve patients in all 50 states and provide services in urban, rural, and super-rural areas. As the National Highway Transportation Safety Administration identified in its 2013 report on emergency services, EMS-only systems – such as our members – provide the vast majority of emergency ambulance services throughout America.

Our members are often the first health care teams to encounter patients who are sick and/or suspect they might have COVID-19. In addition to responding to 911 emergencies and transporting patients to appropriate destinations, they are also being asked to provide health care services within their existing State-defined scope of practice without transporting patients to help reduce hospital surge, as well as to protect high-risk patients from potential exposure to COVID-19. State and Local governments and public health authorities are also enlisting ground ambulance organizations to assist with testing suspected COVID-19 patients. In addition, ground ambulances provide important medical transitional care for patients moving between facilities in both emergency and non-emergency situations.

During this pandemic, our members have experienced first-hand the gaps in the public health infrastructure and the medical preparedness and response systems and programs. One of the most frustrating aspects of the current system has been the lack of recognition and support for communities that contract with non-governmental ground ambulance providers/suppliers in everything from federal grant programs to the distribution of personal protective equipment for EMTs and paramedics.

Many of the federal grant programs triggered during the pandemic have fallen short of their promise because the statutes and regulations governing them do not recognize non-governmental ground ambulance providers/suppliers as eligible entities. This distinction remains confusing because in other areas of health care, federal grant programs are accessible by private, for-profit health care providers and suppliers.

Outdated statutes and regulations often assume that first responders are governmental or not-for-profit entities and ignore the decisions of State and Local governments to contract with private ground ambulance providers/suppliers to provide 911 or equivalent services. As others have recognized, “State and Local officials know what works best in their communities – what works best in New York City may be much different than what works in rural Tennessee.”1 The federal government should respect these local decisions and support all first responders.

An example of this problem arose early during the COVID-19 pandemic. The FEMA public assistance grant program reimburses first responders for PPE and other expenses related to the response to COVID-19. When public and private non-profit emergency ambulance providers/suppliers sought direct reimbursement under the program, they were turned away. Private emergency ambulance providers/suppliers were required to have a State or Local government agency apply on their behalf. As State and Local governments responded to the public health emergency, it was understandably difficult for them to allocate resources to work through the application process on behalf of their contractors.

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.

In contrast to statutes like the one government FEMA allocations, the Homeland Security Act of 2002 (6 U.S.C. § 101) includes language that recognizes the decision of State and Local governments to contract with private not-for-profit and for-profit ground ambulance providers/suppliers within the definition of “emergency response providers.”

The AAA urges the Congress to adopt the Homeland Security Act definition of “emergency response providers” throughout the U.S. Code as applicable. Such language will help to make sure that when funding is available to help State and Local governments prepare and respond, the allocation mechanisms governing the funding permit all types of first responders, including non-governmental ground ambulance providers/suppliers, to access the dollars quickly and with minimal burden.

Recommendation

The Committee should carefully review federal public health programs and revise them as necessary to ensure that the funds may be used to support both non-governmental and governmental ground ambulance providers/suppliers to ensure that all communities, regardless of their individual decisions related to the entities operating their EMS systems, have federal funds to support their response efforts during public health emergencies.

On behalf of the AAA, I want to thank you for your ongoing support of EMS and ground ambulance providers/suppliers, as well as the leadership demonstrated by your work to prepare for the next pandemic. Over the years, the Congress has consistently recognized the vital and unique role that ground ambulance providers/suppliers play in protecting their communities and providing mobile health care services. In light of the lessons learned during this pandemic, we encourage you and your colleagues to revise antiquated language that no longer represents the innovations and progress that have led to State and Local governments to rely upon ground ambulance providers/suppliers, including non-governmental organizations.

The AAA and its volunteer leaders would welcome the chance to discuss this recommendation. We would also be pleased to participate in any fact-finding discussion or hearing that the Congress plans to host to better understand how the problems experienced during the current pandemic can be avoided in the future. Please do not hesitate to reach out to Tristan North at (202) 486-4888 or tnorth@ambulance.org, or Kathy Lester at (202) 534-1773 or klester@lesterhealthlaw.com to schedule a time for further discussion.

Sincerely,

Shawn Baird
President, American Ambulance Association
Vice President of Rural Services, Metro West Ambulance

1The Honorable Lamar Alexander, “Preparing for the Next Pandemic” White Paper” 4 (June 9, 2020).

40 Under 40: Catherine Counts (University of Washington & Seattle Medic One – Seattle, WA)

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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Catherine Counts
Acting Instructor (UW) & Research and Quality Improvement Manager (SMO)
University of Washington & Seattle Medic One
Seattle, WA

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LinkedIn | Twitter
Nominated by: Rob Lawrence (AAA Board of Directors)
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Biography:

Dr. Catherine R. Counts is a second-generation EMS professional who, after taking an ambulance to show and tell in kindergarten, was hooked. Dr. Counts has since transitioned this interest into a career focused on the patients and providers in the pre-hospital setting. Dr. Counts also has research interests in domestic healthcare policy, quality and patient safety, and organizational theory and culture. Given the crossover between her background in public health and her expertise in EMS, Dr. Counts specializes in the mechanisms by which providers are changing the way healthcare is delivered in the pre-hospital setting.

Dr. Counts has worked across the healthcare spectrum from EMS to long term care and is well versed in the systemic issues facing the American healthcare system. In addition to her work at the University of Washington, Dr. Counts serves as a consultant for a variety of quality improvement and EMS related projects, and contributes as a columnist for a number of trade publications.
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Reason for Nomination:

For EMS to advance into the future the industry must rely on evidence-based research and a scientific approach to the type of pre-hospital medicine delivered on the streets. EMS agencies must also ensure that Public Health partners are fully integrated to ensure prevention becomes as much a part of our ethos as mobile healthcare provides, as response and transport is. Catherine Counts Ph.D. represents this future. Dr. Count’s academic achievement and more importantly, her published work suggests she is already affecting the future direction of mobile healthcare. EMS agencies do not only need operations directors and executives to take the industry into the future, they also need an academic brain trust to steer science and performance. Dr. Counts represents that future and is an excellent candidate for the American Ambulance Association’s inaugural 40 under 40.

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View all of the 2020 Mobile Healthcare 40 Under 40 Honorees

Spotlight: Randy Strozyk

Randy Strozyk
Tukwila, WA, USA
Senior Vice President of Operations, American Medical Response (AMR)
Secretary, AAA Board of Directors
Randy’s LinkedIn Profile

Tell us a little about yourself, please.

My life-long automobile obsession continues, but that’s old news. Something people may not know about me is that I’m a relatively new and incredibly proud grandfather. My grandson, Samuel, was born in April 2014. Samuel’s parents are brilliant—our son, Terrell, is an attorney and the deputy director of the Oregon insurance commission; Sophie, our daughter-in-law, is Taiwanese and took her final exam for her MBA just a few days before Samuel was born (despite being dilated and having some minor contractions, she aced the test)—so we assume Samuel will develop a cure for cancer, broker peace in the Middle East or do something else to change the world. Samuel is learning English and Taiwanese, which means that when he goes through his awful adolescence period, he’ll be able to hurl insults at me in a language I don’t understand.

My wife, Karma, and I are excited to meet our second grandchild—Samuel’s cousin, and the first child of our other son, Todd, and his lovely wife, Julie—in November. I don’t expect my granddaughter to be speaking a language I don’t understand before she’s potty-trained, but stranger things have happened. What I do know is that this baby is going to have Grandpa wrapped around her little finger in no time.

Our youngest child, Erin, just got married to a great guy, Keith, this summer. No kids in that household, but they have four-legged babies and a shared passion for helping the underprivileged by expanding access to affordable, reliable solar energy.

Our children are unique, interesting and, with six degrees between the three of them, highly learned individuals. I couldn’t be prouder of my family.

How did you come to work in the industry? How long have you been involved?

Becoming a paramedic and healthcare executive wasn’t my initial game plan, but I was bitten by the EMS bug. I had the chance to ride out with ambulance crews as a medical explorer scout in high school. I enjoyed the medicine and quick pace, so I earned my EMT certification while studying microbiology at Washington State University and worked on the ambulance during the summers before my junior and senior years. After earning my bachelor’s degree, I went to paramedic school. I planned to do it for only a short while. That was back when the Phillies were a championship baseball team and the only Madonna anyone had heard of wore a serene expression and hung out in mangers. Nearly 36 years later, I’m still here.

What do you enjoy most about your job?

Over the past 15 years at AMR, I’ve had the opportunity to work on many different projects. In the course of a single month, you might find me in Oklahoma at EMSA, in Denver at our National Resource Center and AMR-Air headquarters, in Washington on AAA business and in Hawaii with our air operation there. I love seeing how EMS functions across the country. I won’t say that I’ve “seen it all” just yet, but if there’s something I don’t know, there’s someone I know with an answer.

What is your biggest professional challenge?

Some people may think that the biggest challenges I’ve faced have to do with specific tough projects or some of the legendary personalities I’ve worked with or for over the past 36 years. But I’d say the biggest challenge for me—and probably for others—is more internalized. People with deep experience in one field have to work at remaining enthusiastic and engaged. We can’t become attenuated to our circumstances and accept “that’s how it’s always been” as acceptable answers. EMS is a dynamic industry. Many of the tools and techniques that were considered cutting-edge when I first started in the business have already gone the way of the dinosaurs; likewise, the next generation of paramedics are going to look at some of the things we’re doing now with utter disbelief. To remain relevant, leaders must stay informed and be open to new opportunities and alternative viewpoints.

What is your typical day like?

There is no “typical” day in my world. I might be in Oklahoma working with our operations team at EMSA, in Denver at our corporate headquarters or working with the AMR-Air folks, or in any number of other places. No two days are the same.

How has participation in AAA membership and advocacy helped your organization?

AMR has been a part of the American Ambulance Association since the beginning. Involvement—not just paying dues to have a name on the membership roll, but serving on committees, attending meetings and being part of the conversation—provides a platform for professional networking and shared learning. It gives us a chance to uncover about new solutions, hear different perspectives and see the big picture.