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Patrick Ryan, PAAW President
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Current News and Information from PAAW

January 12, 2017

Wisconsin EMS Office
Two regional EMS coordinators hired

Wisconsin EMS Director James Newlun announced today Mark Mandler and Rick Stenson were hired as regional EMS coordinators.  They began their duties on January 9

According to Mr. Newlun, "
The EMS Section is now fully staffed, and includes three EMS regional coordinators, one data manager, one licensing coordinator, and one office assistant".

Mark Mandler came to the EMS Section as a limited term employee in 2016. He has assisted with operational plan and protocol reviews.  In the released announcement, Mr. Newlun wrote, "Mark has proven his ability to assist services, EMS directors and medical directors. He has been directly involved in the review of community paramedic programs".

Prior to coming to the EMS Section, Mark volunteered as both a firefighter and an EMT.  Mark holds a paramedic license, various fire service certifications, and is currently completing his law degree at the University of Wisconsin-Madison Law School. Mark will be the EMS regional coordinator for Regions 6, and 7.

Rick Stenson has served as an EMS professional for the past 13 years in both the municipal and private sectors, working in both urban and rural settings. Rick has worked as a licensed EMT since 2004, a Critical Care Paramedic since 2008, and has served as a BLS, ACLS, or PALS Instructor for most of his career. Rick will be the EMS regional coordinator for Regions 4, and 5.

With this change, current EMS staff member Ray Lemke moved from First Responder/BLS/Education Coordinator into the Coordinator spot for Regions 1, 2, and 3. 

According to the announcement, Mark, Rick and Ray's responsibilities will be within the seven Healthcare Coalition Regions.  >> Click for Healthcare Coalitions Regions map.  This is a departure from past practice whereby coordinators were assigned by level of licensed provider, i.e., paramedic, intermediate, advanced EMT, basic, first responder, etc.

Coordinators will work with all EMS professionals, Training Centers, Technical Colleges, and agencies within their regions.  The Wisconsin EMS statewide system is comprised of over 600 ambulance services, emergency first responders, and training centers, and 16,500 individual licensed providers.

January 10, 2017

EMS Live in Wisconsin Podcast
MTM, Wisconsin's Medicaid patient ambulance transportation broker

>> Click for on-demand playback of this podcast.

In 2016, the number of non-emergent ambulance transports in the state totaled between 1,100 and 1,200 BLS and ALS runs per month.  In 2013, that number was between 200 and 400.  A dramatic increase.

According to MTM General Manager Danielle Dale, "We manage transportation for just under one-million eligible members in the state's Medicaid program".  Transportation includes bus, member or personal caretaker mileage reimbursement, taxis, wheelchair vans and non-emergent ambulances."

The Professional Ambulance Association of Wisconsin's President Patrick Ryan, along with board members Dana Sechler and Larry Knuth, have been holding regular conference calls the past few months with MTM to open lines of communication, and remedy some of the operation and billing challenges between ambulance services and MTM, the state's third party Medicaid transportation broker since 2013.

Two items highlighted in the podcast, include:
  1. A two-day rule to file post-authorization with MTM for hospital to discharge, or hospital to hospital transfers.  Many ambulance services have difficultly submitting their bill within two-days, and any bill sent after two-days is declined.  MTM recently established a dedicated email address to help streamline the process.  In Illinois, MTM's contract with the state is a bit more forgiving with a post-authorization rule of 30-days.
  2. If an ambulance is dispatched emergent, but the call is later deemed and billed non-emergent there is a black hole whereby the transporting ambulance service cannot file a billable claim.  Of course, this type of call was not pre authorized and is not included in the two-day post authorization rule.  Under this circumstance, MTM won't offer forgiveness and will decline the claim since they must follow the contract established with the Wisconsin Dept. of Health, so the transporting ambulance service can't bill and must write it off as non collectable.

To help hospitals and ambulance services with the process, file a claim and hopefully be reimbursed in a timely manner, MTM has offered a >> fact sheet to navigate.  The new email address to file a two-day post-authorization claim is wipostauth@mtm-inc.net.  To file an appeal, email ambulanceappeals@mtm-inc.net.

On Tuesday, January 10, PAAW completed an EMS Live in Wisconsin podcast with MTM General Manager Danielle Dale and Transportation Manager Chris Behling.  >> Click for on-demand podcast playback.

Don't miss a beat of the action - listen to EMS Live in Wisconsin the second and fourth Tuesday every month starting at 9:00 a.m. and running 30-minutes.

January 10, 2017

State Government
Study Committee vote tallies announced, sent to Legislative Council for consideration

"The votes are in" as they say.  However, this time it's another step in the process to correct one of the biggest challenges facing emergency services in Wisconsin and the nation - building up the number of community volunteer firefighters and EMTs.

The process started with the state's Joint Legislative Council creating a study committee on volunteer firefighter and EMT shortages.  Study committee members began their work in July, and concluded it this past December by individually casting ballots for proposed legislation.   >> Click for study committee vote tallies by proposed legislation.

The next step is for the Joint Legislative Council to schedule a meeting to receive the committee's report and hold votes on proposed legislation they wish to move forward to the full legislature, to include public hearings.

On Tues
day, December 13, PAAW completed an EMS Live in Wisconsin podcast with Legislative Study Committee members John Eich and Dana Sechler.  Both offered an update on work of the committee, pending vote and what it all means.  >> Click for on-demand podcast playback.

January 9, 2017

Wisconsin EMS Advisory Board
Governor appointments announced

Governor Scott Walker recently announced the appointments to the EMS Advisory Board of Don Kimlicka, Director, Clintonville EMS, and Dustin Ridings, Captain, Green Bay Fire Dept.  Each appointment is for a three-year term, but renewable.

The EMS Advisory Board makes recommendations to the Department of Health on general EMS issues either assigned by legislation or raised by members of the public.   EMS Advisory Board members are appointed by the Governor.  Medical issues are referred to the Physician Advisory Committee.

The statutory duties of the EMS Advisory Board, include:

  • Appoints EMS Physician Advisory Committee
  • Periodically reviews and makes recommendations on rules changes
  • Provides review and recommendations to the Department on department-proposed rule changes
  • Provides recommendations to the Department on the funding assistance program
  • Provides review and recommendations to the Department on preparation of mandated reports

The next board meeting is February 7 and 8 in Middleton.  >> Click for the 2017 meeting schedule and location.

January 9, 2017

Standby for Tones Blog

The address was straightforward enough – until we got in the neighborhood. The streets curved around and the numerics visible all were for the cross street. We had been told the patient would meet us in the parking lot, then updated information from MedComm was that he was advised to wait in his apartment. Inquiring for an apartment number, we were told the dispatcher would call back to find out. Updated information? The subject was indeed waiting in the parking lot; we were to go to the rear of the building. Finding the alley, we rolled slowly along, our right flood lights illuminating the successive row of apartment buildings. The problem with this method was that the rear of apartment buildings – including these – often does not have numerics displayed. We’d rolled along behind half a dozen when the radio came to life again. “301, caller is on the line again, advises you to come out of alley, take a left and you will see him outside.” We acknowledge, follow directions and emerge from the alley to find a front light across the street furiously winking on, off, on and off again. I flick our floods on and off in acknowledgement but the furious winking does not subside. Driving up alongside the curb directly in front of the door where the light lives does not make it stop, either. Directly beneath the light, cast by turns into stark relief and pitch blackness in paroxysms of the continuing on, off – is our caller. I roll my window down and he barks with extreme agitation, “I said to tell ya, go around back! AROUND BACK!” “Yes, sir, we…..” “GO AROUND BACK!” “yes, sir.”

>> Click to read more of the story...

"Standby for Tones" is a monthly blog written by Crystal Wallin, a La Crosse paramedic.  Her stories, written from real life events, bring to light the human experience in having an EMS career and work life.  >> Click to read Crystal's blog.
December 26, 2016

EMS Agenda for the Future
Effort to Create New EMS Agenda Underway

The two-year project aims to bring the EMS community together and develop a vision for the nation's EMS systems    

Twenty years ago, pioneers and leaders in the EMS industry described a vision of data-driven and evidence-based EMS systems in the EMS Agenda for the Future. Since then, the profession has worked tirelessly to fulfill the vision set out in that landmark document.

The Office of EMS, alongside colleagues at EMS for Children in the Health Resources and Services Administration, the Office of the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services, and the Office of Health Affairs at the Department of Homeland Security are pleased to announce joint funding of the NHTSA-awarded contract to support the process to create a new Agenda for the Future.

A two-year contract was awarded to a respected consulting firm, Redhorse Corporation, to ensure an organized, transparent and inclusive approach to creating a new Agenda that engages the entire EMS community. Redhorse Corporation has partnered with a well-known EMS leader and facilitator, Mike Taigman, and the writing team at the RedFlash Group to support the development process.

EMS community members, stakeholder organizations and the public are all encouraged to get involved by attending public meetings and providing feedback during public comment periods.

December 26, 2016

State EMS Office Memo 1606
WARDS Elite Update

At the October 2016 EMS Board meeting, the System Quality and Data Committee reviewed the current status and the dates associated with the transition to WARDS Elite. They still encourage all services to make the transition by January 1, 2017, if at all possible. This would allow all of Wisconsin’s data to continue being shared with the NEMSIS national database. The January 1, 2017, date also provides a clean cut-off date for all services when running reports. Any data entered prior to the cut-off date would come from WARDS, while any data entered after that date will be available in WARDS Elite.

Because NEMSIS will not extend their December 31, 2016 transition date and will only accept v2 data through December 31, 2016, the System Quality and Data Committee recommended extending the transition date an additional three months. Therefore, all services will have until March 31, 2017, to complete the migration. To allow services to enter any data occurring through March 31, 2017, Wisconsin will maintain the WARDS database until June 30, 2017. During this time we will work with our vendor, ImageTrend, to combine the WARDS data with the WARDS Elite data so everyone will only need to access one database for any reports going forward.

To migrate to WARDS Elite your Service Director needs to email the EMS office at dhsemssmail@Wisconsin.gov.

>> Click for EMS Office Memo 1606, WARDS Elite Update, dated December 7, 2016.

December 23, 2016

Bob Sternhagen honored for his EMS work

EMT Instructor of 42 years at Fox Valley Technical College passes away

Before his passing peacefully on November 3 following a diagnosis of cancer, Robert (Bob) Sternhagen of Appleton was recognized for his considerable contributions to emergency medical services.

Bob spent his 40+ year career in EMS, an interest that started when he was a teen in the late 1960's going on emergency calls.  In 1974, Bob was hired by the Wisconsin Technical school system as its first EMS instructor, and in 1975 he began training paramedics. His dream of human patient simulation training became reality in 2013 with building a state-of-the art 66,000 square-foot, three-story Health Simulation and Technology Center on the Appleton campus at Fox Valley Technical College.

This past October, just a few weeks before Bob's passing, Gold Cross Ambulance, Menasha, the ambulance service he began his career at in the 1960's, celebrated its 25th year of service.  At this occasion, Bob received the Honorary Star of Life award from the Professional Ambulance Association of Wisconsin (PAAW) for his commitment to, and support of, emergency medical services throughout the Fox Valley.  Pictured at the event with Bob, center, are Dr. F. Mark Moore, left, and Jim Welch, right, former owner of Gold Cross Ambulance.  All three gentlemen were instrumental in the early days of EMS in the Fox River Valley.

Another of Bob's highest honors came in September 2016 when Dr. Susan May, President of Fox Valley Technical College, established the annual Robert G. Sternhagen Innovation through Technology Award as a tribute to his pioneering work in advancing technology and innovation at the college.  At the time of his death, Bob was in his 42nd year of teaching at Fox Valley Technical College.

December 23, 2016

Community Paramedicine/MIH
Minnesota Dept. of Health produces CP Toolkit

Recently, the Minnesota Department of Health released a Community Paramedicine (CP) Toolkit.  The kit is intended to be a resource for Minnesota ambulance services, hospitals, and other stakeholders considering the development or expansion of a community paramedicine program.

The Toolkit contains a series of helpful tools and resources that can be used by a wide variety of stakeholders, but primarily prospective employers interested in hiring and integrating (CP) into their organization. While the Toolkit contains information reflecting the current state of the profession in Minnesota, not all aspects of the CP profession are defined in the state.  Statute, policy, and procedure defining the profession will continue to evolve.

The tools contained in the Toolkit are intended to be both actionable and measurable, and will help streamline an employer’s decision-making and, hopefully, the successful adoption of a community paramedicine program. The Toolkit also includes references, resources and examples to help planners get started quickly.  >> Click to download the Toolkit.

Minnesota began several years ago with its introduction of Community Paramedicine.  Wisconsin has had a few ambulance services integrate a variety of Community Paramedicine delivery methods; however, most of them have targeted reducing repeat callers into 911 systems for an ambulance. 

Wisconsin's fire and EMS stakeholders, including PAAW, have prepared a bill draft and vetted it among stakeholders the past many months.  They intend to ask legislators to introduce the bill draft this February, so Community Paramedicine is formally recognized by the state.  With the Governor's signature, the bill becomes law allowing Wisconsin's ambulance services and other providers to bill Medicare for CP services provided.

December 23, 2016

Advanced Training
Critical Care Paramedic Training

Gundersen Health System will be offering the University of Maryland Baltimore County's CCEMTP course in La Crosse this coming April and May. Class dates will be every Thursday and Friday, 8am - 5pm, April 6 - May 25.

UMBC’s CCEMTPs course is one of three critical care paramedic courses approved by the Wisconsin EMS Section office.

Contact Rick Barton, course site coordinator, via email at rkbarton@gundersenhealth.org for course brochure, registration, and other information.

December 23, 2016

Leadership Training
EMS Supervisors "Boot Camp"

Waushara County EMS recently announced they will be sponsoring an EMS supervisors "Boot Camp", April 13 and 14, in Wautoma.  It will be facilitated by nationally recognized presenter Jon Politis.

The 16-hour training course is a powerful-interactive workshop intended to ease the sometimes painful transition to EMS leadership.  The two-day course tuition is $250.

>> Click for more information or to register.
>> Click for area lodging and dining information.

December 21, 2016

EMS Live in Wisconsin Podcast
Legislative Study Committee members vote on recommendations, send to Joint Legislative Council

Mailed ballots were due today from members of the Legislative Study Committee on Volunteer Firefighter and EMT Shortages.  Based on their discussions, members are voting on legislation drafted to address one of Wisconsin's, and the nation's for that matter, longstanding concerns - ways to increase volunteer recruitment and retention in emergency services.  >> Click for the Study Committee's website.

According to committee member Dana Sechler, photo insert left, "Once the ballots are counted they will be given to the Joint Legislative Council, which established the study committee this past summer".  According to the Joint Legislative Council's website, the Council reviews the legislation recommended by the study committees and, if a majority of Council members vote for introduction, the legislation is sponsored by the Joint Legislative Council.  The next legislative session begins in February.

PAAW would like to extend its appreciation to Legislative Study Committee members and those who testified before the committee or provided documents and letters.

On Tues
day, December 13, PAAW completed an EMS Live in Wisconsin podcast with Legislative Study Committee members John Eich and Dana Sechler.  Both offered an update on work of the committee, pending vote and what it all means.  >> Click for on-demand podcast playback.

Legislative Study Committee listserv email created

Signup today to stay informed!

The Professional Ambulance Association of Wisconsin, in cooperation with the Wisconsin Office of Rural Health, has created a listserv email group dedicated to the firefighter and EMT volunteer shortage discussions currently taking place.  Signup to receive Legislative Study Committee updates, share your ideas and weigh in on the topic.

According to PAAW Executive Director Joe Covelli, "The listserv offers an immediate email communications link for those who would like to participate and stay on top of the latest information being discussed, recommended and decided.  We are coming to a point very soon when legislation is going to be introduced and debated".  Covelli added, "This is a pivotal time for the EMS and fire industry and communities they serve - ambulance services and fire departments need to pay attention to what is happening".

To subscribe to the listserv, click on the link below and enter your name and email address.  Link:  https://lists.wisc.edu/read/all_forums/subscribe?name=volunteer.  You may unsubscribe at any time.

EMS Product Savings
Naloxone (Narcan) purchases eligible for rebate

Wisconsin Attorney General Brad Schimel announced on March 23, 2016 details of a rebate program for the heroin and prescription opioid antidote naloxone, also known as Narcan.  State, county, and local government agencies, as well as law enforcement and other public and government entities that distribute naloxone are eligible for the Amphastar naloxone rebate.  The Professional Ambulance Association of Wisconsin was instrumental in bringing the rebate to Wisconsin, which is valued at approximately $6.00 per syringe, or a 25% savings.

Rebate forms must be submitted within 60-days of each quarter's end date. Please see Naloxone Rebate Instructions below for submission information.

  • Quarter ended July 30, 2016 (deadline to submit rebate September 30, 2016)
  • Quarter ends October 30, 2016 (deadline to submit rebate December 30, 2016)
  • Quarter ends January 30, 2017 (deadline to submit rebate March 30, 2017)
>> Amphastar Pharmaceuticals, Inc. Contract
>> Naloxone Rebate - Press Release
>> Naloxone Rebate Instructions
>> Naloxone Rebate Account Form
>> Naloxone Purchase Summary Rebate Form

Upcoming Events

Current PAAW Priorities
Community Paramedicine Legislation
MABAS/WI Liability Protection Statute 893.80
State Medicaid Reimbursement & MTM
>> Legislative Study Committee on Firefighter and EMT Volunteer Shortages
Recognize Do-Not-Resuscitate Pendant

Next EMS Live Podcast

Tuesday, January 24

starting at 9:00 a.m. central time


To be determined

To be determined

Dial in number to listen to the live show or speak with the co-hosts and guests: 


Or listen on any internet connected device - even email in a question.

Treating CHF patients with better results (Tyler Christifulli, Training Coordinator, Lifestar EMS, West Bend, WI)

Most recent EMS Live in Wisconsin Podcast - Listen Now!

Emergency calls or patient contacts to PAAW members last year

Over 272,000

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Crystal Wallin

Feature writer and La Crosse Paramedic

Recent blog posts by Crystal: Standby for Tones

Weekly IV Fluids and EMS Pharmaceutical Backorder Report

PAAW continues to monitor the ongoing EMS pharmaceutical drug and IV fluids backorder situation by posting weekly updates, courtesy of Bound Tree Medical.

Through a special arrangement with EMS World magazine, PAAW members and their employees or volunteers receive a free 12-month subscription, a $40 value. 

Stay on top of national EMS news, tips, a variety of topics and special reports - delivered right to your home or work address or e-mail account the beginning of every month!  >> Click to receive this benefit.

Monitor Police, Fire and EMS Radio Traffic Around the U.S.!

Browse over 2,000 police, fire and EMS scanner monitoring stations around the U.S. with a simple click of your computer mouse.  It's sure to make any scanner junkie go wild!

>> Click here to find out more about selecting your own monitoring station or click the scanner below to open the audio player for Milwaukee County Fire radio traffic.

Milwaukee County Fire
(click scanner below to activate feed)

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