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Dana Sechler, PAAW President

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Current News and Information from PAAW

December 8, 2017

Next EMS Live in Wisconsin Podcast
Community EMS is officially law in Wisconsin
By Joe Covelli, PAAW Executive Director

Next podcast Tuesday, December 12 starting at 9:00 a.m.
>> Listen live at http://tobtr.com/10454797

With the stroke of a pen on the morning of November 27, Governor Scott Walker officially ushered into the state the skeletal framework of Community EMS by signing Assembly Bill AB 151 (Act 66) into law.  For PAAW and other EMS stakeholders who worked collaboratively to make this reality, it was a five- year effort.

In many ways, the emergence of Community EMS, Community Paramedicine and Mobile Integrated Healthcare is reminiscent of the early years in the late 1960’s and early 1970’s of another EMS industry changing dynamic – Paramedics.  Oh yes, there were questions asked – to include training, funding, equipment, as well as state laws to be written, barriers to overcome and some uncertainty.

In May 2010, I had the great pleasure of serving on the committee that brought together in Los Angeles for a dinner and awards program the five doctors credited with starting the first paramedic systems in the United States in the late 1960’s.  I asked one of them, Dr. Eugene Nagel, how he knew he was at a moment in time of developing something great (i.e. a paramedic system)?  His response to me went something like this, “We were trying to do the best we could for our community, and our program at the City of Miami Fire Department developed into what we could do at the time. We didn’t know there were other programs just starting out in Los Angeles and Seattle too.  I knew about paratroopers dropping in war areas to render first aid, so we called our trained fire personnel who received medical training “Paramedics”, and the name stuck”.

This podcast is live on Tuesday, December 12 starting at 9:00 a.m. and lasting 30 minutes.  The dial-in number is 646-929-1081, or listen on the internet at .  Our guests include:   PAAW President Dana Sechler and Pete Carlson and Dr. Pete Tenghe, both with North Memorial Medical Center, Minneapolis.

We will discuss the Wisconsin Community EMS law, administrative rules that need to be written by the Wisconsin EMS Section before ambulance and healthcare providers can use these programs, funding sources, staff training considerations and more.  Minnesota has been using Community Pararmedicine programs the past five years and is credited with giving Wisconsin the framework to start from.

>> Listen live at http://tobtr.com/10454797



December 8, 2017

Legislative Outreach
We are stronger together

By Samantha Hilker, PAAW Contributor

“Do not go where the path may lead, go instead where there is no path and leave a trail.”– Ralph Waldo Emerson

November 1, 2017 marks an unprecedented moment for EMS in Wisconsin.  Four associations historically focused on their own specific agendas gathered at the Wisconsin State Capitol with a common goal: moving EMS in Wisconsin forward.  Although they didn’t know it at the time Patrick Ryan (PAAW President), Jerry Biggert (Chair of Wisconsin EMS Board) and Mahlon Mitchel (PFFW President) set this into motion over 5 years ago. 

“They sat down together and agreed to focus energy on the 90% of EMS related items we can all agree on, and let the other 10% go to another day” explains Dana Sechler, Legislative Liaison and President for PAAW.  Over the next several years the change was subtle and the action slow.  Legislation affecting EMS was passed without known consultation of the various stakeholder groups -- and instead of assuming the other was to blame, the leaders of the EMS associations and organizations started talking to each other and asking how and why this could happen.  Last year, a legislative study committee was formed to address the decrease in volunteerism in both EMS and Fire.  Additional relationships were forged and strengthened between the stakeholders.  Eventually, someone had the audacity to ask what we can do now, in this moment, to ensure stakeholder groups are consulted on legislation that directly effects EMS in Wisconsin.  John Eich, Director at the Wisconsin Office of Rural Health, asked the question and provided the leadership needed to unite these four organizations and make EMS at the Capitol Day a reality.   

Stronger together was the message of the day.  This was expressed in the ability to celebrate the Community EMS bill passing unanimously through the Senate just one day prior, and reiterated during the Legislator Panel with Representatives Loudenbeck, Kolste and Shankland.  (The Community EMS Bill also unanimously passed in the Assembly earlier this year and the Governor recently signed into law.)  Each of the three Representatives echoed the importance of getting to know your elected officials and the power of stakeholder groups working together and sharing a clear, unified message. 

Wisconsin EMS Day, November 1, 2017, State Capitol, Madison

For some participants, the biggest takeaway of the day was seeing so many private, hospital based, county and fire based EMS services, as well as 3rd party service providers and leaders in the same room with a common goal.  Many young EMS providers hungry for change were musing at the collection of people in the room, while providers and leaders who have been in EMS for 20 years or more were awestruck looking at something they never thought they would see.  Although there was a hint of apprehension leading into the afternoon visits, it seemed to melt away and be replaced with a certain sense of pride.  On more than one occasion I heard attendees say they never would have put themselves in a room with the 2 or 3 people they met legislators with.  They continued to report their individual surprise that they really did agree on many of the issues discussed, and found themselves listening to understand…instead of listening to respond. 

Others had a slightly different takeaway; they saw their years of leadership expressed in their colleagues and team members. 

“I’ve increasingly challenged myself to seek others with differing views…those on the fringe, outside my typical group of colleagues and peers.  This approach not only provides unfamiliar perspective but leads to building relationships and better outcomes. EMS Lobby Day is another example of relationship building that inspires me to continue stepping outside comfort areas and hopefully challenges others to be more inclusive and collaborative as well.” reflected Jon Cohn, Greenfield Fire Department Chief, President of Wisconsin State Fire Chiefs Association.

On the surface, a group of professionals with the same “job” shared a day at the Capitol talking to politicians.  A deeper look reveals the power of a conversation; the willingness to let go of the past and turn our attention towards a future full of possibilities.  An exciting change for the veterans of EMS who never thought they’d see the day -- and the newcomers to EMS who will grow up in a culture of collaboration instead of territorial limitations. 

RESOURCES:

Interactive map: find your representatives
http://maps.legis.wisconsin.gov/#



December 6, 2017

Patient Documentation
Patient face sheets made easy through WISHIN records for billing purposes

Take the delay out of receiving hospital face sheet data

Effective January 18, 2018, ambulance and emergency medical services (EMS) providers will be able to access specific clinical data available in the WISHIN Pulse Community Health Record for billing purposes.

This change is in response to requests from ambulance and EMS providers, who are often not in a position at the time of transport to collect all t he information necessary to bill for their services. They typically follow up days later to seek "face sheet" (encounter) information from the hospital to which they have transported a patient.

According to Nate Hunstiger, Communication and Engagement Specialist, Wisconsin Statewide Health Information Network, "WISHIN recently approved a new use case granting EMS and ambulance providers access to clinical face sheet data in the WISHIN Pulse Community Health Record for billing purposes."

Ambulance and EMS providers often make multiple contacts with hospitals before they receive the face sheet from the encounter. This new use case relieves the hospitals of the burden of responding to these requests and allows ambulance and EMS organizations to more promptly bill for their services.

Ambulance/EMS providers with questions or who are interested in WISHIN Pulse services should contact WISHIN via email at wishin@wishin.org or by phone at (608) 274-1820.  For additional information, go to >> http://www.wishin.org/


November 30, 2017

State Capitol
Stars of Life honorees meet Governor Scott Walker

On November 29, the 2017 Wisconsin Stars of Life had the opportunity to represent EMS at the State Capitol.  The morning event brought together Star honorees for a welcome reception with legislators and Department of Health officials, as well as a meeting and photo opportunity with Governor Scott Walker in the Governor's Office.

2017 Wisconsin Star of Life honorees at the State Capitol event included, left to right, 
Bob Kelter nominated by Baraboo EMS, Tami Aerts nominated by County Rescue Services, Dan Morth nominated by Health Partners / Ellsworth Area Ambulance,
Amanda Holtz nominated by Orange Cross Ambulance, Mark Willer nominated by Baraboo EMS, Governor Scott Walker, Chris Cuddy nominated by Mayo/Gold Cross Ambulance, Benjamin Waldera nominated by Divine Savior Healthcare EMS,
Brian Randall nominated by Gold Cross Ambulance, David Mike nominated by Paratech Ambulance, Kenny Monteith nominated by Tri-State Regional Ambulance and
Jeri Schiffman nominated by Tri-State Regional Ambulance.

Governor Walker shares words of congratulations and appreciation with the Stars of Life honorees during the Nov. 29 meeting.

November 27, 2017

State Capitol
Community EMS Bill Signed Into Law

Assembly Bill 151 (AB 151) authored by Rep. Amy Loudenbeck (R-Clinton), Rep. Katrina Shankland (D- Stevens Point) and Sen. Terry Moulton (R- Chippewa Falls) was signed into law by Governor Walker on November 27 after passing both legislative chambers with unanimous bipartisan support.

Community EMS Bill Signing, Governor's Office, November 27, 2017

AB 151 advances opportunities for non-emergency health care services in Wisconsin by creating and defining community paramedics (CPs) and community emergency medical technicians (CEMTs). It also creates the framework allowing hospitals, private ambulance companies, and municipal EMS providers to develop new strategies for delivering quality care, in the right place, at the right time.

“The Wisconsin EMS Association commends Reps. Loudenbeck and Shankland and Sen. Moulton for their tireless effort and commitment to the safety and continuum of care for all patients in Wisconsin. Today EMS and Fire unite as one voice by utilizing their skills and talents to improve patient outcomes while reducing costs of healthcare to individuals, hospitals, insurance providers and communities, said Marc Cohen, Executive Director of the Wisconsin EMS Association 

“I am pleased the Governor is signing this important public health legislation into law. Community EMS promises greater flexibility and room for innovation to lower healthcare costs and meet any number of local healthcare goals,” said Sen. Moulton.

Greenfield Fire Chief Jon Cohn, President of the Wisconsin Fire Chiefs Association stated, “The future of health care is to be proactive instead of reactive. The Wisconsin Community EMS Bill achieves this by optimizing health system performance, improving the patient care experience, improving the health of populations and reducing the per capita cost of health care. Thanks to our Legislators for recognizing the need to shift and allow these expanded services.” 

“Wisconsin has many challenges in the health care workforce, including an aging population,” said Rep. Shankland. “Community EMS helps bridge this gap by expanding patient-centered care, especially in regions that are underserved, rural, or have high health care demands. This bill will offer local communities a new innovative tool to improve public health outcomes and serve at-risk patients, and I’m excited to see the positive impact it will have.”

“The Professional Fire Fighters of Wisconsin are energized to promote Community EMS to our most medically at risk citizens. Fire Fighters and EMS Professionals are experts in prevention, and the impact of this legislation will be felt by those in need of better access and more help throughout rural and urban Wisconsin, said Mahlon Mitchell, President of the Professional Fire Fighters of Wisconsin.

Patrick Ryan, owner of Ryan Brothers Ambulance Service and Past-President of the Professional Ambulance Association of Wisconsin (PAAW) said, “PAAW is extremely proud to be a part of this collaborative effort from all across EMS in Wisconsin to pass this enabling legislation for CEMS. Because of this bill, services throughout the state will be able to develop and implement CEMS programs that will improve the health and well-being of our citizens.”

“Pilot programs have already demonstrated that community-based, mobile integrated health produces improvements in health outcomes and medical cost savings. I hope to continue to hear stories about the life-changing impacts on CEMS in the communities across the state,” said Rep. Loudenbeck.

>> Read Wisconsin Act 66 (AB151) signed into law.


November 22, 2017

Federal Law
POTUS Signs DEA Standing Orders Bill into Law

On Friday, November 17, President Trump signed H.R. 304, the Protecting Patient Access to Emergency Medications Act of 2017, into law.

H.R. 304 will improve the Drug Enforcement Administration (DEA) registration process for emergency medical services (EMS) agencies, and clarify that EMS professionals are permitted to administer controlled substances pursuant to standing or verbal orders when certain conditions are met.

Authored by committee member Rep. Richard Hudson (R-NC), H.R. 304 initially passed the House by a vote of 404-0 in January. It passed the Senate, as amended, by unanimous consent, in October. H.R. 304 passed the House, as amended by the Senate, sending it to President Trump earlier this month.

“This is an important bill that will help equip our first responders in the most unpredictable and urgent situations,” said Energy and Commerce Committee Chairman Greg Walden (R-OR). “The clarifications in this bill will translate to more detailed accounts of how registered agencies can administer controlled substances.”

“I’m thrilled to see this important fix signed into law,” said Rep. Hudson. “This is an example of how to get things done — finding common ground and advancing bipartisan solutions to get results people deserve.”

November 21, 2017 

EMS Leadership
Two Wisconsin EMS leaders named to American Ambulance Association Board of Directors

In addition to serving Wisconsin EMS providers with state-level advocacy excellence, PAAW's reach continues to grow on the national stage.

At the AAA Conference & Trade Show last week, representatives of two PAAW member organizations were elected to the American Ambulance Association board of directors. 

  • Congratulations to Wayne Jurecki of Bell Ambulance, who continues his service as AAA Region III Director. (Wayne's colleague at Bell, Chris Anderson, is PAAW's new Vice President.)

  • Congratulations to Tom Tornstrom of Gundersen Tri-State Ambulance, who joined the AAA board as Region III Alternate Director. (Tom also serves on the PAAW Executive Committee as Treasurer.)

PAAW is proud to offer Wisconsin ambulance services the opportunity to have their voices heard in Washington, DC through our joint PAAW-AAA leadership.


November 16, 2017

Standby for Tones Blog
He Could Have Been The Marlboro Man

The whole way there I had pulmonary edema on the brain. Dispatch information wasn’t very alarming; “70s male, shortness of breath, coughing up blood.” But as soon as my boots hit the garage floor, that’s all I kept thinking. I’ve had three calls before with pulmonary edema – and two of those times it was the same patient. I’ve never been to this address, and despite nothing screaming clearly in the dispatch information, my gut says its pulmonary edema. 3am thoughts or gut instinct?

So the trip out to the country road consists of me, all the way awake in a way you understand if you’ve ever seen pulmonary edema – bonus points for the pucker factor that is flash pulmonary edema – I’m chattering. My partner is an EMT tonight and he’s still waking up. He bears with me though. I explain what we will need to do in a short period of time if it is pulmonary edema. He gets it, he’s a great partner and I know I can concentrate on what I need to do. Knowing he will do what needs to be done and he isn’t the sort of partner who requires a lot of hand holding and validation.

We arrive on scene, he puts it in park and I hop out the passenger side, round the side corner and spy a man approaching. He’s well dressed, fully dressed, and walking spryly. Coat neatly zipped up to the chin. Dapper hat atop his head. He looks like a retired cowboy, tan skin and western button up shirt. I ask if he’s the patient and he nods. I’m able to get the side door open and my patient is loading himself right up the steps before I can say much.  Climbing up after him, I catch my first auditory of my patient.

Pucker. Factor. Right there. Right now. Yep, we’re about to do medicine. I nod at my partner, and we go to work in the choreographed steps we worked out while the truck winked and blinked its red and blue strobes down this back road and across the corn still waiting to be harvested.

Sublingual nitro – check. CPAP – check. IV – check. Nitro drip – check. Furosemide – check.

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

"Standby for Tones" is a 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 more on Crystal's blog page.

November 14, 2017

EMS Live in Wisconsin Podcast
EMS Compliance:  The Importance of Documentation

>> Click to listen now!

What does compliance mean in the EMS world and who says we need it?  Why is it important?  Was medical necessity met?  What is the exclusions list?  These are important questions as proper documentation plays a big role in EMS. 

This podcast was recorded on November 14.  Our guest was EMS Consultant Dan Williams.

Some important facts:

  • In 2012, Medicare “Part B” paid $5.8 billion for ambulance transports, almost double the amount it paid in 2003.
  • Medicare paid $24 million in the first half of 2012 for ambulance transports that did not meet certain program requirements to justify payment.
  • Medicare paid $30 million for transports for which the beneficiaries did not receive Medicare services at the pick-up or drop-off locations, or anywhere else.

>> Click to listen now!



PAAW News
State and National Ambulance Associations unite to bring key education to Midwestern EMS providers


Midwest EMS Expo May 2-3, 2018 - La Crosse Center

The American Ambulance Association (AAA), Minnesota Ambulance Association (MAA), and Professional Ambulance Association of Wisconsin (PAAW) today officially announced the launch of the Midwest EMS Expo conference and trade show. This event will take place annually in La Crosse, Wisconsin beginning in May 2018, and will feature content from national- and state-level ambulance experts. 

“AAA is proud to partner with PAAW and MAA in the development of the Midwest EMS Expo. We look forward to bringing together the best in ambulance expertise to deliver a powerful educational experience for EMS leaders,” said American Ambulance Association President Mark Postma.

The program will open on Wednesday, May 2, with key updates from the American Ambulance Association’s renowned experts on EMS reimbursement and advocacy. Highlights include a federal legislative overview by AAA President Mark Postma, as well as strategies for maximizing revenue from reimbursement gurus Asbel Montes, Brian Werfel, Brian Choate, and Scott Moore. 

Thursday, May 3rd’s programming was developed collaboratively by the Minnesota Ambulance Association and Professional Ambulance Association of Wisconsin. The day will begin with speaker Captain Ray Dupuis of the Watertown Police Department. In this riveting keynote, he will share what happened in first minutes after the explosions at the marathon finish line, then explain police and EMS action plans that day. Don’t miss this opportunity to learn from a seasoned public servant who helped to lead his city in its darkest hour.

Additional conference topics include employee recruitment and retention, billing and compliance, executive leadership, community paramedicine, employment law, managing across generations, EMS resilience, and many more. For a complete conference agenda, visit www.midwestemsexpo.com/schedule.

According to PAAW President Dana Sechler, “The Midwest EMS Expo will offer a platform for the exchange of ideas and information among ambulance leaders of all levels. Given the constantly changing nature of EMS, it is critical to bring this educational and networking opportunity to our region.”

In addition to powerful educational content, the Midwest EMS Expo will offer attendees the opportunity to experience the best in products, services, and vehicles for EMS providers. Gold Sponsor Savvik Buying Group will be joined by Silver Sponsor Cindy Elbert Insurance Services, Bronze Sponsor eCore, and dozens more exhibitors on the show floor. For a complete list of current vendors, please visit www.midwestemsexpo.com/exhibitors

Conference registration is now open, with member early-bird rates as low as $200 per attendee. Sponsorship, booths, and vehicle spaces are also available online at low introductory rates. To register for the Midwest EMS Expo or view the complete schedule of events, please visit www.midwestemsexpo.com.


Upcoming Events

Current PAAW Priorities
Community Paramedicine Legislation
State Medicaid Reimbursement & MTM


Next EMS Live Podcast

Tuesday, December 12

starting at 9:00 a.m. central time

Topic

Community EMS bill signed into law - Now what?

Guests
Dana Sechler
Peter Carlson
Dr. Pete Tanghe

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

646-929-1081

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)


2017 Stars of Life Awards and Recognition Program

(The next Stars of Life will be in 2019)

2017 Stars of Life Honorees


Crystal Wallin

Feature writer and La Crosse Paramedic

Recent blog posts by Crystal: Standby for Tones

Emergency calls or patient contacts to PAAW members last year

Over 272,000

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