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Dana Sechler, PAAW President

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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!

November 8, 2017 

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.



November 3, 2017 

State Capitol
A Day at the State Capitol

By Samantha Hilker, PAAW

On November 1, 2017 EMS providers of all backgrounds and service levels gathered at the Capitol to learn about the legislative process as well as the current bills and initiatives impacting EMS; the afternoon would be spent meeting with the Representatives and Senators for their political districts to discuss Community EMS (CEMS), EMS volunteer incentives, 911 Dispatcher-assisted bystander CPR, and levy limits on EMS services. 

As the attendees arrived and started filing in the room, the mood was light – full of laughter, the chatter of catching up with old friends and making new ones.  A subtle excitement filled the room as John Eich, Director of the Wisconsin Office of Rural Health, started the program by highlighting the important work and unprecedented collaboration of all four organizations in the room: Professional Ambulance Association of Wisconsin (PAAW), Professional Fire Fighters of Wisconsin (PFFW), Wisconsin EMS Association and Wisconsin (WEMSA), and the Wisconsin State Fire Chiefs Association (WSFCA).  Representatives Shankland, Loudenbeck and Kolste joined the group for a panel discussion.  Each of them have been major supporters of legislation that will help lead EMS into the future including AB-151 (Community EMS) which was unanimously passed by the Assembly earlier this year, and was also unanimously passed by the Senate on October 31st -- and is currently awaiting Governor Walker’s signature.  The Representatives took questions from the group and gave direct feedback, answers, and recommendations. 


As the morning program concluded, lunch was served and the 105 (yes, 105!) attendees made their way across the street for meetings with their legislators.  After a quick pause on the steps for a group photo, the individual meetings with the Representatives and Senators began.  Having had the opportunity to sit in on several of the meetings, it was encouraging to see the individual EMS provider shake off any nerves they may have had about meeting with an elected official, and gain confidence as the conversation continued.

“The ability to have face time with the policy makers – to have conversations with them and watch the light bulbs come on as they begin to understand the impact the policies can have on EMS, is invaluable” said Amber Osowski, EMS Coordinator for Portage County. 

Feedback from EMS leaders and providers following the day’s events was resoundingly positive.  What were the most valuable moments of the day?

  • Face time with elected officials
  • The opportunity to have a conversation versus listening to a speech or a pitch
  • Seeing private EMS, hospital based EMS, 3rd party services, County services, Firefighters, leadership,  and clinical providers in one space at one time with the same goals
  • These officials truly want to add to their network and hear from us, we should continue with the large effort but also make individual commitments to speak to them more about what matters to us
  • The education on the legislative process – walking away with a better understanding of the amount of effort that goes into positive change on a larger scale

More than one attendee reported thinking about seeking out elected officials to discuss items important to EMS on one or more occasions, but admitted they probably wouldn’t have taken the time to do it on their own; some reporting they wouldn’t have known where to start if they had tried to do it on their own.

(Photo insert, Senator Mark Miller, Kristopher Loy and Steve Wunsch during Wisconsin EMS Legislative Day.  See more photos https://www.facebook.com/paaw.us/)

Brian Randall, paramedic and one of the 2017 Star of Life recipients shared his thoughts on the day: “I feel a sense of pride.  Proud of the fact that we can all put personal agendas aside and come together in common goals that serve the patient.  Proud that our collective voice is respected by the Legislators and they actually want to hear what we have to say.”

While the number of attendees equaled roughly one half of one percent of all licensed EMS professionals in the state, attendance far exceeded initial expectations for this inaugural event and sets a goal for coming years.  If you’re interested in getting more involved and staying informed, visit www.paaw.us and tune into our bi-weekly EMS Live in Wisconsin podcast where we’re always discussing current events, trends, and initiatives in EMS.  Reach out to your representatives and get involved; grab a friend and join us for EMS at the Capitol in 2018!

RESOURCES:

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


Special Post-Event Podcast Discusses Initial Results of Wisconsin EMS Legislative Day

>> Click to listen now.

On November 7th, our Podcast was dedicated to discussing the first Wisconsin EMS Legislative Day at the State Capitol, Madison.  Our guests were John Eich, Executive Director for the Wisconsin Office of Rural Health and Dana Sechler, Director/Chief Baraboo District Ambulance Service.  The event, coordinated by John, Dana and many others, was attended by over 100 EMS providers, directors and leaders from across the state.  In total, the one-day event produced meetings with 31 out of 33 state senators and 57 out of 98 state representatives.  

According to John Eich, “The turnout was fantastic for a first-time event, and the stories we heard after the legislative visits were powerful.  Telling the EMS story, one legislator at a time.”

>> Click to listen now.

November 3, 2017 

PAAW News
Association leadership changes announced

At the November 2 Professional Ambulance Association of Wisconsin (PAAW) Board of Directors meeting, and previously at the annual meeting, elections were held for leadership positions.

(Photo insert:  Vice President-elect Chris Anderson, President Patrick Ryan and President-elect Dana Sechler)

Current board members newly elected to officer positions, included:  Dana Sechler, President, Chris Anderson, Vice President, and Cody Doucette, Secretary.  Patrick Ryan and Larry Knuth, President and Vice President, respectively, concluded many years of service to PAAW in their respective roles and responsibilities.  The association thanks them for their dedicated service.  Both Patrick and Larry will continue as current members of the Board of Directors.

Board members who were elected for another three-year term at the annual meeting, included:  Cody Doucette, Larry Knuth and Dana Sechler.

The Board of Directors also hired the American Ambulance Association (AAA) as the association's new management company and Samantha Hilker, Hilker Project and Strategy Management, to write content and produce the monthly podcast for PAAW.  Their responsibilities begin January 1.  This past summer PAAW Executive Director Joe Covelli provided his resignation, effective December 31, so the association could hire and make future plans without a gap in service to its members.

The next PAAW Board of Directors meeting is January 4 in Portage.


November 3, 2017 

State Capitol
Governor announces Rural Public Safety Initiatives

The last week in October, Governor Scott Walker released his Rural Initiative Plan, to include priorities for Rural Public Safety the Governor's Office supports.

Under Step Six: Investing in Public Safety, the following was included in the Governor's Rural Initiatives Plan:

  • Encouraging High School Volunteer Firefighters & EMTs.  We will support legislation that will reward high schools and students that participate in EMT or Firefighter basic training.
  • Prolonging The License Renewal Period.  We will support legislation to change the certification renewal period from every two years to four years for a first responder, licensed EMT, or paramedic.


November 1, 2017 

State Capitol
Community Paramedicine Bill Passes Senate, Moves on to the Governor for Signature

The Professional Ambulance Association of Wisconsin is pleased to share the Senate version of the community paramedicine bill was passed unanimously on October 31!  The Assembly's version passed a few months ago.  That’s both houses passing it without a single ‘nay’ vote. 

Now, on to the Governor’s desk for signature and becoming law.


October 18, 2017

Advocacy
Stakeholder group suggests removing  "Ambulance" from state's transportation brokerage model

Members of the Transportation Advisory Council, which includes the Professional Ambulance Association of Wisconsin, recently authored a joint letter to the Wisconsin Department of Health (DHS) with several recommendations to improve the program as it moves forward.  The transportation contract is issued by the state and will be bid out sometime in 2018.

One recommendation offered in the letter is to remove non-emergency "ambulance" from covered services in the upcoming bid.  >> Click to review letter.

Since 2011, non-emergency ambulance transportation was first included in the broker model.  Broker services began with Logisticare and later changed to MTM, who is the current broker management company.   Under the model, ambulance services are required to get an authorization number prior to transporting a non-emergency patent.

The broker model hasn't been kind to ambulance services with brokers often short paying bills, delaying payment for months or not paying invoices at all - even after patient transportation services were provided.  It is estimated that over one-million dollars has been lost to unpaid bills since inception of the program. 

When a covered beneficiary under the Medicaid program summons an ambulance and it is deemed an emergency, then the transporting ambulance service is outside the broker model and can bill DHS directly as a covered service.  That's how is was handled too for non-emergency ambulance services, until the broker model was introduced by the state as a cost saving and Medicaid program management initiative.


October 11, 2017

EMS Live in Wisconsin Podcast
Seeing Benefits with Video Laryngoscope at Sun Prairie EMS

>> Click to listen to this podcast.

During the October 10, EMS Live in Wisconsin podcast, PAAW Executive Director Joe Covelli spoke with Acting Director Eric Lang and long-time Paramedic Bob Barrix, both with Sun Prairie EMS, regarding their use, training and experience with video laryngoscopes in the field.

What Sun Prairie EMS has learned in deploying use of video laryngoscopes:

  • Continued simulation mannequin training is necessary, skill retention was lacking.
  • Need to stress to the users of the device to use it how it was designed.
  • Medics were not suctioning adequately prior to attempted placement.
  • Each medic needed to increase familiarity with devices, systems and airway anatomy.
  • The overall goal was ‘mastering the normal’, which resulted in difficult airway management becoming easy and impossible airways becoming possible to manage.

>> Click to listen to this podcast.

September 25, 2017

Stars of Life
Dedication, Commitment, Heroism:  Key words that describe 2017 Stars of Life honorees

The 2017 Stars of Life honorees were recognized during two events on September 21 in Green Bay at Tundra Lodge Resort and Conference Center.

The program began with a welcome reception where each Star was introduced by their employer or family member.  Words of appreciation, dedication, commitment, to include stories of heroism, were frequently shared.  To mark the special occasion, each honoree received a gold Wisconsin Star of Life lapel pin.



Next, came the dinner and awards program where each Star was recognized before an audience of 200 and formally presented Wisconsin Stars of Life honors.  Each honoree was presented with a custom engraved medallion and framed certificate of appreciation from Governor Scott Walker.  The dinner program was co-located with the Paramedic Systems of Wisconsin conference.

The evening concluded with the announcement David Mike with Paratech Ambulance Service, Milwaukee, was selected to represent Wisconsin at the 2018 National Stars of Life event in Washington, D.C.  The selection committee felt David's commitment to EMS and community touched every aspect in the suggested criteria for Stars of Life.  Tami Aerts with County Rescue Services, Green Bay, was selected as the alternate 2018 National Star of Life.

To review the 2017 Stars of Life program booklet and biographies on each Star honoree, >> click here.

2017 Wisconsin Stars of Life Honorees

Tami Aerts nominated by County Rescue Services

Chris Cuddy nominated by Gold Cross Ambulance

Christopher Dallas nominated by Valders Ambulance

Patrick Donoghue nominated by Bell Ambulance

Elizabeth Ferger-Olsen nominated by Paratech Ambulance Service

Angela Gonzalez nominated by Palmyra Public Safety Department

Jon Hagen nominated by Flight For Life

Paul Harrison nominated by Ryan Brothers Ambulance

Steve Hensley nominated by Tri-State Ambulance

Amanda Holtz nominated by Orange Cross Ambulance

Ryan Janus nominated by Bell Ambulance

Bob Kelter nominated by Baraboo EMS

David Krueger nominated by Grant EMS

Mary LaPorte nominated by Riverside Fire District 

Dr. Suzanne Martens nominated by Valders Ambulance

Lori McConochie nominated by Cambria Community Ambulance Service

David Mike nominated by Paratech Ambulance

Tyler Miller nominated by Tri-State Ambulance

Kenny Monteith nominated by Tri-State Regional Ambulance

Dan Morth nominated by Ellsworth Area Ambulance

Tom Pasch nominated by Ryan Brothers Ambulance

Brian Randall nominated by Gold Cross Ambulance

Russell Schafer nominated by Lodi Area EMS

Jeri Schiffman nominated by Tri-State Regional Ambulance

Sandra Steenweg nominated by Pickerel Rescue Squad

Bob Sternhagen (posthumous) nominated by Gold Cross Ambulance

Benjamin Waldera nominated by Divine Savior Healthcare EMS

Robert Whitton nominated by Paratech Ambulance Service

Mark Willer nominated by Baraboo EMS

Wisconsin Stars of Life has been proudly produced by PAAW since 2006.

Upcoming Events

Current PAAW Priorities
Community Paramedicine Legislation
State Medicaid Reimbursement & MTM


Next EMS Live Podcast

Tuesday, November 28

starting at 9:00 a.m. central time

Topic

Walworth County EMS

Guest
Dr. Steven Andrews

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)


Stars of Life Dinner and 
Awards Program

September 21, 2017

Tundra Lodge & Convention 
Center, Green Bay

>> Click for 2017 Stars of Life Webpage and Event Information

2015 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

>> See who's a PAAW member.  Not a PAAW member? That's okay. Subscribe to receive free email updates and alerts from PAAW.  >> Click to get started.













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