PAAW | Professional Ambulance Association of Wisconsin News and Information

WI needs to ensure payments to ambulance providers

Mon, 26 Jan 2026 14:35:55 GMT

The Cap Times - Chris Anderson, guest column

January 21, 2026

Ambulance copays - fed rule change

Mon, 19 Jan 2026 15:26:42 GMT

Letter to Centers for Medicare and Medicaid Services on ambulance copays.

WBAY Green Bay; No Surprises Act

Wed, 14 Jan 2026 15:45:59 GMT

https://www.wbay.com/2026/01/08/proposed-bill-aims-limit-surprise-ambulance-costs-wisconsinites/

Fox 6 News Milwaukee; No Surprises Act

Wed, 14 Jan 2026 15:41:29 GMT

https://www.msn.com/en-us/health/other/new-wisconsin-bill-targets-surprise-ground-ambulance-bills/ar-AA1TMCmm?ocid=BingNewsSerp

PAAW in the State Capitol

PAAW Administrator — Wed, 14 Jan 2026 00:28:11 GMT

PAAW advocates answered the call at the State Capitol this week, testifying in front of two legislative committees on the No Surprises Act, a proposal to end the practice of “balance billing patients” for EMS services not covered by private insurance.

Testimony on the subject was lopsided at both public hearings. At last Wednesday’s hearing in front of the Assembly Health Committee, five PAAW advocates and one patient defined the need for this bill in simple terms: require insurance companies to provide fair reimbursement, directly to the EMS provider, in a reasonable timeframe. On Tuesday, six PAAW advocates repeated the narrative to the Senate Insurance Committee.

On the other side of the table, the insurance industry had the same person at both hearings reading similar written testimony. In that testimony, insurance advocates registered their support for EMS services - especially in underserved areas - but could not support legislation that removed their ability to negotiate service rates.

The feedback from lawmakers at the hearings was overwhelmingly favorable. Our advocate team made strong arguments and addressed every aspect of the issue. However, it is far from complete. With the 2025-26 Session winding down at the end of February, chairpersons must prioritize which bills their committee will forward for consideration. With limited session days left, legislative leaders will further prioritize which bills make it to the floor.

PAAW always plays to win in the legislative game. Our motto with the No Surprises Act this week was, "Swing hard in case you hit it!" We definitely hit it. Now we need a handful of lawmakers to act boldly and add Wisconsin to the list of states that have resolved this issue for patients.

Uniformed Services University Partners with NHTSA to Improve Post-Crash Survival on Highways

Samantha Hilker — Fri, 19 Dec 2025 15:19:16 GMT

Uniformed Services University Partners with NHTSA to Improve Post-Crash Survival on Highways

Prehospital Blood Transfusion to be the Main Focus

The Uniformed Services University (USU) in Bethesda, Maryland, through its National Institute for Defense Health Cooperation (NIDHC), is partnering with the Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) to save lives on America’s roadways with prehospital blood transfusions.

USU has signed an Interagency Agreement with NHTSA aimed at supporting improvements in emergency medical services, 911, and post-crash care. This joint effort between USU’s NIDHC and NHTSA’s Office of Emergency Medical Services (OEMS) will improve motor vehicle post-crash survival rates while advancing our Nation’s medical readiness for other events in which trauma patients may require more robust prehospital care.

As NHTSA’s Chief Counsel, Peter Simshauser, indicated in his Road to Zero Annual Meeting remarks, “We know how critical post-crash care is to survival. Research shows that prehospital blood transfusion decreases mortality among trauma patients with severe bleeding by 37%. So, we’re partnering with the Department of War. This partnership will launch the largest federally-sponsored prehospital blood transfusion project ever undertaken, with the aim to create at least 25 new prehospital blood transfusion programs throughout the country in the next three years.”

Over the next several years, NIDHC and OEMS will facilitate the development of prehospital blood programs at sites across the U.S. Ultimately, this work will provide a clear path to greater and faster access to blood transfusion at the scene of a crash and to improved post-crash care on all of our Nation’s roadways.

The program will leverage NIDHC’s Joint Disaster Medicine and Public Health Ecosystem, which is composed of leading medical, academic, and research institutions from across the nation.

“This is not the first time, nor will it be the last, that the Departments of War and Transportation work together to translate lifesaving innovations from the military to the civilian medical community,” NIDHC Executive Director Dr. Jeff Freeman said. “NHTSA has a history of leaning forward in this way and countless lives have been saved because of it.”

”NHTSA’s Office of EMS and National 911 Program appreciate the partnership of NIDHC,” said Gamunu “Gam” Wijetunge, Director of NHTSA’s OEMS. “The resources and support for this effort will advance prehospital blood transfusion ⎯ a proven clinical intervention ⎯ and reduce the number of lives lost after a motor vehicle crash.”

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MedPAC Releases 2025 Medicare Payment Basics Series

Samantha Hilker — Wed, 19 Nov 2025 15:31:58 GMT

Payment Basics is a series of brief overviews of how Medicare’s payment systems function. The Commission produces Payment Basics as a resource for policymakers and others to better understand how Medicare pays for health care services.

https://www.medpac.gov/document-type/payment-basic/

Your Voice Matters - Take Action for WI EMS

Samantha Hilker — Tue, 11 Nov 2025 19:24:09 GMT

Wisconsin’s emergency medical service providers are on the front lines every day, answering 911 calls and saving lives, but we need your help to protect the future of our work. LRB-0277/1 is critical legislation that will ensure fair reimbursement for emergency ambulance services, protect patients from surprise medical bills, and hold insurers accountable.

We’re asking every EMS professional and supporter to take a moment today to contact your state senators and representatives. Urge them to co-sponsor LRB-0277/1 and stand up for Wisconsin patients, EMS providers, and local communities.

Together, we can make sure that when someone calls 911, help will always be there - anywhere, anytime.

Contact Your Legislators Now

New Prehospital Blood Transfusion Guideline and Standards for EMS

Samantha Hilker — Fri, 08 Aug 2025 15:46:26 GMT

New Prehospital Blood Transfusion Guideline and Standards for EMS

Important Resources from the Prehospital Blood Transfusion Coalition and the Association for the Advancement of Blood & Biotherapies

As more EMS agencies launch prehospital blood transfusion programs, the need for guidelines and standards is growing. Implementing a program requires a number of steps, most notably the appropriate training, an understanding of quality control measures and ongoing adherence to regulations.

The Prehospital Blood Transfusion Coalition is a multidisciplinary U.S. collaboration working to expand access to safe and effective blood transfusions in prehospital care. The new Clinical Practice Guideline (CPG) from the Coalition offers essential instructions for EMS clinicians to provide early resuscitation with blood products for patients experiencing hemorrhagic shock, with the goal of reducing mortality and improving clinical outcomes. The guideline, which is intended to serve as a living document based on evolving evidence and best practices, outlines the indications, procedures, equipment and monitoring required to safely administer blood products.

Download Guideline

Also available for EMS agencies is the new standards, Emergency Prehospital and Scheduled Out-of-Hospital Transfusions, from the Association for the Advancement of Blood & Biotherapies (AABB). The goal of these standards enhance the quality and safety of prehospital transfusion services and provide the basis for accreditation by the AABB. It also supports better communication between the EMS agency and blood centers. In addition, accredited agencies gain a better understanding of outcomes reporting, traceability and how to respond to transfusion-associated adverse events.

Download Standards

Professional Ambulance Association of Wisconsin Announces 2025 Stars of Life Honorees

Samantha Hilker — Thu, 31 Jul 2025 19:38:14 GMT

FOR IMMEDIATE RELEASE
Date: July 31, 2025

Professional Ambulance Association of Wisconsin Announces 2025 Stars of Life Honorees

Madison, WI – The Professional Ambulance Association of Wisconsin (PAAW) proudly announces the 2025 recipients of the Wisconsin Stars of Life Award, honoring 20 outstanding emergency medical services (EMS) professionals from across the state. These honorees have demonstrated extraordinary dedication, skill, and compassion while serving patients and communities in their most critical moments.

The Wisconsin Stars of Life program celebrates the best of EMS, recognizing individuals who have gone above and beyond the call of duty to provide lifesaving care, leadership, and mentorship to the next generation of EMS providers. The 2025 honorees will be celebrated during a special ceremony this October in Madison, WI.

This year’s Wisconsin Stars of Life honorees include:

James Acker, CCP, Ryan Brothers Ambulance
Brady Alfred, Dispatcher, Ryan Brothers Ambulance
Ben Coenen, Supervisor, Gold Cross Ambulance
Amanda Corrao, Community and Education Coordinator, Gold Cross Ambulance
Bailee Espelien, Paramedic, Mayo Clinic Ambulance Service
Kaitlyn Frank, Paramedic, Bell Ambulance
Colleen Hall, Critical Care Paramedic/FTO, Gold Cross Ambulance
Lemya Hangrove, Paramedic, Bell Ambulance
Derek Hernandez, Emergency Medical Technician, Superior Air Ground Ambulance
Callie Hofmeister, Operations Supervisor, Gundersen Tri-State Ambulance
Don Iggulden, Advanced Emergency Medical Technician, Superior Air Ground Ambulance
Emma Klein, Emergency Medical Technician, Superior Air Ground Ambulalnce
Andrew Lane, Paramedic, Bell Ambulance
Eric Lucas, Paramedic, Bell Ambulance
John Moen, AEMT, Ryan Brothers Ambulance
Davis Opel, Field Training Officer, Orange Cross Ambulance
Joshua Schmidt, Paramedic, Bell Ambulance
Bob Stein, Logistics Coordinator, Gundersen Tri-State Ambulance
Kat Wojnar, Paramedic, Bell Ambulance
Cody Zehnder, Critical Care Paramedic, Gundersen Health System Ambulance

“The Stars of Life honorees are the heart of EMS in Wisconsin,” said Chris Anderson, PAAW President. “They represent the courage, compassion, and dedication that define our profession. It’s an honor to recognize these individuals who make an incredible difference in the lives of others every day.”

The Wisconsin Stars of Life ceremony is part of PAAW’s ongoing commitment to advocate for EMS providers, promote excellence in pre-hospital care, and honor those who deliver critical services to communities statewide.

For more information on the Wisconsin Stars of Life program or this year’s honorees, visit https://paaw.us/2025Stars/.

NHTSA Launches New Resource Giving Emergency Responders Easy Access to Electric Vehicle Information

Samantha Hilker — Mon, 21 Jul 2025 17:34:10 GMT

NHTSA Launches New Resource Giving Emergency Responders Easy Access to Electric Vehicle Information

Comprehensive resource for ERGs and rescue sheets available

As part of the National Highway Traffic Safety Administration’s ongoing commitment to supporting first responders with timely and accurate information to enhance public safety, emergency responders have quick and easy access to electric vehicle (EV) Emergency Response Guides (ERGs) and rescue sheets through a new resource available on the NHTSA website.

Explore New Resource

Key features include:

Comprehensive Access: Emergency responders can quickly find and download ERGs and rescue sheets for EVs from all manufacturers.
Historical EV Files: Historical emergency response files for EVs have been transferred from the National Fire Protection Association (NFPA) website to NHTSA’s new platform.
Transition Away from NFPA Site: The NFPA will discontinue its ERG portal, and NHTSA’s new page will serve as the primary resource for these materials moving forward.

For further information or assistance, please contact James Myers at james.myers@dot.gov.

Wisconsin EMS Board Subcommittee Application Now Open

Samantha Hilker — Thu, 08 May 2025 15:11:33 GMT

EMS Board Subcommittee Application Process

Wisconsin EMS Subcommittee Applications

The Wisconsin Emergency Medical Services (EMS) Board Subcommittee application process is now open effective April 28, 2025, through 4 p.m. on May 19, 2025.

This email is being sent on behalf of Jerry Biggart, Chairperson of the Emergency Medical Services (EMS) Board. 

The EMS Board is recruiting qualified EMS professionals to participate in the EMS Board Subcommittees.Subcommittee members assist in addressing specific issues and developing recommendations. The goal of every subcommittee is to achieve the highest quality and standards possible for the Wisconsin EMS system which in turn delivers the best pre-hospital care to citizens and visitors of Wisconsin.

EMS Board subcommittees

Physicians Advisory Committee (must be a physician & EMS Medical Director)
System Quality and Data Subcommittee
Education and Training Subcommittee
System Management and Development Subcommittee
Human Relations Subcommittee
Rural EMS Subcommittee

Expectations of EMS Board subcommittee members

Term is one year starting July 1, 2025, through June 30, 2026.
Subcommittee members do not receive compensation or reimbursement.
Subcommittee members provide recommendations based on the effect to the entire Wisconsin EMS system versus individual service, geographic area, or representational groups.
Subcommittee members only serve on one subcommittee per term unless appointed by the EMS Board Chair to a second subcommittee.
Subcommittee members are expected to participate in all scheduled meetings and complete work projects outside of meetings.
In-person attendance, when appliable, to subcommittee meetings is a high priority. There are currently four regularly scheduled in-person meetings per year in Madison or surrounding area.
- The Human Relations Subcommittee currently conducts all meetings virtually.
- The Rural EMS Committee currently conducts all meetings virtually and in the evening.

Application process

For new applicants: submit a completed application, F-00568 to the Wisconsin EMS Sectionby 4 p.m. on May 19, 2025. Applications received after this date and time will not be considered. PAC applicants must be a physician and EMS Service Medical Director.

For incumbents: submit a letter of intent to maintain membership to the Wisconsin EMS Sectionby 4 p.m. on May 19, 2025. Letters received after this date and time will not be considered.

Selection process for subcommittee membership

The completed applications are provided to the EMS Board membership for review and selection during the June 4, 2025, meeting.  The EMS Board meeting agenda will be posted on the Wisconsin Public Meeting Notices & Minutes website. If elected to a subcommittee, the chairperson of the subcommittee will contact applicants by email.

If interested, you are encouraged to apply to this rewarding opportunity. Questions on the process may be directed to dhsemssmail@dhs.wisconsin.gov.

Please do not reply directly to this email message. If you have a question, please email dhsemssmail@dhs.wisconsin.gov.

Registration Open for CMS’ Person-Centered Listening Sessions on Improving Health in Rural Communities on November 20

Samantha Hilker — Mon, 18 Nov 2024 15:21:52 GMT

Registration Open for CMS’ Person-Centered Listening Sessions on Improving Health in Rural Communities on November 20

On November 20, the CMS Innovation Center will host a Person-Centered Listening Session on Improving Care Experience, Outcomes, & Equity in Rural Communities

This listening session will focus on access and delivery in rural health care, and key takeaways from CMS Innovation Center Rural Health Hackathons and a listener Q&A.

Insights from this session will help inform the Innovation Center’s strategy on addressing
common rural health issues.

The listening session will take place on Wednesday, November 20 from 12:00-1:00 PM ET. Registration is open.

Please Note: Attendees may submit written comments or questions before the webinar via the registration page or during the Q&A session. Please indicate if you would prefer not to have your comments read or wish to remain anonymous. For more information, please visit the following links:

Sign up for the CMS Innovation Center listserv for details on future events, model
updates, and more

Follow us on X

Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.

Marburg Virus Disease: New EMS Guidelines

Samantha Hilker — Wed, 06 Nov 2024 19:24:48 GMT

Marburg Virus Disease: New EMS Guidelines

Viral Hemorrhagic Fevers (VHFs) are severe illnesses caused by a range of viruses, some of which have high fatality rates. Although cases are rare in the United States, these viruses are becoming more prevalent internationally. Examples of VHFs include Marburg virus disease (MVD), with a fatality rate averaging around 50% (ranging from 24% to 88%), Lassa fever, with a hospital fatality rate of 15% to 20% (and as high as 50% in pandemic settings), Ebola virus disease (EVD), and Crimean-Congo hemorrhagic fever (CCHF). The recent national attention surrounding a fatal Lassa fever case in Iowa underscores the importance for EMS clinicians to stay informed about VHFs.

The National Highway Traffic Safety Administration (NHTSA) Office of EMS strongly encourages EMS clinicians to familiarize themselves with VHFs, including where they occur, how they spread, what questions to ask patients, and how to protect themselves. The National Emerging Special Pathogens Training & Education Center (NETEC) provides guidance for the management of VHFs and has recently updated the MVD NETEC guidelines for EMS clinicians, in October 2024 to align with current CDC recommendations. These guidelines for EMS clinicians emphasize the "Identify, Isolate, and Inform" paradigm, previously used for diseases like Ebola and mpox.

Review Guidelines Here

Emergency responders are encouraged to learn the signs and symptoms of VHFs and to assess patients with travel-related questions when appropriate. While most EMS clinicians in the United States are unlikely to encounter a VHF case during routine operations, international outbreaks heighten the risk of encountering an infected patient who may have traveled from an affected region. EMS agencies serving areas with international ports of entry should be especially vigilant.

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1200 New Jersey Avenue, SE
Washington, DC 20590
nhtsa.ems@dot.gov

CMS Rural Health Day Webinar

Samantha Hilker — Wed, 06 Nov 2024 18:43:44 GMT

Register now for our upcoming National Rural Health Day webinar

The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) invites you to celebrate National Rural Health Day on November 19 at 2 p.m. ET with a webinar highlighting the latest resources from CMS including reports and information on rural, tribal, and geographically isolated communities. We’ll also get to feature the work of a 2024 CMS Health Equity Awardee Augusta Health to improve health equity within the Shenandoah Valley.

When: November 19 from 2 – 3 pm ET

Where: Virtual webinar, please register

Registration:https://us06web.zoom.us/webinar/register/WN_8e5JeFaiTfOH8sWvPKwsiQ#/registration

We’re proud to have recognized Augusta Health as a 2024 CMS Health Equity Award winner for their work in helping to improve health care access in rural communities. Augusta Health is a non-profit, independent hospital serving communities of the Shenandoah Valley in Virgina. Since its launch in 2022, their Primary Care Mobile Clinic program has grown to 14 different sites every month including community centers, churches, fire houses, the mayor’s office, and homeless shelters. In one year, the program provided over 1,700 primary care visits for 825 patients at 17 different sites. Augusta Health’s Primary Care Mobile Clinic program illustrates the impact of community-driven interventions in addressing health disparities.

Click here to register.

Paid for by the US Department of Health and Human Services.

CY 2025 Physician Fee Schedule Final Rule

Samantha Hilker — Tue, 05 Nov 2024 16:24:59 GMT

Dear Ground Ambulance Providers and Suppliers,

We wanted you to be aware that we posted the following announcement on our Ambulances Services Center website:

CY 2025 Physician Fee Schedule Final Rule

CMS issued the CY 2025 Physician Fee Schedule (PFS) final rule that announces finalized policy changes for Medicare payments under the PFS and other Medicare Part B payment policy issues, including ambulance services. For CY 2025, we proposed to modify the definition of advanced life support level two (ALS2) at § 414.605 by adding the administration of low titer O+ whole blood transfusion (WBT) to the list of ALS2 procedures. We also solicited comments on whether we should add alternative blood product treatments, such as the administration of packed red blood cells (PRBCs) and plasma, to the list of ALS2 procedures.

After consideration of public comments, and considering further that the indications for use, storage requirements, administration, monitoring, and training for the use of PRBCs and plasma are similar to those previously described for WBT, we are finalizing our proposal to modify the definition of ALS2 at §414.605 by adding the administration of prehospital blood transfusion (PHBT) which includes low titer O+ and O- whole blood transfusion therapy, PRBCs, plasma, or a combination of PRBCs and plasma. A ground ambulance transport that provides one of these PHBTs would itself constitute an ALS2 level transport.

IV Fluid Conservation Briefing and Supply Update

Samantha Hilker — Mon, 04 Nov 2024 19:25:16 GMT

IV Fluid Conservation
Briefing and Supply Update

On Monday, October 28th, the U.S. Department of Health and Human Services hosted a briefing on intravenous fluid (IV) conservation best practices. This session was recorded and is now available at the link below.

Up-to-date information on shortages related to Hurricane Helene’s impact on Baxter’s North Cove, NC, facility can be found on the U.S. Food & Drug Administration’s Hurricane Helene webpage, as well as on Baxter’s website.

View the Recording

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1200 New Jersey Avenue, SE
Washington, DC 20590
nhtsa.ems@dot.gov

Time to Register: NEMSAC Meeting

Samantha Hilker — Wed, 23 Oct 2024 15:02:52 GMT

Time to Register: NEMSAC Meeting

November 6-7, 2024

The National EMS Advisory Council (NEMSAC) will host a hybrid meeting on Wednesday, November 6, 2024, at 1:00 pm ET, and Thursday, November 7, 2024, at 12:00 pm ET. Members of the public are welcome to attend the meeting virtually or in person and offer public comment.

Location: Hotel Washington, 515 15th Street NW, Washington, DC 20004

Due to limited space, virtual attendance is encouraged

NEMSAC meets throughout the year to deliberate on specific policy issues affecting EMS systems across the nation. NEMSAC members provide counsel and recommendations to the Federal Interagency Committee on EMS (FICEMS) and the Secretary of the Department of Transportation (DOT) through the National Highway Traffic Safety Administration (NHTSA).

Register Now

Agenda Highlights:

Updates from OEMS and FICEMS Chairperson
NRSS and Post-Crash Care update
Reports on advisories in progress from the Subcommittees on:
- Adaptability & Innovation
- Equitable Patient Care
- Preparedness & Education
- Professional Safety
- Sustainability & Efficiency
- Integration & Technology

Guest Presentations (Day 1 & 2)
- Behavioral Health in EMS with John R. Niemiec (IAFF)
- Applications for Artificial Intelligence in Healthcare with Stephen J. Konya, III (ASTP, formerly ONC)
- Updates from the National Association of EMS Physicians (NAEMSP) with Jose Cabanas, MD, MPH, FACEP, FAEMS
- Updates from the National Association of EMS Educators (NAEMSE) with Arthur Hsieh, MA, NRP
- Updates from the American Ambulance Association (AAA) with President, Randy Strozyk

Registrants who wish to address the Council during the public comment periods can submit comments in writing to NHTSA.NEMSAC@dot.gov by October 31, 2024. Questions and comments for the Council may also be presented during the meeting using the live chat feature.

We are committed to providing equal access to this event for all participants. People with disabilities can submit an accommodation request, and people with limited English proficiency can submit a language access request. Please submit any request to Clary Mole by phone at (202) 868-3275 or by email to Clary.Mole@dot.gov no later than October 31, 2024. A sign language interpreter and closed captioning services are available, through the Zoom virtual meeting platform, but only upon request.

Sign up to receive the latest news from the Office of EMS, including webinars, newsletters and industry updates.

Contact Us

1200 New Jersey Avenue, SE
Washington, DC 20590
nhtsa.ems@dot.gov

EMS Heroes To Be Honored in Madison as 2024 Wisconsin Stars of Life

Samantha Hilker — Tue, 10 Sep 2024 15:00:00 GMT

News Release

September 10, 2024

FOR IMMEDIATE RELEASE

Contact: Samantha Hilker
920-202-2955
shilker@ambulance.org

EMS Heroes To Be Honored in Madison as 2024 Wisconsin Stars of Life

Madison, WI—This week, the Professional Ambulance Association of Wisconsin announced the 2024 Wisconsin Stars of Life honorees; extraordinary EMS professionals who have gone above the call of duty to serve their communities. 23 individuals from across the state will be recognized as the 2024 Wisconsin Stars of Life at an October 16, 2024 banquet.

Stars of Life pays tribute to the dedication of these hometown heroes while shining light on the critical role EMS plays in our healthcare infrastructure. The Madison Concourse Hotel will host an awards ceremony where executive hosts and family members will join in the recognition and celebration of the Stars’ contributions to the field and their community.

Professional Ambulance Association of Wisconsin President Chris Anderson noted that, “EMS professionals work tirelessly to provide round-the-clock healthcare where and when it is needed most.” He continued, “We look forward to this event all year, and look forward honoring our 2024 recipients in October.”

This year’s distinguished Stars of Life honorees are:
Brent Bischoff | Operations Manager – EMT | Midwest Medical Transport
Travis Downing | Team Leader – Critical Care Paramedic | Midwest Medical Transport
Diana Frances | Assistant Station Manager, Norther Wisconsin | Superior Ambulance
Mariana Gonzales-Walker | EMT | Bell Ambulance
Katie Halbach | Operations Manager | Gold Cross Ambulance
Brian Heisz | Paramedic | Gundersen Health System Ambulance
Patrick Janzen | Field Training Officer, EMT | Bell Ambulance
Mary Johnson | Cadet & Outreach Supervisor/AEMT | Bell Ambulance
Tom Loescher | Physician, Posthumous Recognition | Gold Cross Ambulance
Cindy McDonald | Critical Care Paramedic | Gundersen Tri-State Ambulance
Nicholas (Niko) Oehlenschlager | Paramedic | Ryan Brothers Ambulance
Tariq Sabbah | EMS Dispatcher | Superior Ambulance
Natasha Sager | Supply & Logistics Officer | Orange Cross Ambulance
Jason Santos | Paramedic | Mayo Clinic Ambulance
Greg Schaefer | AEMT | Ryan Brothers Ambulance
James See | Field Supervisor | Orange Cross Ambulance
Dee Dee Thornton | Dispatch Call Taker/EMD | Bell Ambulance
Mariah Ullrich | EMT | Gold Cross Ambulance
BJ Van Engen | Shift Supervisor, Critical Care Paramedic | Bell Ambulance
Carol Varys | EMT Field Training Officer | Superior Ambulance
Casey Welsh | Paramedic Shift Lead | Gundersen Tri-State Ambulance
Brittany Wirth | Dispatch Manager | Ryan Brothers Ambulance
Travis Wright | Paramedic, Dispatch Call Taker/EMD | Bell Ambulance

Please note that members of the media are welcome to attend the Stars of Life Banquet at the Madison Concourse hotel on October 16 from 5:00–9:00pm. Interviews with Stars of Life as well as state EMS leaders will be available.

# # #

About The Professional Ambulance Association of Wisconsin

The Professional Ambulance Association of Wisconsin (PAAW) is a leading organization dedicated to advancing the quality and professionalism of emergency medical services in Wisconsin. Founded with a mission to support and advocate for the state's ambulance services, PAAW provides essential resources, training, and legislative representation to its members. Through collaboration, education, and innovation, PAAW strives to ensure that all communities in Wisconsin receive the highest standard of pre-hospital care. For more information, visit paaw.us.

Shared Revenue Payments and EMS

Samantha Hilker — Wed, 07 Aug 2024 15:29:47 GMT

Matt Kussow, PAAW Lobbyist
MK Lobby

On August 1, Governor Evers announced the first payments to Wisconsin Counties and municipalities under 'historic' shared revenue increases. Read the full press release here.

The State of Wisconsin made an "historic" commitment to county and municipal governments in the last budget, ending decades of stagnant or declining revenues in Shared Revenue payments. Now it is up to local governments to actually make history and address the problems the Legislature intended with the new funding. Fortunately, lawmakers tipped the scale in our direction in a handful of important ways.

First, to receive the new funding. local service providers had to certify they are not reducing staff or funding for police, fire or EMS services. (You probably recall the one-page form you had to complete in June certifying these numbers.) Avoiding more funding cuts seems obvious to building up such services yet you might be surprised how many municipalities were considering such cuts.

Second, a big portion of the new Shared Revenue payments are specifically allocated to "support essential services such as law enforcement, fire protection, emergency medical services, emergency response communications, public works, courts, and transportation". While this definition is beneficial, inclusion of "public works, courts, and transportation" was a significant discussion among lawmakers and will undoubtedly draw funds away from EMS, fire and police. In some communities, the "historic" investment might be a new snowplow or section of road.

And finally, a future challenge with the new funding that could directly affect PAAW members still awaits county and municipal governments. Lawmakers created a $300 million Innovation Fund specifically targeting efforts to consolidate county and municipal services. This includes EMS but it also includes everything else from library services to human resources. As such, communities could apply for funding to combine or expand EMS services if a cost-savings is demonstrated. This might open a door for some PAAW members to expand into new communities.

The new Shared Revenue funding is a welcomed development for municipalities, but it comes with new challenges. EMS is in the front of the money line but our situation is often more complicated than that one road project that has been waiting for funding for several years. PAAW members already embedded in communities have an advantage to stabilize their delivery systems with the new funding. If you are looking to expand, local leaders should be a little more susceptible to the numbers you are putting in front of them.

EMS Operations Management & Leadership Course

Samantha Hilker — Mon, 15 Jul 2024 13:54:42 GMT

EMS Operations Management & Leadership Course

Wisconsin Office of Rural Health Virtual Class

August 2024

Registration is now open for the August 2024 EMS Operations Management & Leadership Courses, sponsored by the Office of Rural Health. Over the past five years 500 participants from over 300 Services have completed this popular course and we have received requests from around the State to host more sessions. We are offering this course virtually, via Zoom.

Read what past participants are saying:

v It was great! I learned a lot and the timing was perfect as I was just hired as EMS Chief.

v It was a great course that I will recommend to other officers within our organization.

v I have been the manager since 2004, I've taken this course multiple times and always walk away with something useful.

v There was a wide array of information supplied. This class should be required before taking a management position in EMS.

Workshop Sessions

The August course will meet according to the schedule below, 6:30 pm - 8:45 pm; six sessions = 13.5 hours total. Participants who complete a course will receive 12 CEUs.

August 5, 7, 12, 14, 19, 21

This virtual Leadership course will dive into the management of Operational and Administrative duties and tasks. Sessions will include:

v Review of Key Attributes of a successful EMS agency

vIdentifying Positive & Negative Characteristics of a Leader/Manager

v Creating meaningful policies and procedures

v Developing and managing an annual budget

v Creating a useful QA/QI process, and assuring involvement of the Medical Director

v Discussion of Recruitment & Retention tools, Human Resources, and Just Culture principles

v Navigating State administrative rules & regulations, statues, and programs

v Demonstration of the various components of the State e-Licensing system

v Understanding compliance requirements in EMS related to the State EMS Office, CMS/Medicare, HIPPA, and other entities

v Current Grants and other funding sources

Who Should Attend?

The course is intended for those currently in EMS management positions, as well as those aspiring to management positions. Those interested in guidance or clarification on issues, and those interested in becoming a supervisor, manager, or leader in their agency will benefit.

Your instructor is Dana Sechler, former Wisconsin State EMS Office Paramedic/ALS program Coordinator, former Chief and EMS Service Director; partner at Strategic Management & Consulting, LLC.

Registration

The registration fee for the course is $45. Participants will receive a link to the Zoom meeting before each session. This link will take you to the course registration. Note: This course duplicate some of the material from previous courses, it is not a new or additional course, although you are welcome to register and take it again. Feel free to post the attached flier. The registration page can be accessed with the QR code.

Questions?

Contact Kevin Jacobson, kmjacobson2@wisc.edu

WORH EMS Ops course flier.docx

Calendar Year (CY) 2025 Physician Fee Schedule (PFS) Proposed Rule

Samantha Hilker — Mon, 15 Jul 2024 13:53:05 GMT

Dear Ground Ambulance Providers and Suppliers,

We wanted you to be aware that we posted the following announcement on our Ambulances Services Center website:

Calendar Year (CY) 2025 Physician Fee Schedule (PFS) Proposed Rule

CMS issued the CY 2025 PFS proposed rule: https://www.federalregister.gov/public-inspection/2024-14828/medicare-and-medicaid-programs-calendar-year-2025-payment-policies-under-the-physician-fee-schedule that announces proposed policy changes for Medicare payments under the PFS and other Medicare Part B payment policy issues including ambulance services. CMS is proposing to modify the definition of advanced life support level two (ALS2) at 42 CFR §414.605 by adding the administration of low titer O+ whole blood transfusion (WBT) to the list of ALS2 procedures. For patients in hemorrhagic shock, the use of WBT has demonstrated a survival benefit when compared to traditional hemorrhagic resuscitative therapy. Under this proposal, a ground ambulance transport that provides WBT would itself constitute an ALS2-level transport.

We are also seeking comments on whether we should add alternative blood product treatments such as the administration of packed red blood cells and plasma to the list of ALS2 procedures. We are aware that some established Emergency Medical Services (EMS) systems may already provide WBT to treat patients in hemorrhagic shock, while other jurisdictions, including those in rural areas, may rely on alternative blood product treatments.

We encourage you to submit comments on this proposal by September 9, 2024, to the website provided in the CY 2025 PFS proposed rule.

2024 Ride-Along Tool-Kit Now Available

Samantha Hilker — Fri, 05 Jul 2024 14:33:33 GMT

2024 Ambulance Ride-Along Toolkit

Educating your members of Congress about ambulance industry issues makes them much more likely to support your efforts. An easy and effective way to educate them is to invite them to participate in a local Ambulance Ride-Along!

The House and Senate will be adjourning for summer recess at the end of July and members of Congress will return home to their districts and states. This is the perfect opportunity for you to educate your members of Congress about issues facing our industry, in particular the extension of our Medicare add-on payments, the VA Final Rule, and the EMS workforce shortage, which are important to your operation. For additional information on these issues, visit the AAA Advocacy Page, which includes one pagers about all of our initiatives.

The most effective way to deliver these key messages is to host your member of Congress or their staff on a tour of your operation and an ambulance ride-along. The AAA has made the process of arranging a ride-long or scheduling a meeting easy for you with our 2024 Congressional Ride-Along Toolkit.

Are you willing to host a Member of Congress at your service but unsure of how to set it up? Email Meghan Winesett at mwinesett@ambulance.org!

Everything you need to arrange the ride-along or schedule a meeting is included in the Toolkit. Act now and invite your elected officials to join you on an Ambulance Ride-Along!

Webinar: EMS Harm Reduction and SUD Treatment

Samantha Hilker — Wed, 20 Mar 2024 12:44:11 GMT

EMS Harm Reduction and SUD Treatment Webinar

Hosted by NHTSA’s Office of EMS on March 22 at 2 PM ET / 11 AM PT

According to the National Harm Reduction Coalition, “harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.” This can include improving access to naloxone (Narcan) to prevent death from opioid overdose, providing sterile syringes to reduce the spread of HIV and hepatitis C, and fentanyl testing programs, among other types of help.

EMS clinicians are often on the frontline of addiction and the unintended consequences of both legal and illicit drug use and substance use disorder (SUD). In addition, drug use greatly impacts the larger context of our nation’s roads and highways through impaired driving and the resulting risks to the impaired driver, other drivers, passengers, bicyclists, and pedestrians. A 2022 NHTSA study of seven trauma centers around the U.S. found that nearly 56% of people injured or killed on roadways tested positive for one or more drugs, including alcohol. The most prevalent drug category was cannabis, and opioids made up 8.5% of cases at the trauma centers.

In this EMS Focus webinar, panelists will discuss:

Harm reduction and SUD treatment in the context of EMS care
Recent research
How innovation and intervention can drive overdose prevention in your community and reduction of other health risks, including traffic crashes that may be a result of impaired driving

REGISTER HERE

Panelists Include:

Kate Elkins, Emergency Medical Services/911 Specialist, NHTSA’s Office of EMS (moderator)
Gerard Carroll, M.D., EMS Medical Director, Cooper University Health Care; Division Head of EMS/Disaster Medicine; and Program Director, EMS Fellowship Program
John Ehrhart, Paramedic; EMS Manager, San Diego Health Connect; Co-Founder, California Paramedic Foundation; and Founder, Mission Critical Protocols
Simon Taxel, Paramedic Crew Chief and Public Safety Diver, Pittsburgh Bureau of EMS; Bloomberg Fellow, Johns Hopkins Bloomberg School of Public Health

About EMS Focus

EMS Focus provides a venue to discuss crucial initiatives, issues and challenges for EMS stakeholders and leaders nationwide. Be sure to visit ems.gov for information about upcoming webinars and to view past recordings.

We are committed to providing equal access to this webinar for all participants. Persons with disabilities in need of an accommodation should contact nhtsa.ems@dot.gov to request an accommodation no later than Friday, March 19, 2024.

Register Now: January 16 EMS Focus Webinar

Samantha Hilker — Wed, 03 Jan 2024 14:17:25 GMT

WEBINAR

Leveraging DOT Grant Funds for EMS Crash Response Improvement

Hosted by NHTSA’s Office of EMS on January 16 at 1pm ET / 10am PT

Learn how EMS Agencies are taking advantage of Department of Transportation (DOT) grant funding opportunities to improve EMS system response to roadside crashes.

NHTSA’s Office of EMS will host a discussion with Fire Chief Bruce Evans with the Upper Pine River Fire Protection District and Paul Teicher, Transportation Policy Analyst at U.S. DOT to share information and best practices to help EMS agencies nationwide prepare to apply for the upcoming Safe Streets for All (SS4A) grant program.

Panelists Include:

Gam Wijetunge, Director, NHTSA’s Office of EMS
Paul Teicher, Senior Policy Analyst, DOT - Office of the Secretary (OST)
Bruce Evans, MPA, CFO, NRP, SPO, Fire Chief, Upper Pine River Fire Protection District

Attendees will be encouraged to submit questions during any point of the discussion. The webinar and Q&A will last approximately one hour. Sign up to get email updates about this webinar series, new projects and more.

About EMS Focus

Sign up to receive the latest news from the Office of EMS, including webinars, newsletters and industry updates.

Contact Us

1200 New Jersey Avenue, SE
Washington, DC 20590
nhtsa.ems@dot.gov

2023 Election Results

Samantha Hilker — Thu, 30 Nov 2023 17:03:48 GMT

We are delighted to announce the results of the 2023 elections for the Professional Ambulance Association of Wisconsin, which transpired at the Annual Meeting on November 3, 2023. The newly elected directors are set to play pivotal roles in guiding our organization to new horizons.

Please join us in congratulating Scott Mickelson of Bell Ambulance, who has been elected as For Profit Director. Daniel Althaus of Orange Cross Ambulance will be taking on the role of Nonprofit Director, while Robert Lulling of Marquette County EMS has been elected as Government Director. Their diverse backgrounds and expertise will undoubtedly enrich our board's perspectives.

In addition to the directors, we extend our heartfelt congratulations to the elected officers who will continue to lead the association with dedication and skill. Chris Anderson of Bell Ambulance will continue to serve as President, Nick Romenesko of Gold Cross Ambulance as Vice President, Tom Tornstrom of Gundersen Ambulance as Treasurer, and Daniel Althaus of Orange Cross Ambulance will continue in the role of Secretary.

We look forward to the collaborative efforts of our newly elected directors and officers as we work together to advance the mission of the Professional Ambulance Association of Wisconsin.

New Resources @ EMS.gov

Samantha Hilker — Thu, 30 Nov 2023 16:27:47 GMT

Discover New Resources Available on EMS.gov

View the latest EMS By the Numbers - October 2023

EMS By the Numbers is provided by NHTSA in an effort to help State EMS Officials track particular EMS activations. It originated during the COVID-19 pandemic to provide current information regarding temporal variations in the type and characteristics of EMS activations In addition to Influenza-Like Illness (ILI) and COVID-19 data, it also includes trends in EMS response to Cardiac Arrest, Scene Death, Injury, Vehicle Crashes, and Opioid-Related Activations.

Access the most recent version of this document that was released in October 2023.

View EMS By the Numbers

New EMS and Fire Grant Funding Opportunities Available from USFA

USFA has released the Funding Alternatives for Emergency Medical and Fire Services, which outlines various grants and innovative funding alternatives available for EMS and fire protection services. EMS agencies are encouraged to review this document and explore the grant opportunities available for your state.

Review Grant Funding Opportunities

NIOSH Advisory on PPE Recommendations for Responding to Chemical Suicide Incidents

The National Institute for Occupational Safety and Health (NIOSH) has partnered with the leading experts from the Pennsylvania Association of Hazardous Materials Technicians to release a new Safety and Health Advisory. The Personal Protective Equipment Recommendations for Response to Chemical Suicide Incidents advisory aims to provide responders with critical guidelines on the recommended personal protective equipment (PPE) when attending to chemical suicide scenarios. This advisory can be used as a guideline to provide personal protective equipment recommendations for first responders to minimize the likelihood of exposures, injuries and fatalities during chemical suicide incidents. If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org.

Read the Advisory Here

Sign up to receive the latest news from the Office of EMS, including webinars, newsletters and industry updates.

Contact Us

1200 New Jersey Avenue, SE
Washington, DC 20590
nhtsa.ems@dot.gov

PAAW Announces 2023 Star of Life Recipients

Samantha Hilker — Mon, 28 Aug 2023 13:00:00 GMT

The Professional Ambulance Association of Wisconsin is proud to announce our 2023 Star of Life recipients. This year, 28 individuals are being recognized as a Wisconsin Star of Life.

Meet Our 2023 Stars

2023 marks our twelfth Wisconsin Stars of Life event. Creating space and opportunity to recognize those who show up for their communities, and share that celebration with their family and friends who support them, is truly a joy.

These 28 dedicated EMS Professionals will be celebrated at a dinner banquet in Madison, WI on October 10, 2023.

Governor Evers Signs SB157!

Samantha Hilker — Sun, 06 Aug 2023 02:32:40 GMT

We have some positive updates regarding the Wisconsin ambulance assessment initiative.

Over the past months, we have been working with our lobbyist to pass Senate Bill 157 and on August 4, Governor Evers signed the bill into law. This law officially allows federal funding of this program to move through the state to the providers once the Centers for Medicare & Medicaid Services (CMS) approves the initiative.

To that end, we also reached another milestone in the CMS approval process at the end of June when DHS published an official public notice describing the program. Currently PAAW is working with DHS on the next steps in the process to finalize the program design that will be submitted to CMS. Approval can take a few months depending on any questions CMS may have and if they may ask for changes in the program design. With that said, we have made important progress these last few months on getting this program in place and securing supplemental funding for our industry for years to come.

We will communicate our progress as we work closely with DHS and continue to reach these important milestones.

Medicare Ground Ambulance Data Collection System: Office Hours Session — April 27

Samantha Hilker — Mon, 17 Apr 2023 15:14:32 GMT

Dear Ground Ambulance Providers and Suppliers,

Starting January 1, 2023, ground ambulance organizations selected in Year 1 and Year 2 are required to report cost, utilization, revenue, and other information to CMS within 5 months after your data collection period ends. Organizations that fail to report may be subject to a 10% payment reduction.

Ground ambulance organizations selected in Year 3 and Year 4 will begin collecting data in 2023 and reporting data beginning in 2024.

Medicare Ground Ambulance Data Collection System: Office Hours Session — April 27

Thursday, April 27 from 2–3 pm ET

We divided the office hours session into 2 topics:

2–2:30 pm: CMS will answer live questions on the data collection requirements (such as what am I required to collect and when do I report?). This part of the session is for all selected organizations in Years 1–4.
2:30–3 pm: We’ll answer live questions about registering and requesting access to the Medicare Ground Ambulance Data Collection System portal. This part is for selected organizations in Years 1–2 who are required to report beginning in 2023.

Visit Medicare Ground Ambulance Data Collection System for:

Lists of ground ambulance organizations selected in Years 1–2 required to collect information starting in 2022 and report information starting in 2023
Organizations selected in Years 3–4 required to collect information starting in 2023 and report information starting in 2024
FAQs

CMS Opens Registration for First GAPBAC Meetings

Samantha Hilker — Fri, 14 Apr 2023 15:15:15 GMT

CMS has opened registration for the first set of meetings for the Ground Ambulance and Patient Billing Advisory Committee (GAPBAC). The meetings are scheduled for May 2 and 3. To register for the virtual meetings, please click here.

The formal notice of the meetings was posted in today’s Federal Register. To access a copy of the formal notice, please click here.

Meet our 2022 Wi Star of Life Recipients!

Samantha Hilker — Thu, 29 Sep 2022 22:19:07 GMT

Our 2022 Wi Star of Life Recipients will be recognized at a welcome reception and dinner to include an awards ceremony in Madison, WI on Wednesday, October 5, 2022.

Governor Evers signs AB874!

Samantha Hilker — Fri, 08 Apr 2022 18:08:43 GMT

Senate Passes Bill 32-0!

Samantha Hilker — Tue, 08 Mar 2022 22:43:51 GMT

PAAW Thanks Bipartisan Leaders for Supporting WI EMS

Samantha Hilker — Wed, 16 Feb 2022 18:52:21 GMT

RELEASE: First Responders Thank the Wisconsin Joint Committee on Finance for Their Support of EMS

Fri, 18 Jun 2021 00:27:33 GMT

FOR IMMEDIATE RELEASE
June 17, 2021

First Responders Thank the Wisconsin Joint Committee on Finance for Their Support of EMS

The Professional Ambulance Association of Wisconsin (PAAW) would like to thank the members of the Wisconsin Legislature’s Joint Committee on Finance for their efforts to provide a significant Medicaid rate increase to Emergency Medical Services (EMS). The PAAW board extends its deepest appreciation to Representative Amy Loudenbeck (R-Clinton), Representative Mark Born (R- Beaver Dam), Representative Tony Kurtz (R-Wonewoc), Senator Mary Felzkowski (R-Irma), Senator Howard Marklein (R- Spring Green), and Senator Jerry Petrowski (R-Marathon) for their leadership on this crucial public health and public safety issue.

To secure the increase in the Medicaid reimbursement rate for EMS in Wisconsin, the budget bill must pass both houses of the State Legislature and be signed by Governor Evers.

“Wisconsin’s EMS system is vulnerable right now,” said Chris Anderson, President of PAAW. “The reimbursement levels for mobile healthcare fall far below ambulance providers’ costs of readiness. This has suppressed wages, escalating our workforce shortage and causing delays in service. The action taken by the Joint Finance Committee this week would nearly double our reimbursement rates in 2022. This increase—if passed by the full Legislature and signed by the Governor—would represent a lifeline for our first responders.”

Anderson continued, “EMS proudly served our community with frontline emergency healthcare throughout the COVID-19 pandemic despite extraordinarily challenging circumstances. Between skyrocketing costs for PPE, supplies, and training, coupled with dwindling reimbursement, EMS cannot continue to provide care to every citizen without sustainable reimbursement. We are depending on the support of our elected officials so that your community can continue to depend on us—24/7.”

###

About the Professional Ambulance Association of Wisconsin

The Professional Ambulance Association of Wisconsin (PAAW) safeguards the future of mobile healthcare through advocacy, thought leadership, and education. PAAW advances sustainable EMS policy, empowering our members to serve communities across the state with high-quality on-demand healthcare. We proudly represent those who care for the people of Wisconsin—first. www.wiambulance.org

Sign Up for Medicaid Match Updates!

Fri, 02 Apr 2021 12:44:39 GMT

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Wisconsin EMS Providers Can Solve Our Revenue Challenges—Together

Thu, 04 Mar 2021 20:37:28 GMT

As President of the Professional Ambulance Association of Wisconsin (PAAW) and Director of Operations at Bell Ambulance, I know that our state's EMS agencies are stretched to the financial brink. I invite you to join PAAW, the American Ambulance Association, and our trusted partner Sellers Dorsey for an educational webinar to learn how we can speak with one voice in Madison to bring federal supplemental payments to EMS at NO COST to our state.

Please join us at one of the three upcoming sessions to discuss the implementation of a "Medicaid Match" program encompassing both a provider assessment for for-profit and non-profit private providers as well as a Certified Public Expenditure (CPE) or Intergovernmental Transfer (IGT) program for municipal agencies. Due to our unique arrangement with the American Ambulance Association and Sellers Dorsey, PAAW is able to offer the support of our experts for the implementation of such programs at NO UPFRONT COST and NO RISK.

Please consider registering to attend a session—the institution of these supplemental payments can only succeed with YOUR support and participation!

Register Now!

Wisconsin EMS Supplemental Payments Info Session 1

Thursday, March 11, 2021 9:00 AM CT | Zoom
Wisconsin EMS Supplemental Payments Info Session 2

Tuesday, March 30, 2021 8:00 AM CT | Zoom
Wisconsin EMS Supplemental Payments Info Session 3

Wednesday, April 07, 2021 9:00 AM CT | Zoom

UW-Madison COVID-19 Healthcare Study

Tue, 10 Nov 2020 19:54:56 GMT

Are you an EMT, paramedic, or other EMS professional? You may be eligible for a University of Wisconsin-Madison study looking to prevent transmission of COVID-19 in healthcare workers. Compensation may be available for participants. Contact shield@medicine.wisc.edu for more information, or visit https://shield.medicine.wisc.edu.

Press Release: Ambulance Providers Denied State Assistance

Wed, 02 Sep 2020 15:24:26 GMT

FOR IMMEDIATE RELEASE
SEPTEMBER 2, 2020
CONTACT: Chris Anderson, 414-349-3732 / canderson@264bell.com

AMBULANCE PROVIDERS DENIED STATE ASSISTANCE

Paramedics and EMTs on the front lines of the fight against COVID-19 were denied access to $100 million in federal CARES funding which was designated by Governor Evers for EMS and long-term health care providers which incurred significant unreimbursed costs related to the pandemic.

“We’re at a complete loss as to why EMS is always passed-over by State officials,” said Chris Anderson, President of the Professional Ambulance Association of Wisconsin (PAAW). “New personal protective equipment (PPE) and decontamination protocols have added over $35 in supply costs per response yet most of us received zero from Wisconsin’s CARES Act funding. We cannot sustain current service levels without immediate assistance.”

EMS services were initially eligible for assistance from the State as part of Wisconsin’s nearly $2 billion allocation from the Federal CARES Act. As the Department of Health Services developed the rules, support for local EMS providers was all but eliminated. “The largest ambulance service in Wisconsin received no state assistance despite expending over $300,000 on additional PPE,” said Anderson. “We saw huge corporations getting CARES Act aid while the people on the front lines took another slap to the face. I cannot overstate the vulnerability of Wisconsin’s EMS infrastructure right now, even as we head into flu season and a possible COVID-19 resurgence in the Fall.”

EMS services were already in dire need. On average, Wisconsin Medicaid reimburses ambulance services significantly less than the average of four surrounding states (IL, IA, MN, MI) as well as much less than the already low average Medicare reimbursement. “EMS needs permanent help right now to stabilize the system,” said Anderson. “We lose money on every Medicaid transport—the mobile healthcare that serves some of the most at-risk populations in our State. We have already seen one ambulance service discontinue participation in the city of Milwaukee's 911 system due to the abysmal Medicaid reimbursement rates. This cannot continue or citizens will not get lifesaving care when it is needed the most.”

“EMS is proud to answer the call to care for our neighbors in need, day or night,” stressed Anderson. “We are essential to the pandemic response and risking our lives to help others.”

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About the Professional Ambulance Association of Wisconsin

Rest In Peace, Patrick Ryan

Tue, 12 May 2020 22:17:00 GMT

It is with very heavy hearts that the board of the Professional Ambulance Association of Wisconsin shares the passing of Patrick Ryan of Ryan Brothers Ambulance Service. Patrick was a true family man, a trusted EMS leader, and a pillar of the Madison community. His unmatched kindness, insight, and dedication will never be forgotten. Rest in peace, Patrick. We will remember and miss you always. [A virtual memorial service will be held for Patrick on Tuesday, May 19. Details are available from the Ryan Funeral Home.]

Mental Health Resources for EMS

Tue, 05 May 2020 12:50:35 GMT

Mental Health for First Responders

Please visit the Code Green Campaign website for a state-by-state list of behavioral health resources.
Safe Call Now (staffed by first responders) – 1-206-459-3020. Assists with mental health, substance abuse, and related issues.
Share The Load (National Volunteer Fire Council) – 1-888-731-3473
National Suicide Prevention Lifeline – 1-800-273-8255 or via online chat
SAMHSA’s National Helpline – 1-800-662-4357 A confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.
Crisis Mode: Building Resilience During COVID-19 – Simple and practical suggestions that people can use to cope while in crisis mode.
Crisis Mode: Strategies for Leaders and Management – Offers suggestions for leaders to facilitate actionable steps to help their team cope during a crisis.

Alcohol Abuse

NIAAA Alcohol Treatment NavigatorSM
SAMHSA’s National Helpline – 1-800-662-4357 A confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.
SMARTrecovery – Mutual support meetings are free and open to anyone
seeking science-based, self-empowered addiction recovery.
Alcoholics Anonymous – An international fellowship of men and women who have had a drinking problem. It is nonprofessional, self-supporting, multiracial, apolitical, and available almost everywhere. There are no age or education requirements. Membership is open to anyone who wants to do something about his or her drinking problem.

Drug Abuse

Personal Finance & Debt

Consumer Credit Counseling – Consumer credit counseling service agencies are Internal Revenue Service 501(c)93) nonprofit organizations that will help you find a workable solution to financial problems. Each CCCS agency offers a common set of services, including financial education, budgeting assistance, and Debt Management Plans.

For Veterans

Many EMS providers have also served in the military.

PTSD Foundation of American Warrior Groups – Warrior Groups are fellowships for combat veterans and their families to share their experiences, testimonies of healing, compassion and hope in overcoming the invisible wounds of war.
VA National Center for PTSD

Advocacy Action! Support EMS During COVID-19

Thu, 16 Apr 2020 17:06:31 GMT

Yesterday, PAAW President Chris Anderson, WEMSA Executive Director Marc Cohen, PFFW Board Member Jerry Biggart, and WSFCA President Timothy Bantes held a joint press conference to ask for legislative and regulatory support of mobile healthcare in our state.

As ambulance providers face skyrocketing PPE and labor costs, Paramedics and EMTs face daily the dangers of the pandemic in the field. As yet, the State of Wisconsin has not provided ANY dedicated COVID-19 aid for emergency responders. Ambulance providers have also not received a Medicaid rate increase since 2008—when rates were increased just 1%.

Ambulance services deserve the support of all Wisconsin residents. Contact your legislators in support of sustainable EMS funding during the COVID-19 pandemic and beyond!

Congratulations, Will Pearson, 2020 Wisconsin Star of Life!

Tue, 10 Mar 2020 14:22:26 GMT

Will Pearson
Calumet County Sheriff's Office
2020 Wisconsin Star of Life

Deputy Will Pearson was born and raised on the southside of Chicago, and moved to Wisconsin when he was 15 years old. He attended Menasha High School for his Sophomore and Junior years and Seymour High School for his Senior Year. After High School, Will went to Fox Valley Technical College for Criminal Justice. While finishing school, he worked as a Community Service Officer for the City of Appleton and as a part-time Police Officer for the City of Seymour.

In 2009, Will graduated and took a full-time patrol position for the City of Seymour. Then, in 2011, he took a full-time position for the Calumet County Sheriff’s Office, where he is currently employed. Throughout his career Will has had the opportunity to hold many specialized positions in his department, and currently he is a patrol assigned K9 handler as well a member of the SWAT team.

Deputy Will Pearson is being nominated as a 2020 Star of Life for his life-saving response to a patient who had fallen and sustained a serious injury to her upper left extremity. Due to the fall, the patient had fractured and dislocated her left elbow and suffered transection of the left brachial artery, jeopardizing the main blood supply to the distal left arm. Deputy Pearson arrived on the scene and utilized his medical knowledge to promptly apply a tourniquet above the area of bleeding. Without his intervention, the patient could have bled to death or suffered the loss of her upper extremity. His quick thinking and jump to action allowed the patient to be transferred to the trauma center in time for her vessel to be repaired and her elbow properly relocated. While Will is not a medic, he was able to help save a life with his prompt medical intervention.

Will and his wife Trista have been married for nine years and they have three children, Joshua, Rylee, and Isabella. Their family currently resides in the Sherwood, WI area. When he is not working, Will enjoys hunting and finishing with family and friends. We are so proud of Will and honored to nominate him as a 2020 Wisconsin Star of Life!

Congratulations, Larry Haas, 2020 Wisconsin Star of Life!

Thu, 05 Mar 2020 18:43:49 GMT

Larry Haas
Mayo Clinic Ambulance Service
2020 Wisconsin Star of Life

Larry Haas is employed by Osseo Automotive in Osseo, Wisconsin and has been servicing Mayo Clinic’s fleet of ambulances since 2003.
While we greatly value the work of our patient care providers, we also realize that someone must keep the wheels turning, literally, on our fleet in order for us to deliver quality patient care. Larry shares in the Mayo Clinic primary value that the needs of the patient come first, and he plays an essential role in delivering positive patient outcomes.

Larry was born in the Town of Allen in Eau Claire County and started working in automotive repair at the age of 14, following in his father's footsteps. Larry began working at Osseo Automotive in 1992 and is certified by both Ford Motor Company and General Motors. He is known for his positive attitude, attention to detail and for demonstrating deep passion for the work he performs. Larry goes above and beyond to help whenever needed. Larry is known to his colleagues as the "ultimate team player" and is viewed as someone who makes the people he is working with better.

Larry and his wife, Sandy, have six children and 11 grandchildren, and reside in Augusta, WI, where Larry is also a member of the Augusta Lions Club. When Larry is not helping family and friends he enjoys four-wheeling, hunting, camping, and fishing. Mayo Clinic Ambulance Service and Osseo Automotive are proud to have Larry represent us as a 2020 Wisconsin Star of Life!

Congratulations, Mel Jorgenson, 2020 Wisconsin Star of Life!

Thu, 20 Feb 2020 17:17:27 GMT

Mel Jorgenson
HealthPartners Medical Transportation
2020 Wisconsin Star of Life

Community has always been something near and dear to Mel Jorgenson’s heart. At her rural EMS department, she has helped develop numerous outreach programs and events that have made a tremendous positive impact on her community and the county as a whole. These programs include First Aid Instruction, Car Seat Safety, Geriatric Falls Prevention, and a free Community Safety Day that educates over 300 children and families on safety and awareness.

When the time comes and the tones drop, Mel always drops everything to help those in need. She brings with her a sense of calmness, and when she arrives on the scene everyone feels a sense of relief. On one call Mel responded to for a pulseless non-breather (PNB) adult male, there was a large amount of family present when the ambulance arrived. The responding staff were new to the service, making this the first resuscitation they had ever worked. Mel arrived on scene and immediately took charge of the incident. When you hear "take charge" people typically think of someone running the show and telling people what to do, but that's not how Mel takes charge. She is an educator at heart and that's exactly what she does in the field. She was able to coach the staff through the situation, answer their questions, and explain the importance of what they were doing. She then educated the family on what was happening and what to expect next. Ultimately, Mel was calm amid the chaos of a very serious emergency, which resulted in a save. Mel's not your average medical provider, she is someone that goes above and beyond each and every day, making those around her better. We are honored to nominate Mel as a 2020 Wisconsin Star of Life!

Congratulations, Steve Woodstock, 2020 Wisconsin Star of Life!

Wed, 19 Feb 2020 21:34:41 GMT

Steve Woodstock
Baraboo District Ambulance Service
2020 Wisconsin Star of Life

Steve Woodstock has worked for Baraboo Ambulance for three years. In his time with the service, he has worked to implement an inventory management system, taught at our training center, and ran many 911 and critical care transfers. Steve is an excellent Paramedic and patients have commented on the compassionate care they received while in his care.

Steve is an Acting Lieutenant on his shift. He is the kind of person that every service would love to have working for them. If he sees something that needs to be done, he always steps up and takes on the responsibility of getting it done.

Our training center is capable of teaching EMR, EMT, and AEMT courses, and Steve has been involved in instructing at all these levels. He is an excellent instructor that students respect and like. He looks forward to the future of our service, which is rapidly excelling and growing to reach its fullest potential. Steve has also received the Employee of the Year Award from Baraboo District Ambulance Service for his exemplary performance of duties. We are proud to nominate Steve as a 2020 Wisconsin Star of Life!

Congratulations, Rachel Willer, 2020 Wisconsin Star of Life!

Wed, 19 Feb 2020 21:22:57 GMT

Rachel Willer
Baraboo District Ambulance Service
2020 Wisconsin Star of Life

Rachel Willer has worked part-time for Baraboo District Ambulance as a billing coder for the past three years. She truly enjoys working for the district and takes pride in being part of such a dedicated service. She has a Communication Degree with an emphasis in Public Relations, and she loves to write. Her writing skills have proved invaluable and have helped Baraboo EMS secure the Assistance to Firefighter Grant, providing a fully funded bariatric ambulance to the service. Rachel received the Chief’s Award for her ability to rewrite our grant application so that it was finally accepted. Her writing and creative skills are also being utilized to update the ambulance service’s new social media page. When she is not at work, Rachel enjoys spending time with her husband, Mark, and her three children, Tilly, Max and Gus. We are so grateful to have Rachel as a part of our team and are happy to nominate her as a 2020 Wisconsin Star of Life!

Congratulations, Wendall Bare, 2020 Wisconsin Star of Life!

Wed, 19 Feb 2020 20:18:39 GMT

Wendall Bare
Ryan Brothers Ambulance
2020 Wisconsin Star of Life

Wendall Bare has been an Advanced EMT with Ryan Brothers Ambulance since June of 2009 and he will be retiring from EMS this summer to be able to spend more time with his family and grandchildren. His family moved to Portage, WI in 1993, where he joined the local EMS service, Paske Ambulance Service, which overtime became Divine Savior Hospital EMS. After passing his EMT-I class 11 years ago, he began working for Ryan Brothers Ambulance. Wendall says that working in EMS has been very challenging, but also very rewarding. He has enjoyed watching the industry grow and change in so many ways over the last 34 years. Wendall has given a lifetime of service to his community and he has been an instrumental part of the Ryan Brothers Fleet Maintenance and Fleet team. He has initiated a Cot Maintenance Program and has created important training videos for employee training. To help keep his fellow employees healthy, Wendall implemented the use of ultra violet light units for ambulances and crew quarters.

The first encounter that sparked Wendall’s interest in EMS was while he was a member of the Mt. Pleasant, Iowa Volunteer Fire Dept. He was called to a major accident with multiple people injured. Being strictly on the fire side, he felt helpless on scene and wanted to be able to do more. Soon after, his volunteer department offered an EMS Basic class, and he signed up right away. At the time, Wendall was married with 3 boys and figured at a minimum, the knowledge he would obtain would help with all the bumps, scrapes, and injuries his boys were seeming to acquire daily. He also had experience in being in stressful and dangerous situations because he served as a Combat Life Saver during the first Desert Storm. He always has a smile on his face and is ready to help with any task that is needed to make Ryan Brothers a better place. He will truly be missed upon his retirement. Congratulations Wendall, a 2020 Wisconsin Star of Life!

Congratulations, Cody Letson, 2020 Wisconsin Star of Life!

Wed, 19 Feb 2020 19:39:19 GMT

Cody Letson
Ryan Brothers Ambulance
2020 Wisconsin Star of Life

Cody Letson was born and raised in Milton, WI and now lives there with his wife and two kids. He attended school at UW Madison and shortly after graduating with a degree in Biology, attended Paramedic school at Madison Area Technical College. Cody spends much of his free time with his wife Kristina and his kids, Cade and Elly. Together, they enjoy doing things outside, playing sports, and fishing. Cody is also very close with his extended family and spends a lot of time hunting and fishing with his brothers. He also enjoys working with his hands doing woodworking and home renovation projects for my family and friends.

Cody initially became interested in EMS through his brother Chase, who works full time as a Firefighter and Medic for a local department. Cody then started at Ryan Brothers Ambulance as and EMT-Basic while he was college, and through a sponsorship within the company, he was able to become a Paramedic. He now works as the Quality Assurance Coordinator at Ryan Brothers Ambulance and enjoys the challenges that come with this position. He is a valuable leader and is responsible for the Formal QA process and call reviews. In addition to being a full-time Paramedic, he has also held lead roles in several areas of Ryan Brothers Ambulance operations in his eight years of service, including Safety, 911 Training, and Onboarding Evaluation. Cody enjoys that being a Paramedic has given him an opportunity to meet, help, and work with some amazing people, and gives him the ability to make a difference in his community. He is highly respected by his peers and consistently shows compassion for all people he comes into contact with; patients, customers, and co-workers. EMS is a fast-paced career that is continually evolving, and Cody is looking forward to what EMS has in store for him. We are proud of Cody and excited to nominate him as a 2020 Wisconsin Star of Life!

Congratulations, Jessica Seefeld, 2020 Wisconsin Star of Life!

Wed, 19 Feb 2020 17:14:39 GMT

Jessica Seefeld
Baraboo District Ambulance Service
2020 Wisconsin Star of Life

Jessica Seefeld joined Baraboo District Ambulance Service in 2014 and has also served Colby Ambulance Service, the Spencer Area Ambulance Service & Fire Department, and Spirit Medical Transport. She also worked as an adjunct instructor for MSTC after her graduation.

Jessica enjoys the various tasks you must perform as a Critical Care Paramedic. She says that no two days are the same and serving the citizens that live in the response area of Baraboo District Ambulance Service is exciting and humbling. Being a Paramedic exposes you to diverse and unexpected situations that challenge your problem solving skills. Her actions consistently make a positive impact during calls that are often a very trying time in a patient’s life. For example, Jessica was recently involved in a call for assistance by a homeless veteran who was living in his truck. After taking care of the patient, she took additional time getting him in touch with the Veteran’s Crisis Center who then helped him with his medical care and finding a place to live. This is one of the many instances that Jessica has gone above and beyond to help a person in need.

Jessica has a special connection with veterans and she currently serves in the Wisconsin Nation Guard as a Sergeant. Jessica returned last year from a deployment in the Middle East as part of operations Enduring Freedom, Spartan Shield, and Inherent Resolve.

Jessica is an Acting Lieutenant with Baraboo Ambulance and is in charge of the Billing Department. In the past she has received the Chief’s Award for Outstanding Service and the Employee of the Year Award.

Jessica is currently enrolled in college, working on her Bachelor of Science Degree in Emergency Management, where she is sustaining a GPA of 4.0. She was also selected to the Alpha Chi National Honor Society and the National Society of Collegiate Scholars. Jessica is married to Command Sergeant Major Micheal Seefeld.

We are proud to honor Jessica as a 2020 Wisconsin Star of Life!

Congratulations, Brian Pekarske, 2020 Wisconsin Star of Life!

Wed, 19 Feb 2020 15:51:48 GMT

Brian Pekarske
Paratech Ambulance
2020 Wisconsin Star of Life

Brian Perkarske began his career in EMS back in 2008 as an EMT. Since then he has served as a Paramedic, Critical Care Paramedic, and Operations Supervisor. Additionally, Brain is a graduate of the UW Milwaukee Community Paramedic Program.

Recently while responding to a Motor Vehicle Crash (MVC), Brian’s squad was involved in a significant MVC of its own. Footage of the incident shows another vehicle run a red light and striking Brain’s squad. Without hesitation or evaluation of his own well-being, Brian rushed to the vehicle that had struck his squad to provide aid. Brian’s selfless, heroic actions in this response is just one exemplary example of why he is a Star of life.

Brian is a US Army Veteran; he served two tours in Iraq with the 101st Airborne Division. Outside of EMS Brian is a simple guy who enjoys spending time with his wife and daughter who loves pineapple on his pizza. He does not have any dogs or cats, instead he has several pet rodents!

Paratech Ambulance is proud have Brian as a part of our team and are honored to nominate him as a 2020 Wisconsin Star of Life!

Congratulations, Kim Reimer, 2020 Wisconsin Star of Life!

Wed, 19 Feb 2020 15:39:53 GMT

Kim Reimer
Meda Care Ambulance
2020 Wisconsin Star of Life

Kim Reimer joined Meda Care Ambulance as an EMT in 2018 and received a promotion to Divisional Supervisor in March of 2019. Her attitude, compassion and commitment to providing the very best patient care is unmatched. Kim quickly earned the respect of her colleagues, leading by example and always putting an emphasis on teamwork and making a difference on every call.

Kim grew up in Milwaukee and is passionate about her family, faith, and any outdoor activity. She has two biological children and one adopted son. When she is not with her family or on a hike, she is probably running a call with her local volunteer fire department.

Meda Care Ambulance is proud to have Kim on our team and call her a 2020 Star of Life!

Congratulations, Noelle Gross, 2020 Wisconsin Star of Life!

Wed, 19 Feb 2020 15:29:14 GMT

Noelle Gross
Bell Ambulance, Inc
2020 Wisconsin Star of Life

Noelle Gross has been serving Bell Ambulance for four years. While this is not necessarily a lot of time, her impact on the company has been extraordinary. She started as a shy EMT-Basic, however by 2017 she had received her Paramedic certification, and dove head-first into her new role. She quickly became a knowledgeable and aggressive Paramedic. It didn’t take long for her to venture into Critical Care, and in 2018, she attended the UMBC Critical Care Program.

Noelle shows a true passion for EMS and now, as a field training officer, she is sharing everything she has learned. Noelle breathes a breath of fresh air into the company every day, bringing an energetic attitude and a fun disposition.

Just this past December, Noelle responded to a healthcare facility for a patient complaining of weakness and increased edema. When she arrived, she found the male patient very lethargic and unable to speak. During the assessment of the patient, she discovered that he was suffering from hypotension and a heartrate of only 34 bpm. Noelle and her partner swiftly placed pacer pads on the patient and set the heartrate at 70. With that, the patient became more alert, and his blood pressure stabilized. Noelle and her partner administered analgesics to help the patient tolerate the pacer, and they successfully delivered him to the ER. This is just one of many examples of her excellent care in the field.

Noelle lives with her boyfriend Josh in West Allis. Noelle is also a Paramedic with the Thiensville Fire Department and spends most of her days off playing doggy-mom to her Blue Tick Coonhound and her German Shepard. We are grateful to have Noelle as part of our team and are happy to nominate her as a 2020 Wisconsin Star of Life!

Congratulations, Ashleigh Sagat, 2020 Wisconsin Star of Life!

Wed, 19 Feb 2020 15:12:11 GMT

Ashleigh Sagat
Bell Ambulance, Inc
2020 Wisconsin Star of Life

Ashleigh Sagat has worked for Bell Ambulance since August of 2015. Ashleigh has spent the majority of her career with Bell Ambulance as an EMT Field Training Officer. Ashleigh shows a true passion for Emergency Medical Services daily through the compassion and empathy she has for her patients. In 2019 Ashleigh was promoted to EMT Supervisor. Aside from patient care, you will be hard pressed to find someone who cares more for employee morale and the overall wellness of their coworkers than Ashleigh. She does what she can to make sure they have the knowledge and training needed to succeed. With Ashleigh, whether people new or veteran, everyone is welcome and an important part of the team.

Ashleigh is a lover of dogs, and currently has two little Yorkie pups at home. She was a big softball Player throughout college and she is even in the Alverno College Hall of Fame for her performance.

There is no doubt EMS is more than a job to Ashleigh, it is a calling. Ashleigh makes us proud every day and we are lucky to have her as part of the Bell Ambulance team and nominate her as a 2020 Star of Life.

Congratulations, Dawn Swanson, 2020 Wisconsin Star of Life!

Wed, 19 Feb 2020 15:00:34 GMT

Dawn Swanson
Gundersen Tri-State Ambulance
2020 Wisconsin Star of Life

Dawn Swanson began her career in EMS seven and a half years ago when she decided to go from owning her own beauty salon to a working full time as an EMT at Tri-State Ambulance. Looking for something more challenging and a way to help a wider variety of people, she spent two years as an EMT before going back to school to become a Paramedic in 2014. After proving herself as an effective medic, she moved on to become a Preceptor and Field Training Officer, training EMT and Paramedic students and new employees. After four years of exemplary performance in these endeavors, Dawn is now a leader in the field as a Corporal, leading the coordination of retention and recruitment efforts, scheduling employees, and working directly with management to provide top quality patient care and service to the community.

Dawn truly enjoys teaching and leading the EMTs and Paramedics at Tri-State and has received much praise from former students and trainees and her current coworkers for her patience, caring attitude, and dedication to everyone she works with. She is always willing to answer questions, sit down to review something, and take time to check in on her co-workers. She truly cares for each individual at the company and is an excellent provider. She is an outstanding example of leadership at Tri-State and has goals to continue advancing further within the organization.

When not on an ambulance, Dawn enjoys spending time with her family. Her daughter is a freshman in college and her son is a sophomore in high school and their various athletic events keep her busy. She also loves new experiences, especially traveling. We are proud to nominate Dawn as a 2020 Wisconsin Star of Life!

Congratulations, Rick Conway, 2020 Wisconsin Star of Life!

Tue, 18 Feb 2020 22:13:40 GMT

Rick Conway
Gundersen Tri-State Ambualnce
2020 Wisconsin Star of Life

Rick Conway currently works as a full-time dispatcher and call taker for Gundersen Health System’s Medical Communications – MedComm, where he provides lifesaving EMD pre-arrival orders to 911 callers in a five-county region and dispatches ambulances and helicopters to an even broader area. When he is not in MedComm, Rick can be found working on an ambulance or for the Onalaska Fire Department as a Firefighter and EMS Training Officer.

Rick began his career in public safety in 1977 as Firefighter in a small rural Wisconsin community. In 1984 he successfully completed EMT training and began his EMS career volunteering for multiple rural Wisconsin communities. In 1988 he moved to La Crosse and began working for Tri-State Ambulance as both an EMT and a Dispatcher. Back then, Tri-State only operated two ambulances full-time, one at the paramedic level and the other at the EMT level, with crews rotating between dispatch and ambulance duty.

One of Rick’s favorite ambulance assignments is working special events. Rick’s friendly and accommodating attitude has made him a go-to person at most of our routine special events. Just last year, our local stock car racetrack honored Rick by featuring him on their social media pages and through crowd announcements. Everyone knows Rick by name, and he represents both EMS and our organization very well.

When asked what his favorite part of working in EMS is, Rick’s responses were not at all surprising. His favorite part is caring for people in need and his second favorite part is having the opportunity to meet and interact with so many people on a daily basis, particularly at special events.

Rick currently lives in Onalaska, Wisconsin with his wife Kari and has two sons and three grandchildren who live nearby. Rick’s primary joy in life is his family and the time he spends with them whether that be at family gatherings or just a quiet night at home. We are so thankful to have Rick as a part of our team and are happy to award him as a 2020 Star of Life!

Congratulations, Nate Allen, 2020 Wisconsin Star of Life!

Tue, 18 Feb 2020 20:56:13 GMT

Nate Allen
Gundersen Tri-State Regional Ambulance
2020 Wisconsin Star of Life

Prior to his full-time work in EMS, Nate Allen spent seven years with the Wisconsin Army National Guard where he performed a wide variety of duties including heavy equipment operations and heavy vehicle operations. From 2012-2013, Nate was deployed to the Kandahar Province in Afghanistan where he was part of Operation Enduring Freedom, working as part of the Battlefield Circulation Team supplying and re-supplying the deployed platoons.

Nate has worked for many years as an EMT and AEMT and has his Associate Degrees in both Law Enforcement and in EMS as a Paramedic. Nate continues to expand his knowledge daily and remains up to date with new clinical developments and EMS related issues. Nate also gives back to the community by teaching CPR, first aid, and tourniquet training to a variety of community groups, churches, and law enforcement agencies. He is always willing to modify his schedule to accommodate community education.

Nate receives praise from his co-workers, who refer to him as “a walking textbook.” He is always willing to answer questions or explain things, especially to newer employees. He is a huge patient advocate, and he always wants to do what is best for them. Nate has some of the best patient assessment skills that his educators have observed and is extremely detailed with each and every patient. Nate’s goal is to one day become an EMS service director.

Nate was born in Lancaster, WI and is the youngest of five kids. Nate and his wife, Chasity now live in Bloomington, WI and have three children of their own, ages 12 to 3 years old. They also have seven rabbits and two cats. Nate's hobbies include Firefighting, EMS, radio programming, and spending time with his family. We thank Nate for his service and are honored to nominate him as a 2020 Wisconsin Star of Life!

Congratulations, Dr. Mark Moore, 2020 Wisconsin Star of Life!

Tue, 18 Feb 2020 20:17:04 GMT

Dr. Mark Moore
Gold Cross Ambulance
2020 Wisconsin Star of Life

Dr. F. Mark Moore was recruited by Dr. Thomas Loescher to come to Appleton, WI at the ACEP conference in San Francisco in 1972. Dr. Loescher was spearheading an effort to provide 24-hour emergency room physician coverage in the Emergency Department at St. Elizabeth Hospital and he also had plans to develop a paramedic program in Appleton.
One of the things about Dr. Moore that interested Dr. Loescher, was that he had served in Vietnam, and had seen first-hand the value of medics saving lives on the battlefield. Dr. Moore agreed to come to the Fox Valley to work in the ER, but the job also entailed helping train the first groups of paramedics outside of Madison and Milwaukee.
While Dr. Loescher took care of the administrative duties, the training of the medics was entrusted to Dr. Moore, who arrived in 1973. Dr. Moore taught the EMTs emergency medicine and supervised their clinical experiences in the emergency department. He also enlisted other Appleton physicians to teach special areas, including intubation, cardiology, obstetrics, psychiatrics, orthopedics, and pediatrics. Dr. Moore said, “We decided to train the paramedics here rather than sending them to Madison or Milwaukee so that the local physicians could be involved in the teaching; they would know what the paramedics were capable of doing and would understand how the program works. And this approach has worked. The physician community in Appleton is very supportive of the program. There was no written curriculum and no guidelines to follow. We designed and taught the equivalent of basic, intermediate and advanced paramedic skills in blocks.” Dr. Moore and other ER physicians rode along on EMS runs, provided public education, lectured at EMS conferences, and sought federal funding for equipment for the ambulances. They even made a film to be shown to the public to promote “this new EMS” to the public. He went on to say, “The paramedics are our eyes, ears, and hands in the field. They are a special breed of people.”

In 1980, Dr. Moore issued written “Protocols of the Appleton-Neenah-Waupaca Paramedic Program.” In 1981, under his direction, these same paramedics became the first EMS group outside of Madison and Milwaukee to be certified in Advanced Cardiac Life Support.

Dr. Moore truly was one of the pioneers of EMS in Wisconsin. He served for 48 years in emergency medicine before retiring in July, 2019 and now lives in Berlin, WI.We are very excited to nominate Dr. Moore as a 2020 Wisconsin Star of Life!

Nominations for Interim PAAW Board Seat - Governmental/ Municipal Category

Thu, 23 Jan 2020 14:41:28 GMT

Please nominate yourself or another person for the Professional Ambulance Association of Wisconsin's open board seat by March 1, 2020. This is an interim seat, with a term of service ending at the 2020 PAAW Annual Membership Meeting in the third quarter.

Please note that in order to nominate a candidate your organization must be a member in good standing. The person nominated (whether yourself or someone else) must be a professional member of PAAW in good standing from a Governmental (i.e., municipal, county-owned, or fire-based) service as this is the member type for which there is a board vacancy.

If you have multiple nominees, please complete and submit multiple times.

Nominations will be reviewed by the PAAW board and an appointee will be selected to fill the vacant seat.

Thank you for your ongoing support and participation.

Don't see the embedded form below? Open the nomination form in another browser window.

Create your own user feedback survey

PAAW Announces New President, Vice President

Thu, 16 Jan 2020 18:59:55 GMT

On January 15, 2020, PAAW elected a new President, Chris Anderson of Bell Ambulance. Nick Romenesko of Gold Cross was elected Vice President during the same board meeting. Tom Tornstrom continues to serve as Treasurer, and Cody Doucette continues his service as Secretary.

For the full list of PAAW board leaders, please visit the PAAW site.

Nominations will open shortly to fill the vacant Municipal/Government director seat.

The PAAW board would like to thank former President Dana Sechler for his many years of service, and wishes him well in his retirement.

Key Links from System Quality and Data Committee

Thu, 05 Dec 2019 15:32:02 GMT

Bookmark these important links from the System Quality and Data Committee of the Wisconsin EMS Board!

Pre-Hospital Hemorrhage Control: https://www.dhs.wisconsin.gov/publications/p02345.pdf

Cardiac Arrest Ambulance Runs: https://www.dhs.wisconsin.gov/publications/p02424.pdf

Pediatric Ambulance Runs: https://www.dhs.wisconsin.gov/publications/p02508.pdf

Congratulations, Jerry Biggart!

Thu, 19 Sep 2019 19:13:39 GMT

PAAW President Dana Sechler and Director Mark Fredrickson recognized PFFW Executive Member Jerry Biggart with a Partnership Award. PAAW decided to recognize Jerry for his contributions to the coalition over the past several years. PAAW, PFFW, WSFCA, and WEMSA have come together on a number of legislative initiatives in recent years, and Jerry has been there since the beginning. “I have a lot of respect for the work Jerry does, and the type of person he is. He really opened the door between fire-based and private or municipal EMS services” says Fredrickson.

Jerry was recognized during the Paramedic Systems of Wisconsin conference held in Green Bay, Wi September 18^th – 20^th. “It is always nice to be recognized for your work, and having the opportunity to work with the coalition to make an impact none of us could do alone is humbling” shared Biggart.

PAAW is dedicated to healthy and sustainable ambulance and EMS delivery in the state of Wisconsin, a tall order for one association. “We know that our collective voice is stronger than any single organization on their own, so we set our differences aside and focus on opportunities to work together” explains President Sechler. PAAW is proud to be a part of the coalition and the legislative impact they have made so far but knows there are many more hills to climb. Keep watching PAAW’s website, social media, and email for updates on what is coming next.

ET3 Update from Wisconsin DHS

Tue, 10 Sep 2019 18:47:11 GMT

The notice below was received by PAAW leadership on September 10 regarding the Emergency Triage, Treat, and Transport (ET3) Model program.

All – I have been informed that legislative changes are being introduced that will allow for services to participate in the ET3 pilot program proposed by CMMI and CMS. Wisconsin agencies interested in applying for the ET3 pilot are encouraged to do so as soon as possible due to the deadline for applications being September 19, 2019 (nine days from now). We are very much aware of the short time frame for applying and encourage you to share this news with your agency, any partner organizations, stakeholders, and membership of your representational groups. We understand the CMMI and CMS may be releasing a “round two” and “round three” opportunity in the future but have no other details on that at this time. We will be pushing out updates on the legislative initiative as we receive them.

Specific information can be found on the ET3 Model main page, the ET3 Frequently Asked Questions page and the ET3 Model Eligibility Fact Sheet. There are additional resources listed on those pages.

Mark Lockhart, NRP
EMS Section Chief, Office of Preparedness and Emergency Health Care
Wisconsin Department of Health Services
Main: 608-266-1568 | Direct: 608-261-6870

PAAW / Savvik 5.11 Back Pack Giveaway Winners!

Thu, 15 Aug 2019 14:52:02 GMT

Congratulations to the following winners of the Savvik/PAAW 5.11 Tactical Giveaway!

Colfax Rescue
Donald Knutson, Director

St. Croix Emergency Services
Joanne Kenney, Office Manager

Gundersen Tri-State Ambulance
Eric Ellis, Operations Supervisor

Learn more about how Savvik can help YOUR ambulance service save big at www.savvik.org.

PAAW Board Nominations Open!

Wed, 14 Aug 2019 21:18:43 GMT

It's time! Nominate yourself or another person for the board of the Professional Ambulance Association of Wisconsin.

Please note that in order to nominate a candidate your organization must work for an ambulance service member in good standing.

The election of board members will take place at the PAAW Annual Meeting at 9:30 am on September 13 at Divine Savior Hospital (2817 New Pinery Rd, Portage, Wisconsin 53901) in Portage. Nominations can also be submitted from the floor during the meeting.

Thank you for your ongoing support and participation.

Nominate Now►

Meet Star of Life Tim Couillard from Bell Ambulance

Tue, 16 Jul 2019 12:25:06 GMT

Tim Couillard, Critical Care Paramedic Supervisor with PAAW Member Bell Ambulance, was recently recognized at the American Ambulance Association’s 2019 Stars of Life Ceremony in Washington, D.C.

Tim, a loving husband, and father to three beautiful girls has a passion for sharing his knowledge and learning everything he can. He was chosen as the 2017 Employee of the Year at Bell, which led to his participation in the Stars event this year. When asked what Tim did to earn an employee of the year nomination, he replied, “Well…I just went to work and did my best,” which I think we can all appreciate. In talking with Tim, it is easy to recognize how much pride he takes in his work, whether it is training others or pushing himself to learn more. He earned his certification as an Emergency Medical Dispatcher in 2017, in part, so he could better understand the system he is a part of.
You can read Tim’s full Star of Life bio here.

Tim had the following to say about his experience at the Stars event:

“It was amazing. I am so honored to have been a part of an event like this, to hear everyone else’s stories and be recognized alongside so many…I’m grateful.”

I asked Tim what he will carry forward from participating in this event. Although the opportunity to spend some time traveling and sightseeing with his wife was near the top of his list of favorites, he also offered the following:

“It was cool to see what upper management is out there doing for us daily. We don’t normally get to see that. We were able to meet with lawmakers and talk about the Public Safety Officer’s Death Benefit. Honestly, I didn’t even realize it existed…but then to learn it exists and find out police officers and firefighters are covered, but we’re not because we work for a private service…that’s not right! We’re all out there working together, on the same scenes, for the same reasons and we all deserve to know our families will be taken care of should something happen.”

Tim’s advice for others in EMS?

“Remember why you got into it, and learn as much as you can about the company you work for and the industry you’re in.”

Congratulations, Tim! We’re proud to have you as part of our EMS team and look forward to the great things you’ll do for EMS in the future.

Funding Assistance Program Application Open July 1–17

PAAW Administrator — Sun, 30 Jun 2019 13:10:09 GMT

A note from Wisconsin EMS Section Chief Mark Lockhart

The Funding Assistance Program application period will open on Monday, July 1 at 12 noon and close at the end of business on Wednesday, July 17. The application and required expense report will be available in e-licensing – service directors will need to log in to complete both forms beginning on July 1. These two forms will be submitted through e-licensing during the application period. In addition, the Municipal Signature and Population Verification Page must be completed (including signatures) and uploaded as a document into the documents tab of e-licensing. Between now and July 1, we encourage you to review the FAP Grant Guidance document (especially the Getting Started section), the Frequently Asked Questions document and the FAP Purchasing Guide.

We strongly encourage you to review these documents now and get a head start on the process. Thank you!

Meet Larry Knuth of the PAAW Board!

PAAW Administrator — Wed, 01 May 2019 17:42:51 GMT

Meet Larry Knuth, PAAW Director! Larry is vice president of operations at Paratech Ambulance Service. He is proud to help move mobilehealthcare in Wisconsin forward!

Photos from Wisconsin EMS at the Capitol Day

PAAW Administrator — Mon, 22 Apr 2019 14:29:54 GMT

On April 10, more than 100 mobile healthcare professionals convened in Madison to educate legislators about key mobile healthcare topics. Don't miss photos on PAAW's Facebook page!

Meet PAAW Treasurer Tom Tornstrom

Mon, 04 Mar 2019 20:25:22 GMT

Meet Tom Tornstrom, PAAW's Treasurer since 2014. Tom leads Tri-State Ambulance, and also serves on the American Ambulance Association board.

Meet PAAW Vice President Chris Anderson!

Fri, 22 Feb 2019 14:08:48 GMT

Chris Anderson of Bell Ambulance has proudly served Wisconsin with world-class mobile healthcare for more than two decades.

Meet PAAW Director Patrick Ryan!

Fri, 15 Feb 2019 14:07:09 GMT

Patrick Ryan of Ryan Brothers Ambulance, has served Wisconsin mobile healthcare in a variety of roles over many years.

Meet PAAW President Dana Sechler!

Fri, 08 Feb 2019 13:49:33 GMT

Created by Samantha Hilker

WIIAP's Pediatric Advocacy Day is February 28

Tue, 08 Jan 2019 14:00:22 GMT

2nd Annual Wisconsin American Acadamy of Pediatrics Advocacy Day is February 28

You’re focused daily on ensuring that care for your patients is as effective as possible and that Wisconsin’s kids are as healthy as possible. WIAAP’s Pediatric Advocacy Day broadens the reach of your expertise beyond your practice and puts it into action to advocate for safer, healthier children in our state.

Join us in Madison on February 28, 2019 to:

Learn effective advocacy strategies
Hear from legislative champions about issues that affect children
Interact directly with policymakers
Share your experiences caring for children

This year’s focus is firearm safety – in response to our many members wanting to contribute their perspective with policymakers. As a physician, your messages count at the Capitol. Put that power to work with us in February!

We'll make it as easy as possible - we will schedule meetings with legislators on your behalf, provide breakfast and lunch, and give you talking points and issue briefs to help you prepare for conversations with legislators. This event is open to all, and there is no charge to attend for WIAAP members.

Learn more or register at www.2019WIAAPAdvocacyDay.Eventbrite.com

Interview with John Eich, Director of Wisconsin Office of Rural Health

Thu, 15 Nov 2018 15:38:57 GMT

In honor of today's National Rural Health Day, the American Ambulance Association interviewed John Eich, Director of the Wisconsin Office of Rural Health.

The transcript below was lightly edited for clarity.

Amanda Riordan: Thank you for joining us today. My name is Amanda Riordan, and I am the vice president of member services for the American Ambulance Association. I'm also the administrator for the Professional Ambulance Association of Wisconsin. I'm so happy to have the opportunity to interview John Eich, the director of the Wisconsin Office of Rural Health. John is an exceptional contributor to rural health in Wisconsin. He's also a sterling advocate for the power of EMS to assist with public health in the least accessible areas of Wisconsin. I'll ask John a couple of questions today about the recent Rural EMS Listening Sessions that he conducted in a number of areas across the state. John, thanks again for joining us. Would you mind telling me a little bit about your background and how you became the director of the Wisconsin Office of Rural Health?

John Eich: I appreciate your inviting me to talk about some of our programs, so thank you. I took a bit of a wandering path: I've done everything from carpentry and marketing to social work with homeless teens. I found my way to community [service] down in southern New Mexico. I caught the bug there working on behalf of the community and society at large. When I moved back home up to Wisconsin—I grew up in a rural area here in southern Wisconsin—I saw an opening and at the Office of Rural Health. I've been on board ever since, and it's a lot of fun.

Amanda Riordan: Thanks so much. And we're so glad you took the position. Would you mind sharing a little bit about why EMS is so important to rural health?

John Eich: If you're not familiar with an office of rural health, we receive mostly federal funding to work on the state level. There's an office in every state in the nation. Here in Wisconsin, we are funded mostly, I would say, to work with rural hospitals and EMS, and we find that EMS is one of the areas of greatest need. Every piece of the healthcare delivery system has its challenges and its strengths. EMS, I think by the nature of having formed itself—at least rural EMS formed itself—around the model of volunteer services. In my estimation, it has sort of painted itself into a corner. It started when medicine was not as complicated, and when populations, were not expecting as much. You were helping out your neighbors by getting somebody to a hospital. It has since evolved in a good way.

[EMS has] evolved into a healthcare profession. And so there are a lot more demands. There's a lot more education; continuing education, learning new techniques that are lifesaving. Society depends on it. But that means that these volunteer services that started off small are under increasing pressure. That's why we are trying to dedicate as many of our resources as we can to helping out that system within Wisconsin, and it's paying great dividends. We've always really enjoyed our interactions with EMS. I think it takes a particular kind of person to do it. We just really enjoy our time with those who do the work. That led us to doing what we're calling a "Rural EMS Listening Session." So we did five of these sessions around the state in rural areas, and we intend to do a few more.

Part of the idea was that so often policy in general happens in urban centers. In EMS policy, because the state capital is down in the very southern part of the state and Milwaukee, the largest city is also down in the southern part of the state, the rural areas of the state (which most of the rest of it) tend to feel ignored or unheard. It's much harder for them to participate. So if somebody has to drive five hours to go to a meeting that would take [a city resident] 15 minutes to drive to, that's a disparity in access and it's a disparity in having your voice heard. So we decided that it was important to go listening where rural EMS is practicing. So we did that, and are continuing to do so.

It's been very eye opening. Obviously there was a lot that we expected to hear that we did hear. I mean, there's, there's not a lot new here. People in EMS know what the issue is as someone said these are the same ideas we've been talking about for the last 20 years or more. And that's very true. We like to believe that it's time for things to change. We've been talking about this long enough. Maybe we should do our best to push the issues forward. And that's phase two of these listening sessions: take what we heard and get it into the hands of advocates, like the EMS associations, fire associations, et cetera, and other advocates like the Office of Rural Health that try to speak on behalf of the needs of EMS. I do think I'm optimistic that legislators want to help. When they've been presented with bills, they're interested. Money is always an issue, but I would say that they definitely want to be part of a solution. So, it's all of our jobs to make sure that they have the right solutions and presented to them.

Amanda Riordan: I think that's a great segue to one of your other very popular innovative programs in Wisconsin. The Office of Rural Health actually helped put together the EMS at the Capital Day event in 2017. Would you mind telling us a little bit more about what that entailed and the groups that participated?

John Eich: Absolutely. So again, as we work with all parts of the healthcare delivery system, we work with hospitals and clinics and providers; physicians, PAs/physician assistants, nurse practitioners, the nurses that staff the hospitals and clinics and home health services. When we look at EMS, it always strikes me how it has a level of splintering that I don't see in other professions. In other professions, they've managed to sort of circle the wagons and get on the same page and present a united face to push forward their vision and their legislative goals. EMS, for whatever reason. I'm not sure why it seems to have done the work but also, identified a number of differences. You can be a paid or career staffer versus a volunteer. You can work in a rural service versus an urban. You can be in fire versus EMS. You could be a Paramedic or you could be a Basic EMT or an Emergency Medical Responder. Each of those areas, each of those groups, sort of huddle and identify amongst themselves. I would like to see them working more cohesively together and I'm sure they would as well.

The effort that that led to an EMS Day at the Capital was to try and get all of the disparate groups together and on the same page. All of them had been working very diligently on the issues that were important to them, and I think there is a lot of overlap. As one of the participants said, "We can agree on a 80 percent of the issues, we may disagree about the 20 percent, but let's work on the 80 percent and when we get that done, then we can disagree about the rest of them."

So that was the goal that brought the groups together. So we were lucky to be able to get the two EMS associations in the state, the state fire chiefs, and the professional firefighters. The state EMS board joined in with us as well as they could, in more of a listening capacity. We created a wish list of legislative issues and a lot of it was centered around education: who we are and what we do. And we took that to the state capital. We had tremendous turnout and we had uniforms marching through the, through the offices of the legislature both in the Assembly and the Senate. I like to think we got their attention and we plan to, as I said, take what we're learning from this rural EMS tour, connect with our urban allies as well, and get EMS advocacy on the same page so that they can do tremendous work together.

Amanda Riordan: It was truly exciting and a privilege to witness everything that happened in November 2017 when the Professional Ambulance Association of Wisconsin, Wisconsin State Fire Chiefs Association, the Professional Firefighters of Wisconsin, and the Wisconsin EMS Association, all came together with the help of your office, the Office of Rural Health, to speak with one voice when meeting with state legislators. I think that by working together they were able to present such an incredibly compelling message to legislators and to key staff that worked with legislators. I think a lot of times people are somewhat unaware that winning over the hearts and minds of critical legislative staff is almost as important as running to over the hearts and minds of legislators themselves.

With that in mind, and with all of the successes you've had helping execute your vision of moving EMS and rural health forward in Wisconsin, would you mind telling us a little bit about where you see the future of rural health going in your state, Wisconsin, as well as the country in general?

John Eich: I take it you mean in EMS terms. Because there's a lot going on in healthcare, as you know! As far as EMS goes, I think the future of EMS care is not a wholly volunteer model. I think it is at least a hybrid model, and I think the industry needs to figure out how to make that transition. I think that's going to be a difficult and painful transition. I think it's going to take a lot of education to the local politicians who are used to having their services and frankly to be getting a pretty good deal.

We talked recently to a small community. It was a countywide meeting, but it was held in a small community that had been [served by] a volunteer service. They said they had a core group of about five people. The chief of the service had had volunteered 4,280 hours last year. The rest of his staff [had volunteered] around the 3000-hour level. They were proud of that, understandably. They were also somewhat reluctant to consider another model in their mind. They felt that they were just fine. When I look at that from the outside, I think, "What if one of you tears an ACL as you're getting off the ambulance rig, what if two of you get the flu really bad? Which happens!" [What happens if] then there are two calls for EMS, at the same time, while two of your staff are bedridden. That's three people to make all those calls. I struggle with the vision of that is as sustainable.

But when the local community looked at the numbers, they said, well, it looks like as far as the taxes go, that's about $12 per capita. I was a little horrified, and asked "is that per year?" And they said, "Oh yeah, yeah, that's per year." I was struck by the fact that I pay more for Netflix per month than these folks pay per year to have two highly trained individuals show up with the latest technology to save the lives of their loved ones. I'm not criticizing that, but I do think there's an opportunity there to really examine that in the daylight. And certainly when the board realized that and looked at it, there was a lot of sort of a flurry of questions back and forth. And is this true? On and on.

I think the nature [of the matter is that] if you can possibly put the question to a citizen in a grocery store as they're walking out with their groceries, "How much would you pay per year in your taxes to have this kind of lifesaving service?" I don't think the answer would be $12 a year. I think it would be more, but I don't think most citizens or politicians have been given the opportunity to really look at. I think they assume it's already paid for. It's part of their taxes. I think they assume that Paramedics just show up at their door. They don't necessarily know the difference between a Paramedic and a Basic EMT or EMR. They have a great deal of faith and trust in these people, as they should. I think they're just not aware—they're not aware of the challenges and the lack of funding and the way the system is sort of precariously balanced on top of volunteer hours to an incredible amount. I think the future in my mind, if you look at the data and volunteerism trending down, it's trending down across all sectors, but that is hitting EMS very hard.

If you look at staffing, we're seeing with low unemployment that means that it's harder and harder to fill positions. That especially happens in rural areas. People are moving to urban areas for jobs. There's not as many people there. If they do still live in the rural area, they tend to work in a neighboring larger town or other towns, so it's harder for them to volunteer. So I just think the data is pretty clear where we're headed. We just culturally have to try and do some heavy lifting and change the perceptions of what a society should pay for. As Dana Sechler from the Professional Ambulance Association of Wisconsin often says, we pay for garbage collection at $138, the median per capita cost per year. Like I said, some [areas are paying just] $12 per year for EMS. Garbage is very important. I don't mean to dismiss it, but I think we can do better for lifesavers. I see that as the primary issue.

Garbage is very important. I don't mean to dismiss it, but I think we can do better for lifesavers. I see that as kind of the primary issue. I think another issue is certainly something we're hearing that is in rural areas, you have a lot of Emergency Medical Responders (EMRs). They're taking a class that is 80 hours [in duration] because they want to help their neighbors. They're not transporting— they are showing up to be of help. But they're taking the National Registry tests in Wisconsin, and the National Registry tests, for a lot of good reasons, is lifting the industry into a level of professionalism and knowledge that is important and necessary. But I think that certainly what we heard is that an EMR is sort of an entry level to this.

So how can we figure out a way to lower the barriers to participation, without lowering the standards of care? That's something we need to look at. And I think frankly, as a nation, we need to look at that and have that conversation with the National Registry. I think they're doing the work that they do, and, and in a lot of ways it's good work, but I think they need to have feedback from their customers and all of us states are their customers. All of us need to maintain a dialogue with them and say, this is what we need. We may need critical thinking in our clinicians, but do we need it in our technicians? Do we need it in our EMRs? [For EMRs] do we need sort of tricky questions that two of them are correct and you have to sort of guess which correct answer you wanted to give? I think it's that sort of stuff that demoralizes local people who may not be eager to take a test in the first place and are a little put off by a computerized test in the second place. Then if they don't pass, they go right back home to their church, their gas station, and their bar and tell everybody how this impossible test is not worth their time. I'm not against the National Registry tests, but I do think that we need to have more conversation about it and we need to find ways to lower the barriers and maybe that's preparing EMRs in a different way.

I've got a daughter who is preparing for the ACT [college entrance test], and she's learning the tips and tricks. She's in a class just to help her take that test, and a lot of it's not even about the content. Maybe since the National Registry is modeled on these other types of tests we need to train more on not necessarily the skill levels of how to save someone's life, but how to take a test, which seems a little weird. But if that is our standard, then we need to make sure that our people are prepared when they walk into that room.

Amanda Riordan: That makes a lot of sense. Certainly we hear feedback in both directions from a variety of different stakeholders regarding the increasing professionalization of EMS. On one end, of course, we want to honor and maintain the contributions of those mission critical volunteer providers, particularly in rural areas, and on the other hand we have the push-pull of a Paramedic, in particular, looking for additional certifications and additional recognition of mobile health care as a profession. All of that mixed together with a flat or diminishing reimbursement makes sustaining a mobile healthcare/EMS in all areas really challenging. But of course as you so aptly pointed out, it especially impactful areas of our country and in a state like Wisconsin where you have so much land mass that is in rural areas. [These issues] particularly impact states of that nature is as they look forward to an aging population and the movement of younger people into urban areas. So truly appreciate those insights and those suggestions. And it's certainly something that I'm sure there will be continued dialogue about for years to come.

John Eich: And I would like to say that I see a real difference between a Paramedic—or in Wisconsin, we also have the Advanced EMT classification—where we are expecting them to have a body of knowledge and to be healthcare clinicians, to be making life or death decisions in the field. Absolutely. Everyone in society wants those people to be the best-trained, the most knowledgeable, at the top of their game. And the tests should reflect that. I do think that if we have someone who is a firefighter who's driving out to a site to assist, that's not the same as a Paramedic and I'm not saying that they shouldn't be trained and there shouldn't be a gates for them to go through. We need to be sure that they are trained to the best of their scope and to the best of their ability. But I think it's a different level of care is a different kind of professionalism. So I think we just need to really make sure that we're doing a service to the rural areas where they are scraping together five people to cover a very large area and they just don't have time for the level of nuance that you will often see in an urban, metro area where you've got, um, you've got enough staff to cover these sort of things,

Amanda Riordan: Makes complete sense and certainly something that we know so many communities are wrestling with right now. I thank you for bringing it to everyone's attention. I think that we will get some lively dialogue in the comments when we get this posted about, as you pointed out, the diminishing volunteerism as well as the other pressures facing most mobile healthcare these days. Before we wrap up here, would you mind giving us some tips or thoughts about how EMS providers, mobile healthcare providers, in Wisconsin can work best with your office? Or if you have any generalized tips about how ambulance services and fire departments across the country can best work with the Offices of Rural Health in their state, we would be very grateful. Clearly you are moving and shaking in Wisconsin and we'd love to see that ripple out to other states.

John Eich: Absolutely. So, I have counterparts in every state and they're all doing great work when it comes to rural health and rural EMS. If someone in any state simply goes to Google and, enters their state name and "office of rural health," they'll get right to them. I think there is a difference between Offices of Rural Health. Many of us are in state government, and so what you experienced there is common of state government—It's a more bureaucratic system. The websites tend to be a little bit trickier to find the information because there's obviously a lot going on there and some political considerations. We [here in Wisconsin] are university-based. There's about 12 of those around the nation, and three that are nonprofit, so, even leaner and more flexible. So every [office] will look differently.

I do think that EMS should reach out to their Offices of Rural Health to let them know about their needs, because when we look at metrics for healthcare and for population health, we see the metrics getting worse. It's almost like a horseshoe in that they get worse the more rural and remote you are. Suburban areas have the lowest need, and then the inner city tends to be equally challenging. We share a lot of population health issues with inner cities. The difference I think is really transportation. We're farther away. And if you don't have a car, you're really isolated and stuck, so EMS is mission critical.

If you think about that first hour of care being so important to outcomes, [if sick or injured in a rural area] your first half hour could be without care as people are getting to you and you're trying to find a cell signal to actually call 911. Once they arrive, your rural EMS providers are the people that are giving you that care. So it is vitally important that those people have the resources to do their job the best that they can.

Please reach out to express your needs. One of the things we've been talking about based on this Rural Listening Tour and talking with our state EMS office and the associations just yesterday is the idea of some kind of helpline; Somebody to answer the call when a service is identifying that they are really struggling, because [rural services] are a little nervous about calling the state and saying, "Hey, guess what? Things are really rough here. You might want to shut us down." Nobody wants that. The state EMS office is very clear that it's not in anybody's best interest to remove care and burden neighboring services. So getting a helpline with a number of resources and even someone that can drive out and sit across the table and talk through some issues and get some advice would be very helpful for some of these services that are really struggling. Those are some ways that I think folks can get involved, and I'm always interested in hearing more.

Amanda Riordan: John, thank you so very much for your time and insights today. It has been an absolute pleasure talking to you and I'm sure that we'll be hearing a lot more from the Office of Rural Health, you, and your staff in the years to come. So again, we truly appreciate it and wish you a very happy National Rural Health Day tomorrow, November 15th.

John Eich: Thank you very much, and I look forward to celebrations around the nation.

No Records Fees for Patient Attorneys

Wed, 14 Nov 2018 13:27:37 GMT

By Samantha Hilker

Did you know?

According to a Wisconsin Supreme Court decision in May 2017, attorneys hired to represent a patient are now considered a ‘person authorized by the patient’ when it comes to how you bill for records requests?

PAAW members can find on our site the opinion, the statute, and the current fee schedule.

Member organization Bell Ambulance shared their incidental finding with us last week, and after confirming our understanding with Scott Moore, HR and Operations consultant for the American Ambulance Association, we wanted to share this information with our members and partners throughout the state.

In summary, there is no time that any person, authorized by the patient, can be charged a “retrieval or certification” fee for requests for records. The provider can charge the per page fee, but no the retrieval or certification fee.

Thank you, Bell Ambulance!

Election Recap Highlights from Mike Brozek

Wed, 14 Nov 2018 13:10:39 GMT

By Samantha Hilker

On Tuesday November 12, PAAW lobbyist Mike Brozek provided a recap of the recent elections, and shared his thoughts on how it will affect EMS in Wisconsin and across the US. Here are the high-points.

US Senate

The recount in Arizona likely to go to Kyrsten Sinema, while the Florida recount is still in progress. Overall, the GOP maintained a majority in the senate, however it is a smaller majority than before.

US House

The Democrats now hold a small majority in the House.

Wisconsin Gubernatorial Race

We knew the race for Governor was going to be close in Wisconsin. Below are a few factors why Governor Walker lost and what we can expect to see from Governor-Elect Evers as we move forward.

Governor Walker Loss Factors

Voter weariness
Some feel that the campaign didn’t have the organization or enthusiasm, but
His numbers never amounted to a mandate
Polls can’t be trusted, necessarily, as it all depends how questions are phrased; Marquette poll showed him neck and neck throughout the race.

Governor-Elect Evers

Staffing up
He will be governing with both chambers firmly Republican, which may result in a slower state agenda and perhaps increased conflict.
Governors have extra power in years before reapportionment. Redistricting will likely end up in court.
Focused on education, transportation, healthcare but there was little information about logistics.
Maggie Gau was Gov-Elect Evers campaign manager and has been appointed Chief of Staff. Her role in playing “traffic cop” for access to Evers will be challenging. When we know the members of the transition team, we can start reaching out.
Governor Evers has been a constitutional officer for the state for many years already, which is unusual. He is familiar with bureaucracy.
He will likely be a big advocate for education and teachers

WI Assembly

Overall, there was very little change in the Wisconsin Assembly – the Republicans did gain 1 seat.

WI Attorney General

The loss of Brad Schimel was a bit surprising! Josh Kaul is the new Attorney General for the State of Wisconsin.

Agencies (Overall)

Mike believes we will likely see radical changes in personnel. Although we are not sure yet who will be selected, we do know each Governor brings in his own people. It is possible we may see some Democratic members of the legislature be selected.

Reflections on this Election

Wisconsin is changing its party composition and the suburbs around Milwaukee broke more Democratic than expected. Wisconsin seems to be a microcosm – reflective of the trends we’re seeing nationally.

Budget Process

We will learn more at the State of the State address, however, some things may remain unresolved even by then. We know the new governor will bring in his own budget, but we also know this will be challenging as it will be presented to a GOP-majority legislature. I anticipate some contracts will extend by 6 months to avoid any issues of continuity.

Medicaid Impact

In Wisconsin, a Republican is still at the helm of Medicaid. Evers could have radical changes, or very few – he has not shared many concrete plans about healthcare. Wisconsin took federal Medicaid money, and is at (about) a 70/30 split in favor of federal funding; the $9 billion-dollar budget includes quite a bit of Federal money. Even as the department’s budget increased from $7b to $9b, EMS did not receive any additional funds.

PAAW continues to be in support of removing ‘ambulance’ language from NEMT (non-emergency medical transport) contracts. PAAW’s immediate past president Patrick Ryan is meeting with Mahlon Mitchell, President of the Professional Fire Fighters of Wisconsin, to discuss how they can continue to make progress via coalition.

Balance Billing

Although the Governor ran on healthcare as one of his three principals, it is not yet clear where he stands on balanced billing.

Next Steps

PAAW is advised to do a complete inventory of history and future goals to develop a strategy and priorities. Change may bring opportunity.
PAAW will work to host another update call with Mike Brozek or distribute additional content once the transition team is in place and additional details become clear.

Join a PAAW Committee!

Tue, 13 Nov 2018 21:30:35 GMT

Attention PAAW members! Interested in participating in the new Reimbursement or Government Affairs Committees? Complete our short form to be considered. Thank you for your support and participation!

https://www.surveymonkey.com/r/1811paawcomms

Welcome to the Board, Nick Romenesko of Gold Cross!

Fri, 05 Oct 2018 16:46:12 GMT

By Samantha Hilker

Nick Romenesko was voted on the PAAW Board during executive session at the September 20^th meeting.

Nick brings with him nine years of experience in EMS. I have watched Nick grow as a paramedic throughout his career at member organization Gold Cross Ambulance; he is smart, dedicated and incredibly professional. He knows how to have fun and make you laugh after a tough call, but also pushes himself and those around him to improve each day. Here’s the thing about Nick, though...you know all those dreaded millennials people are always pontificating about? Yep – he’s one of them! A few weeks ago, Nick was promoted to Systems Director at Gold Cross Ambulance Service, Inc. and when I shared the news with a colleague the immediate response was “isn’t he really young for that?”. Yes, he is young, but he is also driven, committed and, most importantly, capable.

Nick started his EMS career in Milwaukee a with member-organization Bell Ambulance and then returned to the Fox Valley as a paramedic with Gold Cross where he flourished. Nick chaired the Safety Committee and became integral to the internal education and quality program while earning his bachelor’s degree in organizational leadership. I think the most important thing to note about Nick, is that he cares. He cares about his people, he cares about his work, the organization he’s charged with leading, and he cares about the future of EMS for everyone involved.

There has been a lot of talk over the past few years about attracting, retaining and engaging millennials – we even had a session dedicated to the topic at Midwest EMS Expo, and PAAW published two podcasts on the subject – perhaps electing one to the board is a good start at bridging the generational divide.

Congratulations, Nick, and welcome to PAAW!

Welcome to the Board, Jon Cohn of Greenfield Fire Rescue!

Fri, 05 Oct 2018 16:42:39 GMT

By Samantha Hilker

Jon Cohn was voted on the PAAW Board during executive session at the September 20^th meeting. Jon brings with him 26 years of experience in the fire service and EMS and currently serves as the Chief of Greenfield Fire Rescue. Jon has also served as President of the Wisconsin State Fire Chief’s Association and held various instructor roles in higher education.

Jon is humble and doesn’t like to talk about himself. Getting a bio out of him for the 2018 Midwest EMS Expo (view here!) was like pulling teeth, and he basically gave me free reign over this profile piece. Instead of copying and pasting the information available via LinkedIn or the Midwest EMS Expo bio, I’m going to share my personal story of Jon Cohn (the short version, don’t worry!).

The first time I met Jon we were both in Ft. Worth, Texas visiting MedStar’s MIH program to learn about their experience, design and how we might bring it back to our respective services in Wisconsin. To set the stage, I was one of two representatives from a private ambulance service (and the other guy came with me). The rest of the room consisted of representatives from career fire departments, a representative from the fire union, and a few representatives from a health care organization in the Milwaukee area. Don’t get me wrong – they were all genuinely nice people, some of which I knew before that visit, but my colleague and I found ourselves sitting quietly on the outer perimeter of the room watching, listening and absorbing. Jon was the only person in the room to walk over to us, extend a hand, introduce himself and ask for our perspective, as representatives from a private service. It was clear from that moment that Jon was excited at the opportunity to raise the bar of EMS in the State of Wisconsin whether it be through a community paramedic program or other ways that encouraged collaboration and relationship building. I didn’t see Jon again until a chance meeting at the CPR in Schools bill signing in Central Wisconsin years later. He remembered me immediately and was quick to walk up and say hello, catch up on what was new and exciting in our respective regions and share his excitement for the CPR in Schools initiative.

So why am I telling you about the first two times I met Jon? Because those two encounters are examples of why I was happy to see Jon elected to the PAAW Board – his focus on progress, commitment to relationships, and hope for the future are qualities that lead to transformative change and future growth. Jon believes it is easy (but wrong) to focus on our mission and serve with individual or organizational interests in mind. The challenge (and most effective) is to focus on our future, the vision and serve the totality of the industry and the interests of all.

Congratulations, Jon, and welcome to PAAW!

Rural EMS Listening Sessions Announced!

PAAW Administrator — Fri, 28 Sep 2018 22:21:53 GMT

From the Wisconsin Office of Rural Health

The Wisconsin Office of Rural Health is holding a series of EMS listening sessions in rural areas across the state in October and November of this year.

The intent is to give a platform for rural EMS providers to describe their work, and the conditions in which they operate. Wisconsin has seen a steady decrease in volunteerism over the last two decades, and municipal budgets are stretched very thin, leading to the closure of several rural services in the last few years. The final portion of the evening will be dedicated to sharing ideas for solutions that could help rural EMS providers to keep their doors open while providing quality patient care.

At each event, state legislators, county and municipal leaders, hospital leadership, and citizens at large will be invited to attend. The messages from the meetings should echo beyond that room, to the policy makers that can address the situation.

These events are held in collaboration with the WI EMS Association (WEMSA), the Professional Ambulance Association of WI (PAAW), the WI State Fire Chiefs Association (WSFCA), the Professional Firefighters of WI (PFFW), and the WI EMS Board.

Locations and Dates Scheduled:

Spooner: Monday, October 8th, from 6:30-8:30pm at Spooner Health System Hospital, 1280 Chandler Drive, Spooner (Classrooms A and B)
Woodruff: Tuesday, October 9th, from 6:30-8:30pm at Howard Young Medical Center, 240 Maple St, Woodruff
Oconto Falls: Wednesday, October 10th, from 6:30-8:30pm at HSHS St. Clare’s Memorial Hospital, 855 S Main St, Oconto Falls
Boscobel: Wednesday, November 7th, from 6:30-8:30pm at Gundersen Boscobel Area Hospital (specific location tbd)

For updated information on rooms and locations, and new sites as they are added to the list, please visit: http://worh.org/events/rural-ems-listening-sessions

New Mailing Address!

Tue, 25 Sep 2018 19:31:11 GMT

PAAW has a new mailing address. Would you please update your records?

PAAW c/o AAA
1420 New York Ave NW
5th Floor
Washington, DC 20005

Thank you for your continued support and participation.

Resources for New Medicare Cards

Mon, 24 Sep 2018 12:20:54 GMT

On a recent EMS in Wisconsin Podcast, LuAnn Slater & Heidi Romansheck joined to share information about the change from social security numbers (SSN) to the new alpha-numeric Medicare Beneficiary Numbers. Distribution for Wisconsin residents is completed, but here are some resources you might find helpful.

New Additions to the PAAW Board

Fri, 21 Sep 2018 03:33:36 GMT

Congratulations to Nick Romenesko of Gold Cross Ambulance and Jon Cohn of Greenfield Fire! Today, Nick and Jon were appointed to the vacant PAAW board seats. We look forward to working even more closely with these two, and thank them for their support and participation.

Look out for your WI Office of Rural Health survey!

Tue, 18 Sep 2018 12:39:26 GMT

Today, ambulance services from across the state will receive an email survey from the Wisconsin Office of Rural Health. Service directors, please be on the lookout for an email from pdblack@qualtrics-survey.com!

New Self-Care Pocket Reference Guide for EMS

Fri, 07 Sep 2018 05:49:26 GMT

From the Wisconsin Department of Public Health:

Responding to an emergency situation can be both rewarding and taxing on individuals. First responders coming back from a prolonged deployment may face challenges adjusting to their normal routine. People may display symptoms and reactions such as:

Emotional symptoms such as irritability or excessive sadness.
Cognitive dysfunction such as difficulty making decisions or following directions.
Physical symptoms such as headache, stomach pain, or difficulty breathing.
Behavioral reactions such as consuming more alcohol or interpersonal conflict.
Failure to adhere to needed physical or psychiatric medication needs.

Self-Care Pocket Reference Guide for Emergency Response Deployment P-01435 (PDF, 256 KB) - A guide for volunteer responders that includes pre- and post- deployment checklists and self-reflection activities. This resource was originally created for the University of Minnesota and the Minnesota Department of Health, and reprinted with their permission.

Aug 30 Livestream Event! EMS Fentanyl Video

PAAW Administrator — Wed, 29 Aug 2018 19:51:32 GMT

VIDEO RELEASE EVENT: Fentanyl: The Real Deal

The video is designed for roll call training and reinforces key messages from Fentanyl Safety Recommendations for First Responders.

Join us for the launch of the video on livestream August 30 at 2:00 pm ET

Speakers

Senior Federal Officials

U.S. Department of Justice, Deputy Attorney General Rod J. Rosenstein
Office of Justice Programs, Acting Principal Deputy Assistant Attorney General Laura L. Rogers
Bureau of Justice Assistance, Office of Justice Programs, Director Jon Adler
Office of National Drug Control Policy, Deputy Director James W. Carroll
U.S. Drug Enforcement Administration, Assistant Administrator John Martin

Representatives from National Law Enforcement, Fire, and EMS Associations

Fraternal Order of Police, National Vice President, Jay McDonald
National Sheriffs’ Association, Executive Director, Jonathan Thompson

International Association of Chiefs of Police, Member of the Board of Directors and Chief of Police, Norwood, Massachusetts, William Brooks III
International Association of Fire Fighters, General President, Harold Schaitberger
National Volunteer Fire Council, Director-at-large for EMS/Rescue Section Executive Committee and Lieutenant, Princeton Junction Fire Department, Brian Foley
National Association of Emergency Medical Technicians, President, Dennis Rowe
National Association of EMS Physicians, President, Dr. Brent Myers

Interview with PAAW AAA Star of Life Dave Mike

PAAW Administrator — Tue, 21 Aug 2018 16:48:58 GMT

By Samantha Hilker

“It was the most humbling and exciting experience of my life…”

Dave Mike was selected as the Professional Ambulance Association’s Star of Stars at the 2017 Wisconsin Star of Life Awards. Dave was selected from 29 of his peers who were also honored at the event held in conjunction with the Paramedic Systems of Wisconsin Conference in Green Bay. Although all 30 stars had amazing stories, something about Dave stood out. 22 somethings, actually…

About 14 years ago Dave and his wife decided to give foster care a try, and in early 2004 they took in their first foster child. Since then, they have fostered 22 children. TWENTY TWO. They also lead and facilitate a foster and adoptive parent support group through their church in Whitefish Bay.

As the Star of Stars, Dave was able to attend the American Ambulance Association’s Stars of Life event this past June in Washington D.C. which included Capitol Hill visits with elected officials, a luncheon at the National Press Club, and sightseeing with his wife and two of his daughters. “Being selected as the Wisconsin Star of Stars was the most humbling and exciting experience of my life. I cannot thank Paratech, PAAW, and the American Ambulance Association enough for the experience” shared Dave.

As a 45-year veteran in EMS, Dave has seen a lot of changes to our profession. His smile is contagious and his attitude inspiring; he offered some advice for those just starting out, or wondering if a long and successful EMS career is really in the cards for them…

“You have to be in it for the people. If you care about the people you are taking care of, you will be happy. I tell foster families the same thing – you have to be in it for the people. You also need to find something away from work (EMS) that makes you happy. You need that time away from all of the stress and terrible things we see to rest and recharge.”

A big part of the Stars event is learning about how government relations and advocacy effects EMS, and how important it is to get out there on a local, state, regional and national level to share our story with elected officials. Dave would love to see all of us in EMS getting more involved as a “newbie” or a veteran of the profession and suggests city council meetings as a great place to start.

PAAW appreciates all EMS providers in the State of Wisconsin and across the nation. The Stars events are a great opportunity to recognize and honor the amazing work you do on a daily basis, and we look forward to another Wisconsin banquet in 2019!

Dr. Riccardo Colella named State EMS Director

PAAW Administrator — Mon, 20 Aug 2018 12:41:20 GMT

From the Wisconsin Emergency Medical Services Section:

We are pleased to announce that Dr. Riccardo Colella has been named State Emergency Medical Services Medical Director, effective immediately. Dr. Colella succeeds Dr. Susan Martens whose term ended June 30, 2018.

WARDS Elite Training Courses

PAAW Administrator — Tue, 14 Aug 2018 20:06:57 GMT

WARDS Elite Training Courses

The Wisconsin EMS Section is happy to announce multiple opportunities to participate in the WARDS Elite Training Course. The purpose of the course is to educate users on the function and options of the WARDS Elite program with emphasis on the CQI and Report Writer modules. Successful completion of this course will provide eight hours of continuing education for attending both nights.

The classes will run for from 6:00 p.m. to 10:00 p.m., with registration starting at 5:30 p.m.

The courses dates and locations are as follows:

August 15 & 16, 2018	Ascension Sacred Heart Hospital	Tomahawk
August 22 & 23, 2018	Waushara County Courthouse	Wautoma
August 27 & 28, 2018	Mountain Ambulance Service	Mountain
August 29 & 30, 2018	Ho Chunk Casino	Wittenberg
September 5 & 6, 2018	Upland Hills Hospital	Dodgeville
September 10 & 11, 2018	Waupun FD	Waupun
September 12 & 13, 2018	West Bend Police Dept	West Bend
September 17 & 18, 2018	Edgerton Fire Protection District	Edgerton
September 19 & 20, 2018	Town of Lincoln FD-Monroe Co	Warrens
September 24 & 25, 2018	Menomonie FD	Menomonie
September 26 & 27, 2018	North Crawford High School	Soldiers Grove

Please register for Course #1049572 through WI Train. Specific location information will be provided when registered for one of the sessions.

Nominations Open: PAAW Board (Governmental Category)

Fri, 13 Jul 2018 01:35:56 GMT

Over the next several months, the PAAW board of directors will appoint a new director to fill a vacancy in the MUNICIPAL SERVICE (ex: municipal, county owned, etc) category. Please submit nominations of self or others via our convenient online form.

SUBMIT A NOMINATION>

Thank you for your support and participation.

Happy Independence Day!

Tue, 03 Jul 2018 15:40:41 GMT

Happy 4th of July from PAAW!

Meet the New Region 4 & 5 EMS Coordinator, Ela Rybczyk

PAAW Administrator — Wed, 20 Jun 2018 12:18:35 GMT

by Samantha Hilker

Elizabeth "Ela" Rybczyk (pronounced rib-chick) is the new Region 4 & 5 Coordinator for the Wisconsin EMS Office. She officially started the role on May 14^th, 2018, and has been hard at work learning the EMS system, building relationships and responding to questions. I had the opportunity to speak with her over the phone about her history in EMS and her vision for EMS in Wisconsin.

S: Ela, can you share a bit about your history in EMS?

E: I started in EMS in 2008 as an EMT Basic for an urban commercial agency in Rochester, New York, and became a paramedic in 2010. I have worked in a variety of different settings including both urban and rural I have had the opportunity to treat a diverse population of patients. In 2012I became a critical care paramedic and began to focus on inter-facility transports. I have also worked as a training director for my agency.

S: What brought you to make a move to Wisconsin?

E: I was looking around at different job opportunities when I found the job posting for this role. Honestly, it just felt right. I have always loved Madison, and everyone in Wisconsin is so outdoorsy; I enjoy being outdoors, too. The EMS system in Wisconsin is quite progressive, and I enjoy that as well. EMS is my passion, and I feel lucky to have the opportunity to come here and work in a different arena of EMS.

S: What are your goals for EMS in Wisconsin?

E: My immediate goal is to learn the region, state, and EMS system as a whole. There are a lot of similarities between New York State and Wisconsin, but a lot of differences as well. My long-term goal is to be supportive of the EMS community and to see the system succeed. I’m going to do my best to be here to answer questions and support services and providers as best as I can. I am still learning, but Ray and Mark have been great at leading me through the process and getting me trained up.

I have to say that Ela’s energy and excitement for EMS came through even on the phone. PAAW looks forward to working with her over the years to come. She also shared that she loves mountain climbing and, with Wisconsin being quite flat, she’s open to suggestions on great climbing spots. If you have any recommendations (or questions) for Ela, you can find her at Elizabeth.Rybczyk@dhs.wisconsin.gov.

Meet the New EMS Section Chief, Mark Lockhart

PAAW Administrator — Wed, 20 Jun 2018 12:14:21 GMT

By Samantha Hilker

Jonathan “Mark” Lockhart started as the EMS Section Chief on May 29, 2018. I had the opportunity to speak with him about his history in EMS, and his hopes for Wisconsin.

S: Mark, we saw the short bio and description come out from the state when your acceptance of the position was announced, but can you share a little bit more with us about your history in EMS?

M: Well, I initially got my start with EMS as a Boy Scout explorer in high school. My 36 year EMS career jumped off in 1982 when I started as a volunteer EMT with a service outside of St. Louis, MO. From there, I was hired by a fire department in 1983, about six months after I had finished paramedic school. I stayed with that fire district for eight years. I also flew with the air medical service during that time (for about 1.5 years) then started teaching and doing some quality assurance in St. Louis County. Working with QA and teaching led me to a full-time position within the hospital full time as the Director of EMS Education. As part of this role, I worked very closely with Medical Control which included writing policy, procedure, and protocol. After some time, the fire department I had previously spent eight years with asked me to come back as their EMS Chief, and I did for the next 12 years. The Chief retired and, after acting as interim Chief, I was appointed as Fire Chief. I began thinking about how I had been in the same area for my entire life, and it was time for a change of scenery. That is what led me to the for Stafford County, VA, where I have been for the past five years as Fire and EMS Chief and two years as an Assistant Chief before that.

S: What made you want to come to Wisconsin?

M: My passion has always been EMS, so after 36 years in the fire service, and some soul searching, I had a bit of an epiphany and decided to refocus on that passion and get back to what I genuinely love doing. I saw the position posted for Wisconsin and thought it seemed like a natural fit. I had heard and read a lot of great things about the EMS system in Wisconsin regarding how progressive it is, including the legislative changes that went through last year, and the community EMS initiative that is taking root. I’m excited to be here and be a part of it.

S: Now that you’ve been in Wisconsin and the role for a few weeks, what are your initial thoughts and goals for EMS in Wisconsin?

M: I had the opportunity to attend my first round of EMS meetings at the beginning of June, and I’ve already learned a lot. I enjoyed the opportunity to listen, learn and get a feel for the perspectives represented. I look forward to working with everyone to move EMS in Wisconsin forward.

S: What do the EMS providers in Wisconsin need to know about you, and your plans for us?

M: I come from a really broad background in that I’ve worked for rural, volunteer, career fire, air medical and hospital services. I have also been involved with professional associations at a local, state and national level. I am very blessed to have seen EMS in many different settings and from many different perspectives, and I want to be able to leverage that experience here so we can build on what is already a very solid foundation. I believe there are significant opportunities for further growth and development. I am excited about what I am hearing discussed in meetings and around WI, and happy to have met everyone so far. I look forward to meeting more EMS providers from around the state and working with the local trauma advisory councils as well.

While it was a short conversation with Mark, his energy and excitement were apparent. He brings a diverse history and perspective to the table, and I believe he wants to make a positive impact on Wisconsin EMS. PAAW looks forward to working with him in the years to come.

If you have questions for Mark, you can contact him at Jonathan.Lockhart@wisconsin.gov

Member Spotlight: Gold Cross Ambulance

Wed, 06 Jun 2018 15:57:47 GMT

by Samantha Hilker
Gold Cross Ambulance Service, Inc., a longstanding member of PAAW, is doing some great things in their corner of the world, so we’re shining the spotlight on them!

The team at Gold Cross is taking community involvement and public outreach to heart, and it is making a difference for the community as well as the EMTs and paramedics on staff.

“Gold Cross Ambulance believes that to be truly involved in pre-hospital healthcare you must educate the public to help improve patient outcomes. At Gold Cross, there are many areas of public education and community outreach that help engage and educate our community. We partner with the local healthcare systems, Ascension, and ThedaCare, to help provide many of these educations. Our public education and community outreach initiatives include our HeartStart Foundation public AED placement, PulsePoint, Stop the Bleed training, Hands-Only CPR education, and participation in Stroke education. We hope that with education and engagement we create a healthier community” explains Nick Romenesko, Clinical & Quality Manager for Gold Cross.

Gold Cross’ flagship event for the last several years has been the CPR at the Park Night, a collaborative event planned by representatives of Gold Cross, Ascension, American Heart Association, ThedaCare and the Wisconsin Timber Rattlers. The event starts with free HOCPR, and AED awareness demos and participants are encouraged to download the PulsePoint Respond app. In June of 2017 Gold Cross launched the Pulse Point Respond app through their dispatch center. The app alerts CPR trained citizens to a cardiac arrest in a public location and tells them the location of the nearest public access AED, so they may respond, initiate CPR, and apply the AED when they are within 0.25 miles of that patient’s location. The Timber Rattlers include in-game messaging about cardiovascular disease, healthy choices, symptoms of acute coronary syndrome, and several survivors take to the field along with their family, bystander rescuers, pre-hospital and in-hospital care teams to highlight the import role each of them plays in the chain of survival.

The main goal of the CPR at the Park event was to educate the public on the importance of bystander action in the chain of survival through highlighting survivors and their rescuers willing to share their stories. This event also provides an opportunity for survivors and their families to reconnect with the responding EMTs and paramedics – an opportunity that makes a difference in the lives of those responders.

"It is incredibly humbling to know that I was part of a team that contributed so profoundly to the positive outcome another person's most perilous moment. Meeting someone, and their family members, face to face after having witnessed them so close to death was extremely inspiring. So far in my career, this success has been the ultimate expression of why we do what we do in EMS. In particular, it was amazing to have the opportunity to meet our young patient's father. He was present during a portion of the resuscitation attempt, and I remember feeling guilty that in the midst of the resuscitation efforts I couldn't give him more detailed information about what was happening to his daughter. I recall that as we left the scene, the only thing I was able to tell him was "she has a pulse again." So, to later shake that man's hand and see him standing alongside his healthy and happy young daughter was something I will remember for the rest of my career" shared John Drees, paramedic with Gold Cross.

I had the privilege of speaking with Don, one of the cardiac arrest survivors that participated in the 2017 CPR at the Park game. Don ran one of the local 5k’s in May 2017; after completing the race, he didn’t feel well and found a shady place to rest near the finish line. A few friends and medical volunteers recognized the warning signs and flagged down the paramedics from the staged ambulance for further evaluation and treatment. Don was having a STEMI, went into cardiac arrest in the ambulance, was resuscitated and transported to a local hospital for definitive treatment. Don ran the same 5k this year, on the one-year anniversary of his arrest. Gold Cross arranged for the treating crew and the bike team to support Don through the 5k and meet him at the finish line. Don shared what it meant for his heroes, as he calls them, to be there to support him:

“I am so very thankful for those who helped not only me but all the others who need the emergency help. The people were very professional and friendly. I enjoyed talking to them after the Sole Burner Run. I appreciated the gal who joined in with me up the Hill of Hope! It gave me a boost! You certainly have a great team! I know that many times there are people who are not as lucky as I am. It must be hard on one’s mind to go through that. My father passed away from heart disease when he was only 50. I never knew his parents, my grandparents, because of the same. I thank God and your team at Gold Cross Ambulance.”

Gold Cross has a busy summer ahead of them with public education and outreach events to include hands-only CPR, AED and Stop the Bleed. They are also in the process of rolling out PulsePoint Verified Responder; they will be joining five other agencies in the country in alerting their off-duty EMTs and paramedics to a cardiac arrest in private residences, so they can respond and administer CPR. This program is completely voluntary for employees and is in addition to the existing PulsePoint Respond app. They will be sharing more about their community outreach program, and PulsePoint, at the Paramedic Systems of Wisconsin conference this September.

Water, Water Everywhere

PAAW Administrator — Mon, 14 May 2018 12:12:55 GMT

By Samantha Hilker

Amid a national opioid crisis where there seems to be heroin everywhere you look, EMS services are struggling to obtain medications needed to treat patients. As we continue to have conversations about the impact of these drug shortages on local, state and national levels a quote from The Rime of the Ancient Mariner keeps rattling around in my head;

“Water, water, everywhere and all the boards did shrink. Water, water, everywhere, nor a drop to drink” Samuel Taylor Coleridge

Many have cited the over-prescribing and easy availability of opioid medications as the underlying cause for the current opioid crisis and, in response, the FDA and DEA reduced the number of opioids that could be produced in 2017; on the list of reductions was morphine, fentanyl, and hydromorphone among others. The overall goal of implementing the quota system as outlined HERE was to “reduce the potential for diversion of schedule II medications for non-medical use while maintaining production for legitimate medical use through a 25 percent buffer for supply levels in 2013 through 2016.” According to the article, much of the reduction ordered for 2017 is a result of eliminating the overstock related to the 25 percent buffer.

The ordered reduction of schedule II drug manufacturing coupled with Puerto Rico (the home of a major medical supply and drug manufacturing facility) being essentially wiped out by hurricane Maria is leaving EMS services across the country between a rock and a hard place. On the surface, it seems like a relatively easy fix – one medication is in shortage and becomes hard (or impossible) to obtain, so you chose an alternate and amend your protocols. But what do you do when your alternative hits the shortage list and becomes hard (or impossible) to get? How do we appropriately balance delivery of high-quality patient care while constantly adjusting protocols and supply while avoiding medication errors?

Dr. John Russell, President, Cape County Private Ambulance, and Chair, AAA Professional Standards Committee offered the following insight:

“Morphine is short for a couple reasons, prefilled syringe manufacturing issue being one, the second being the FDA and DEA sets a limit on how much narcotic can be manufactured in a year. Fentanyl has become the drug of choice for most EMS medical directors for narcotic pain control due to its predictability, short half-life (wears off quick) and it has less hypotension potential than morphine. Again, Fentanyl prefilled syringes are short because of the syringe issue but ampules and vials seem to be available, we just have to practice good drug administration techniques (filter needle to draw up from the ampule, double check dosing with our partner etc.) Hydromorphone (Dilaudid) has been a popular alternative to morphine particularly in hospital but it too is now in short supply mostly from increased demand and hoarding. As you can see there is a domino effect on the drug class when one goes short the demand is moved to another and it becomes a vicious cycle.

Alternatives to opiate pain meds include IV Acetaminophen, Ketorolac (Toradol), and even oral meds such as naproxen and ibuprofen. Certainly, the armed services have successfully used Ketamine for pain but generally speaking it’s a niche drug for trauma use and comes with a whole set of side effect and management issues most paramedics are not familiar with.

When we are forced into an alternative presentation of a drug such as epinephrine or fentanyl vials, we prepackage everything needed to administer in a Ziploc bag and label the bag. a vial of med, appropriate syringe or saline if the drug needs to be diluted, a filter needle if the drug is pulled from ampule or a safety draw needle if from a vial. We also put a cheat card in to make clear the amount to be administered for a particular dose.

We eliminated D50W and D25W from our drug list and instead now just infuse a bolus of D10W from a 250cc bag at 1 ml/kg of patient weight. Works well. Cheap fix.

As for epinephrine we package a 1cc 1 mg 1:1,000 vial or ampule with a 10 cc saline flush syringe and draw needle. We instruct the medic to waste 1 cc of the flush, draw up 1cc of 1:1,000 epi and mix well (functionally now 1:10,000) or 1 mg in 10 cc of 1:10,000 which is the same as the prefilled syringes commonly used. Similar kits can be put together for other drugs.”

Several services in Wisconsin have a state-approved protocol to utilize expired medications in times of shortage – Bell Ambulance has graciously shared their expired medication policy, so others can use as a template for creating one for their service. Dr. Suzanne Martens, Medical Director, Orange Cross Ambulance and State of Wisconsin EMS Medical Director encourages services to put together reasonable training plans and protocols for alternative medications that can be submitted to the state for approval, and potentially shared as models for other services.

DOWNLOAD SAMPLE EXPIRED MED POLICY

This is an issue that is affecting EMS and hospitals across the country and there are no magic answers, only band-aids, and workarounds. New protocols, different medications in varying concentrations and packaging, and use of multiple vendors are all tactics used by services to manage the supply chain interruption. Dr. John Russell illustrates the current situation brilliantly with the following statement:

“… these are stop-gap measures and certainly raise the chance for medication error and take more time to use but until the supply system gets fixed I’m afraid we will be playing McGyver with a lot of our drugs.”

References

Affairs, D. P. (2016, October 4). DEA Reduces Amount of Opioid Controlled Substances to be Manufactured in 2017. Retrieved from DEA: https://www.dea.gov/divisions/hq/2016/hq100416.shtml

Braithwaite, MD, MPH, S., & Myers, MD, MPH, B. (2013). Retrieved from http://www.naemsp.org/Documents/2013%20Annual%20Meeting%20Handouts/HANDOUT%202013%20Myers%20Drug%20Shortage.pdf

Drug Shortage. (2018, March 26). Retrieved from U.S. Department of Health and Human Services: https://www.fda.gov/Drugs/DrugSafety/DrugShortages/default.htm

Lynch, S. N. (2018, April 17). U.S. drug agency proposes rules to rein in opioid manufacturing. Retrieved from Reuters: https://in.reuters.com/article/us-usa-justice-dea-opioids/u-s-drug-agency-to-propose-rules-to-rein-in-opioid-manufacturing-idINKBN1HO2U1

Pharmacists, A. S.-S. (2018). Drug Shortage List. Retrieved from American Society of Health-System Pharmacists: https://www.ashp.org/Drug-Shortages/Current-Shortages/Drug-Shortages-List?page=CurrentShortages

Thomas, K. (2017, October 23). U.S. Hospitals Wrestle With Shortages of Drug Supplies Made in Puerto Rico. Retrieved from New York Times: https://www.nytimes.com/2017/10/23/health/puerto-rico-hurricane-maria-drug-shortage.html

Gundersen Tri-State Ambulance's Essential Oil Program

PAAW Administrator — Thu, 10 May 2018 14:00:59 GMT

By Samantha Hilker

Gundersen Tri-State Ambulance, a longstanding member of PAAW, is doing some great things in their corner of the world, so we’re shining the spotlight on them!

This past December, conversations about the use of essential oils to support patients experiencing pain, nausea and anxiety started shaping a new program for the La Crosse-based service. The national opioid crisis is causing many healthcare organizations, and individual providers, to look at the way some conditions, like pain, are addressed. When Dr. Chris Eberlein, Medical Director for Tri-State Ambulance and ER Physician for Gundersen Health System, started seeing the way essential oils were used to support patients within Gundersen, he wondered if there might be an application for EMS. “I noticed that many of the patients given small doses of Fentanyl or other narcotic pain medications in the field were not leaving the ER with a prescription for painkillers – they didn’t need it. I thought there must be something different we can do to support them without administering opiates. The field providers (and their patients) didn’t have any other options, until now” recalls Dr. Eberlein.

Essential oils work on the limbic system, the same system that controls our fight or flight response. When someone breathes in the oil our olfactory nerve cells carry the essential oil into our brain. They bypass the thalamus and enter the limbic system through the cerebral cortex which lies just above it. Scent is a powerful thing that, for many of us, triggers an immediate and intense response such as memories or nausea; it only makes sense they can have a calming effect on the senses as well. Dr. Eberlein, Nick Eastman, Operations Supervisor – Clinical Services, connected with Denise Nicholson, Registered and Certified Clinical Aromatherapist, who leads the essential oil program at Gundersen Health System. Denise is also an RN, BSN, Advanced Care Plan Facilitator and Nursing System Specialist with Gundersen and has studied essential oils extensively; she believes in their benefits and application for use because she has seen the patient response. Both Gundersen and Tri-State follow the British and German models of use (inhalation and absorption), not the French model (ingestion). “The oils are delivered by putting a few drops on a cotton ball, then taping that to the patient’s chest or by rubbing a small amount of diluted oil on the pads of a patient’s feet. Inhalation is the fastest and safest way to deliver essential oils to a patient, but absorption can be beneficial in certain circumstances as well,” Denise explains.

Tri-State is now carrying six (6) different essential oils on their paramedic units and has a specific procedure for their use. “I want to make it clear that the oils are an adjunct, not a replacement for standard treatments or medical protocols. Although we didn’t implement these oils to manage the current narcotic shortages EMS services everywhere are experiencing, we are hoping the use of the oils allows us to support patients without using as many narcotics. We have also added non-narcotic pain medications to our pain management protocol,” Dr. Eberlein clarifies.

DOWNLOAD PROCEDURE

Company-wide use at Tri-State has just started and although Gundersen has been using them for some time, they have not done any formal clinical trials. Anecdotally, however, the results are changing skeptics into believers.

“We have one long-time paramedic who was part of our pilot group who is a bit of a skeptic. During his introduction and education on essential oils, he decided to try some for his plantar fasciitis. He purchased some from Gundersen (available in the hospital gift shops) and applied it to the soles of his feet…within 30 minutes his feet were pain free for the first time in years. I think it’s safe to say he’s now one of the programs biggest supporters,” Nick Eastman shared.

It is important to note that any service looking to implement a similar program must do their due diligence and research the use, benefits and safety of essential oils before including them in their supportive measures. Essential oils are not regulated by the FDA and are not an alternative to standard medical treatments; some can interact with prescription medications. Any service looking to implement essential oils as a supportive measure should also spend time researching the supplier of any oils they might incorporate into their system. There are a lot of direct-sales companies selling essential oils these days, and you can even purchase them on Amazon. Gundersen works with a supplier who only works with healthcare providers and is a certified and registered clinical aromatherapist; the oils go through extensive testing, so the providers and patients can be confident in what they are getting.

PAAW is proud of the work Gundersen Tri-State Ambulance is doing and their willingness to share their experience with other services across the state – a shining example of how we are stronger together.

Resources:

Price, S., & Price, L. (2012). Aromatherapy for health professionals. Edinburgh: Churchill Livingstone.
Buckle, J. (1997). Clinical aromatherapy in nursing. London: Arnold.
Tisserand, R.,& Balacs, T. (1995). Essential oil safety, a guide for health care professionals. Edinburgh: Churchill Livingstone.
Kevelle, K. (1999). Aromatherapy for dummies. Wiley.
Johnson, S. (2015) Evidence based essential oil therapy: The ultimate guide to the therapeutic and clinical application of essential oils. Johnson

Check out pictures from the Midwest EMS Expo!

PAAW Administrator — Tue, 08 May 2018 14:51:01 GMT

Visit the Midwest EMS Expo Facebook page to see photos of last week's expo and educational sessions.

More information about 2019 coming soon!

Our Thoughts Are With Paramount

PAAW Administrator — Fri, 27 Apr 2018 15:23:28 GMT

Our thoughts go out to the Paramount Ambulance team, whose staff member passed away in the line of duty in Iowa this morning. Our deepest condolences to family, friends, and colleagues.

Condolences to Ascension Spirit

PAAW Administrator — Fri, 27 Apr 2018 14:11:44 GMT

PAAW is deeply saddened to learn of this morning's tragic helicopter crash. Our hearts are with the families, friends, and colleagues of those who passed away in the line of duty. Our deepest condolences to the Ascension Spirit team.

PAAW Leadership at Work: Mileage Reimbursement

PAAW Administrator — Fri, 20 Apr 2018 21:05:05 GMT

By Samantha Hilker

Patrick Ryan, co-owner of Ryan Brothers Ambulance and current PAAW board member, worked furiously to correct a problem some services may not have known they even had.

A few weeks ago, Patrick noticed something strange. The MTM transfers were being reimbursed at $1.75/mile instead of $5.56/mile, and even more curiously, some were being all out denied. A deeper look revealed a potential cause of the problem: billing codes. Typically, BLS and ALS transports are submitted to MTM with the codes A0380 and A0390, respectively, whereas the code reserved for stretcher vans is A0425 with a reimbursement rate of $1.75.

“On some shorter trips, the difference wasn’t that much and might not be immediately obvious as it would on the long-distance transfers. Depending on the services typical number of MTM transports and their distance, they may not have even noticed a change in their reimbursement rates for MTM trips. It was a few long-distance trips that really raised the flag for us.”
—Patrick Ryan

Patrick started making phone calls to other PAAW members to find out if they had noticed any of the same with their MTM authorizations and claims; sure enough, Patrick wasn’t alone. He then reached out to MTM and DHS to find out more. After many phone calls and email conversations, it appears the issue was one of miscommunication and misunderstanding.

DHS has submission requirements that MTM must follow when submitting claims to DHS. This is not to say that DHS can, in any way, enforce MTM’s provider submission expectations; so, when DHS made a request to MTM regarding code A0425, it should not have affected how ambulance service providers were being reimbursed from MTM. As of this morning, PAAW received confirmation that MTM has revised their position on the ambulance codes and will allow providers to submit under codes A0380 and A0390 so they can be paid appropriately for the level of service provided. MTM will also be pulling all claims that were denied for not being coded as A0425 and will be working to get them corrected and paid. At this point, it looks as though there will not need to be any action taken on the part of the Ambulance Service Provider, however, you may want to look at your recent MTM transfers to see if you were affected.

This is a great example of how PAAW benefits its members by building a network of professionals who are willing to step in, take the lead and find the answers; not only for their own service but to the benefit of services across the state. Way to go, Patrick—PAAW is proud to have you!

Signed Into Law: Dispatcher-Assisted CPR and Public Safety Career Grants

PAAW Administrator — Thu, 19 Apr 2018 14:19:39 GMT

This has been a great week for EMS in Wisconsin, with several key bills signed into law, including AB654 for dispatcher-assisted CPR, and AB872 for EMS and public safety career ed tech grants. PAAW President Dana Sechler attended both signings. Great job to all who collaborated to make this happen!

Meet the 2018 Wisconsin National Stars of Life

PAAW Administrator — Wed, 18 Apr 2018 13:57:51 GMT

Staff from several PAAW member organizations, including Bell Ambulance, Paratech Ambulance Service, and Baraboo District Ambulance were selected for AAA's national Stars of Life program. Meet the Wisconsin Stars at http://ems.zone/18WIstars!

Survey: Narcotics & Saline Shortages

PAAW Administrator — Mon, 16 Apr 2018 21:23:36 GMT

Has the current shortage of controlled medications or saline affected your ability to provide high quality care to your patients?

PAAW is working to collect data on how these, and other, medication shortages impact ambulance services throughout the state of Wisconsin as well as how services are adjusting to meet the needs of their patients.

Please complete our short survey here► https://www.surveymonkey.com/r/1804paawshortages

View a list of drug shortages on the FDA website.

Welcome, New EMS Bureau Staff!

PAAW Administrator — Fri, 13 Apr 2018 12:20:06 GMT

The open EMS Section Chief and Regional Coordinator positions have been filled. If your email is up to date in the e-licensing system, you likely received the communications yesterday and today from the EMS Office. Both Mark and Ela appear to have impressive credentials and valuable experience throughout their EMS careers. PAAW is looking forward to working with them, once they officially start their positions!

In case you missed the emails, here are the excerpts:

EMS Section Chief

We are very happy to announce that Jonathan “Mark” Lockhart has been selected to fill the role of Emergency Medical Services (EMS) Section Chief for the Office of Preparedness and Emergency Health Care, EMS Section. Mark, as he prefers to be known, and his family will be moving to Wisconsin from Virginia, and Mark will begin his new role with the EMS Section on May 29, 2018.

Mark’s professional experience includes 8 years at Stafford County (VA) Fire and EMS, where he served as Deputy Chief and Chief. Prior to his work in Virginia, Mark spent 23 years at Maryland Heights (MO) Fire District, progressively serving as a firefighter/paramedic, the EMS Officer, Battalion Chief, Deputy Chief, and Chief. Mark is a Nationally Registered Paramedic, Firefighter I/II, and has held Fire Officer I and Fire Service Instructor certifications. Mark's experience as an EMS and Fire Instructor includes teaching here in the US, as well as in Mexico, the United Kingdom, and Sweden. Mark has also been a contributing author for several EMT, Paramedicine, and Trauma/Life Support publications. Over his career, Mark has been an active participant in many professional associations, including: NREMT, NAEMT, and the International Association of Fire Chiefs.

EMS Regional Coordinator

We are very happy to announce that Elizabeth “Ela” Rybczyk will be joining OPEHC as the new EMS Regional Coordinator for Regions 4 and 5 (Western and Southwestern WI). Elizabeth’s first day in the office will be Monday, May 14, 2018.

Elizabeth, or Ela as she prefers, has a Bachelor of Arts in Health, Behavior, and Society from the University of Rochester (NY), and a Certificate in Public Health Fundamentals and Principles from the University of Albany (NY). Ela started her career as an EMT in 2008, and became a certified Paramedic in 2010, serving at several ambulance services in upstate New York. Ela holds certifications in Remote Medicine for Advanced Providers, Paramedicine, and Critical Care Paramedicine. She has also served as an Administrative Lieutenant and Training Director for the Greece (NY) Volunteer Ambulance and EMS Service, and as a member of the Monroe-Livingston Regional Patient Safety Committee.

What EMS Educators Want You to Know

PAAW Administrator — Mon, 26 Mar 2018 17:25:54 GMT

By Samantha Hilker

I’m not the smartest person in the room, and that is what I love most about my job.

Being an EMS educator is a tough job; it takes a special person to pour their heart into educating others. It takes someone who can stand behind their team to celebrate their accomplishments and also support them through mistakes. A person who will pick up the phone at 3 a.m. to help a crew through a tough call, discuss a protocol, or work through the transport decision trees with dispatch without a second thought. Someone who is OK with not being the smartest person in the room because they live in constant learning and embrace new challenges.

I had the good fortune of speaking with several EMS educators about what they really want their clinical team(s) to know. Here are the highlights:

Mistakes are not the end of the world.

Let’s be real, everyone makes mistakes. EVERYONE. The important thing is that you (1) realize the mistake and take steps to correct or communicate it, (2) learn from your mistake and (3) help others learn from you. Making a mistake once is part of the learning process – making the same mistake twice is foolish.

I am here for you.

Call me. Anytime. I’d honestly rather have you ask a question if you’re unsure of something – or call me right away to discuss a concern than receive a complaint or find something concerning on QA reports a few days or weeks later. A lot of times, the mistakes people think they made really aren’t that big of a deal – especially if we know about them and understand the why right away.

I don’t like doing QA any more than you like me calling you about QA concerns.

While looking at high-level outcome data and trends is interesting, I don’t like having to call you about protocol or documentation compliance issues. QA is necessary – it lets us know how we’re doing, how I’m doing as an educator…but please know that I do not spend time pouring over reports just looking for reasons to call you. Trust that I am looking for every reason not to call you before that phone rings.

It’s not always as exciting as I’d like it to be.

I know the education isn’t always the most exciting and sometimes we repeat things – but sometimes we need to repeat things for the benefit of the whole team. I would love to do exciting, cutting edge, new education all the time…but there is also value in getting back to the basics.

Practice how you play.

It is so important to train how you work…meaning realistic scenarios via simulation or low-fidelity equipment, partner configuration, uniforms and using the tools you use in real life. A lot of what we do in high-stress, time-sensitive situations is done without implicit thought – muscle memory – the more realistic our training the more efficiently we’re able to react in a real situation.

As I write this article, I am about midway through a virtual instructor-led paramedic refresher and never have I been more thankful for the EMS educators that helped shape me through the years, and the services who supported the role of an internal educator. When education is viewed as a burden or requirement you meet just to maintain your license, it is easy to dismiss the value of a passionate educator providing face-to-face or hands-on transfer of knowledge. I encourage you to take full advantage of the educators in your life, both formal and informal, especially if you are fortunate enough to work for a service willing to support that role internally.

A special thank you to the following EMS educators who took time out of their day to contribute to this article:

Thomas Carpenter, EMS Educator with Gundersen Health
Rick Barton, EMS Educator with Gundersen Health
Nick Romenesko, Clinical and Quality Manager with Gold Cross Ambulance Service, Inc.
Robert Whitton, Education and Quality Assurance Coordinator with Paratech Ambulance
Michael Barrow, Founder/Co-Author CPR Podcast, and Educator with Centura Hospitals

Interoperability Survey Due April 6

Fri, 16 Mar 2018 18:18:55 GMT

Complete the online survey►

With the passage of Act 59 in September 2017, the Legislature directed the Department of Military Affairs to submit a report by January 1, 2019 that addressed the following questions:

Recommended changes to statutory authority of the Interoperability Council
Progress toward creating a statewide public safety interoperable communication system
Obstacles hindering progress toward interoperability
Recommendations for the legislative/executive action to promote interoperability

In order to provide a comprehensive report to the Legislature, the DMA’s Office of Emergency Communications is seeking your responses to several important questions. The resulting survey can be taken online, or responses can be emailed to Lauraine.vanderjagt@wisconsin.gov. Responses are due April 6.

Complete the online survey► | Download Question in a Word Document

EMS at the Capitol 2018

PAAW Administrator — Fri, 02 Mar 2018 15:55:05 GMT

One of the highlights for EMS in 2017 was the EMS at the Capitol day that took place in November; 5 organizations coming together to move EMS forward in Wisconsin. As we look further into 2018, we want to inform you that a legislative day of this nature will not be possible due to the short session and election year. That being said, we do not want to lose the momentum! We are feverishly working with the American Ambulance Association, Office of Rural Health, and others to arrange some equally amazing opportunities to influence how EMS is governed from a state and federal level.

Stay tuned! Detail on 2018 opportunities will be released as events are finalized and open for registration.

You can also look forward to an EMS at the Capitol Day in early 2019.

New! One-Stop Meeting Archive

Mon, 26 Feb 2018 19:47:20 GMT

It just got even easier for PAAW professional members to catch up on board activities! Visit the Meeting Archive for quick access to past minutes and upcoming agendas.

(Going forward, this page will replace the previous separate Agenda and Minutes pages.)

Support Dispatcher-Assisted CPR

Fri, 16 Feb 2018 20:00:52 GMT

Recently several PAAW members participated in an American Heart Association Lobby Day event in support of Assembly Bill 654 / Senate Bill 549. This legislation will ensure all 911 dispatchers are trained to talk callers through how to perform CPR while they wait for first responders to arrive.

Bystander CPR is proven to save lives. Your help is requested to help educate state lawmakers about the importance of this legislation and to highlight the impact it would have in your community.

The Assembly will vote on AB654 on February 20. A vote is not yet scheduled on the Senate side.

Please, reach out to your legislators and let them know that dispatcher-assisted CPR is key to helping EMS in your community! Find my legislators>

Our Podcast Is Changing!

Tue, 13 Feb 2018 01:50:43 GMT

EMS LIVE in Wisconsin is getting a fresh look, and a new name!

Starting now, you can search for EMS in Wisconsin Podcast in iTunes and Stitcher to listen to our podcast on your mobile device or computer. You will also have the option to subscribe to the show, which means you will be automatically alerted when a new episode is available. Of course, you can also find the podcast on our website (www.paaw.us) along with other valuable information and resources.

Our most recent episode (January 23^rd) is already available, and the next episode is scheduled to post on Tuesday, February 20^th.

The next episode will feature Scott Moore, Esq., AAA Operations & HR Consultant. We will discuss employee incentive programs: what are they, which ones work, and what might leave you scrambling.

Future topics include: EMS re-licensing update from the State of Wisconsin EMS Office, What EMS educators want their teams to know, current research in EMS, the challenge of managing former peers, and quality assurance programs.

We look forward to bringing you all the best in EMS from Wisconsin!

Ambulance Medicare Add-Ons Renewed

PAAW Administrator — Fri, 09 Feb 2018 14:29:26 GMT

This morning, President Donald Trump signed into law a Continuing Resolution (CR) that included a five-year renewal of the ambulance Medicare add-ons.

The specific provisions included are:

5 year extension of the ambulance Medicare add-ons through December 31, 2022, retroactive to January 1, 2018.
The American Ambulance Association's preferred method of Cost data collection that provides flexibility to the Secretary of HHS in developing the system. Consultation with the industry is required so that it strikes the appropriate balance between obtaining meaningful data while not overly burdening or onerously penalizing the ambulance services.
The penalty for failing to report required data would be a reduction in payment up to 10% for the year following the year in which the data should have been submitted. American Ambulance Association objected to the house proposed penalty of up to a year of Medicare payments clawback or withholding of payments. A clause is included to wave the penalty in cases of hardship.
A “pay-for” for the 5-year extension of the add-ons with a 13% cut to non-emergent dialysis transports – the American Ambulance Association had objected to the offset and pushed for a cut targeted to just those entities which abuse the dialysis transport benefit. We were successful in reducing the initial cut from 22% to 13%. The American Ambulance Association is actively working on other pay-for options that would replace the 13% cut with something targeting dialysis fraud and abuse.

Our association supported the American Ambulance Association's efforts to drive this renewal through letter-writing campaigns and Hill visits.

President Sechler In Madison

PAAW Administrator — Fri, 02 Feb 2018 16:08:16 GMT

This week, President Sechler testified before the legislature on behalf of PAAW in support of grants for students interested in EMS. He also participated in the American Heart Association Hill Day advocating for dispatcher-assisted CPR.

Podcast Recap: WISHIN & State EMS Medical Director (January 23)

PAAW Administrator — Sun, 28 Jan 2018 20:30:31 GMT

By Samantha Hilker

On Tuesday, January 23rd, the EMS Live in Wisconsin podcast featured two guests who, on the surface, were entirely different. Dr. Suzanne Martens, the EMS Medical Director for the State of Wisconsin, spoke to the Physician Advisory Committee’s (PAC) work and plans for 2018 during the shows first segment. In the second half, Joe Kachelski, CEO of Wisconsin Statewide Health Information Network (WISHIN), talked about the new use case for EMS that allows EMS agencies to access the Health Information Exchange for billing purposes. After listening to each guest share their work, the resources now available for EMS, and future plans, it became clear they were sharing a mission: to remove barriers in the delivery of quality patient care.

Dr. Martens and the PAC are working to remove barriers for EMS services across the state by cleaning up language and ensuring resource documents, like the combined scope of practice and paramedic medication list, are up to date and accessible on the Wisconsin EMS website (https://www.dhs.wisconsin.gov/ems/licensing/scope.htm). They are also taking a critical look at the national scope of practice compared to the current scopes of practice for all levels in Wisconsin; in some areas Wisconsin is ahead of the curve while other areas there is room to grow. She also talked about the importance of accessing information and resources on the EMS website, including contact information for all PAC members and meeting dates for the EMS Advisory Board and committees. Provider and service level involvement is vital to the continued progression of EMS in Wisconsin, and the meetings can even view the sessions remotely! All of this information can be found here.

Joe Kachelski and the entire WISHIN team have been working to remove information barriers by building a robust Health Information Exchange in Wisconsin. Care providers, like hospitals and healthcare systems, can access medical history and patient information that may aid them in clinical decision making, particularly in emergency situations when patients may be unable to share the information. They are now expanding access and use of that network to EMS agencies. While EMS agencies may not have the luxury of time and resources to access an electronic health record and review medical history at the time of care, they can certainly benefit from accessing the network and gathering FACE sheet data for billing purposes after the fact. Organizations do have to be registered users to gain access to the health information exchange, but Joe assured us the process is straightforward and he and his team are there to help by giving demonstrations, answering questions via phone or email, and supporting you through the process. You can find more information on the WISHIN network on their website.

Barking dogs aside, the podcast was full of information and is worth 30 minutes of your time. Be sure to check back in February for the next episode featuring Scott Moore, Esq. where we'll be talking about employee incentive programs.

Help PAAW rename its podcast!

PAAW Administrator — Thu, 25 Jan 2018 14:26:34 GMT

New for 2018, PAAW is proud to bring you a revamped podcast featuring a new host, Samantha Hilker! Please take a few moments to vote on your favorite new name for the monthly show!

Vote Now►

P.S.— Don't miss the next episode February 20 at 9am CT. Scott Moore, Esq will share with listeners the good, the bad, and the ugly about employee incentive programs.

Wisconsin EMS Staffing Update

PAAW Administrator — Mon, 22 Jan 2018 22:33:49 GMT

by Samantha Hilker, Hilker PSM

PAAW’s first podcast of the new year was scheduled with James Newlun, then EMS Section Chief for the Wisconsin EMS Office. The goal of the podcast was to facilitate a discussion with a representative of the State EMS office about staffing and what, if anything, could be done at a state level to help alleviate the burden services are feeling. As you may remember, PAAW mailed a letter to the state office outlining several concerns and potential solutions to the staffing shortage last year (you can read the letter here). Unfortunately, we were unable to secure an alternative representative from the state office as a guest after James announced his exit in late December, and the podcast was subsequently canceled. With the Section Chief role vacant the day to day duties are keeping those remaining at the state office quite busy, and they were unable to provide a comment on the subject.

Without the opportunity to engage a representative of the state office, I engaged friends and colleagues across the country and combed through an endless number of articles about staffing in EMS published over the years. Specifically, articles about the difficulties EMS agencies are having when it comes to finding reliable, committed and loyal EMTs and paramedics. Although it feels as though this topic has consumed discussions over the past year in Wisconsin, the dates on the available articles reveal that finding the right people (or any people, in some cases) is not a new problem for EMS.

In September 2015, EMS Insider published an article in JEMS titled Critical Staffing Shortages that discusses the ongoing decline of volunteerism along with difficulty in retention due to the overall demands of the EMS profession. The article cites research done in North Carolina as early as 2008. Another interesting article published in June of 2014 is an editorial piece by Arthur Hsieh where he calls out the lack of a real identity for the EMS industry as the leading cause of recruitment and retention issues. If we don’t know who we are, after all, how do we go about convincing other people to join?

I’ve spent some time asking people who have voluntarily exited the EMS industry why they decided to leave. While this was not a scientific poll by any means, the answers I received came from across the country as well as right in our own backyard; some I know personally as well as some I have never met in person. The low rate of pay was the most common answer I received while working conditions including the length of shift, the state of equipment, condition of quarters and the ability to get along with their co-workers was a typical answer as well. Supportive leadership, or lack thereof, was comfortably third in the ranking of most common responses right along with a lack of advancement opportunities. Many of you reading this, I am sure, are not surprised by this information. So then, how do we fix it? What can be done to stop, or at least slow, the leak?

It may be time to get creative with staffing in EMS instead of relying on the same practice to yield different results. The days of long-term employment, it seems, have been replaced with habits of “job hopping” as the newer generations begin to enter the workforce. Maybe we are asking too much or setting our expectations too high regarding the length of employment. In a recent article on Business Insider by Becky Peterson lists the average period of employment for the 10 biggest companies in tech and the highest is just over two years even though many of the dissatisfiers identified by EMTs and paramedics are not present. Perhaps the best way to keep employees on your roster for longer is to provide them a career path that can be laid out for them on day one of orientation; show them you believe in their future at your organization, and maybe they will believe in it, too.

Contact Congress: Medicare Add-Ons Update

PAAW Administrator — Fri, 19 Jan 2018 22:02:26 GMT

We Need Your Help to Renew the Ambulance Medicare Extenders

Congress is heading toward a possible partial shutdown of the federal government without taking action on our expired Medicare add-on payments. While PAAW, the American Ambulance Association, and other industry stakeholders have pressed hard for Congress to immediately pass a five-year extension of the ambulance add-ons, our message is not being heard loud enough amongst all the other noise. We need you to contact your members of Congress today in support of extending the 2% urban, 3% rural and 22.6% super rural increases! Please share with your staff and encourage them to write letters as well.

WRITE A LETTER TODAY
(Takes Under a Minute)

Last night, the House of Representatives mostly along party lines passed a Continuing Resolution to fund the federal government through February 16. The fate of the bill in the Senate is uncertain. If Congress does not pass by midnight tonight a measure extending funding for the federal government, there will be a partial government shutdown.

The AAA had pushed for Congress to attach a Medicare provider extender package including a five-year extension of the ambulance add-ons to the Continuing Resolution. Since the extender package was not included in the Resolution, we are pressing Congress to consider a separate extenders only package including the five-year ambulance extension or attach the package to another moving legislative vehicle. We are also pushing Congress to at the very least pass a short-term extension retroactive to January 1 until a Medicare extender package can move.

It is critical that we get the Medicare ambulance add-ons reinstated as soon as possible. So please write your members of Congress today!

Ambulance Billing Debate: Should You Hold Your Medicare Claims?

PAAW Administrator — Fri, 19 Jan 2018 13:02:37 GMT

By:
Brian S. Werfel, Esq. &
Rebecca Williamson, Chair, AAA Medicare Regulatory Committee
Reprinted with Permission from the American Ambulance Association

Ambulance suppliers face an important decision at the start of every calendar year on whether to hold their Medicare claims for the first few weeks.

This decision historically revolved around the patient’s Medicare Part B deductible ($183 in 2018). The argument in favor of holding claims was that a brief claims hold would allow time for the patient’s deductible to be satisfied by another health care provider, thereby relieving the ambulance supplier of the time and expense involved in billing the patient (or their secondary insurance) for the deductible. Ambulance suppliers that hold claims believe that this ultimately results in higher collections. The argument against holding claims is that any increase in overall collections is likely to be minimal, and that the resulting disruption to the company’s cash flow more than offsets any potential benefits from those higher collections.

This year, the debate is complicated by the events surrounding the expiration of the temporary add-ons for urban, rural, and super-rural ground ambulance transports on December 31, 2017. These temporary add-ons increased the Medicare allowables by 2%, 3%, and 22.6%, respectively. Congress failed to act upon these temporary add-ons prior to its adjournment. However, there remains strong bipartisan support for reinstating these add-ons – – and Medicare extenders for other types of Medicare providers – – early in the 2018 Legislative Calendar. The AAA’s political consultants believe these Medicare extenders will likely be included in the next government funding legislation, which must be passed by January 19, 2018.

Assuming our temporary add-ons are reinstated, they are likely to be made retroactive to January 1, 2018. This would require CMS to retroactively adjust claims previously paid at the current (lower) rate. This may also require secondary payers, including State Medicaid Programs, to retroactively adjust their payment amounts to reflect increased cost-sharing amounts. There is precedent for these sort of retroactive adjustments. Most recently, the Affordable Care Act, which was enacted on March 23, 2010, provided for a reinstatement of these same temporary add-ons, retroactive to January 1, 2010.

In this inaugural edition of the Great Medicare Debate, AAA Medicare Regulatory Committee Chair Rebecca Williamson and AAA Medicare Consultant Brian S. Werfel, Esq. debate the merits of holding claims pending a resolution of the add-on issue vs. submitting claims.

Ambulance suppliers would likely benefit from holding their claims for some period of time pending clarity on the status of our temporary add-ons.

Rebecca Williamson, Chair of the AAA’s Medicare Regulatory Committee:

According to CMS, 73% of all ambulance service suppliers bill less than 1,000 Medicare covered transports per year. Additionally, 54% of ambulance suppliers bill less than 250 Medicare covered transports per year. Assuming an average claim amount of $400.00 per call (base rate plus mileage), an ambulance supplier with 1,000 Medicare covered transports per year could collect approximately $320,000.00 per year in a best case scenario ($400,000.00 X 80%). This leaves the service with copays of $80,000.00 to be collected from patients. By adding $183.00 as a deductible for each of these 1,000 patients, the collection from Medicare decreases to only $173,600.00. This means the service now must collect an additional $43,400.00 . In other words, if the patient has not met the deductible, the deductible is applied first and a $400.00 allowable becomes a $217.00 allowable. Medicare now pays 80% of $217.00 which is $173.60. Multiplied by 1,000 claims, Medicare pays a total of $173,600.00 and the balance owed to the supplier is the deducible of $183,000.00 and copayments of $43,400.00.

By holding claims for a brief period, usually thirty days, ambulance services increase the likelihood that another provider, often a hospital, will file claims with Medicare first, meaning collecting patients’ deductibles becomes the facilities’ responsibility.

Of course these numbers are only examples and many factors affect the actual billing and collection process. Some Medicare beneficiaries will promptly pay the deductible, many will have secondary payers or insurances, and a certain percentage will be dually eligible for Medicare and Medicaid, all of which results in higher collection ratios for the ambulance service. However, in plain terms, collecting $320,000.00 versus $173,600.00 can make a very real difference in the viability of a small service. Each service should look carefully at its own payer mix, patient statistics, and demographics to determine individual service projections.

Another good reason to hold claims, this year in particular, is the almost certainty of Congress reinstating the extenders. For those of us who have been in this industry for a long time, the expiration of the add-ons this year is a painful reminder of 2010 when the extenders expired and were not reinstated until March 23, 2010. It wasn’t until July 2010 that CMS even began the process of correcting previously processed claims , and by January 2011 many claims were still outstanding and had not been completely reprocessed. Also by that time, which could have been as long as a year after the date of service, many secondary payers were either unwilling or unable to retroactively correct the reprocessed claims. Some Medicaid states, such as Oklahoma, simply did not have the manpower or ability to even attempt it.

The administrative burden imposed on ambulance suppliers by having claims retroactively reprocessed by CMS, then reprocessed again by secondary payers – potentially incorrectly, if at all – along with the many manual adjustments required in-house, make it even more attractive to advocate and advise holding claims for as long as financially feasible. Of course not every service has the cash reserve to be able to do this, and I would generally not advise holding claims for as long as it may take for Congress to reinstate the extenders and for CMS to implement the correction for services who cannot afford to, but for those who can, not only will they almost certainly increase the amount of payments collected, they will decrease overhead administrative costs.

I am very optimistic that Congress will include the ambulance extenders in legislation as well as being optimistic that it will be sooner rather than later. I know others disagree, but the higher likelihood of it happening versus not, make this a good bet to take.

Ambulance suppliers should disregard the status of the temporary add-ons when making their decision on whether to hold claims for some period of time

By: Brian S. Werfel, Esq.:

Rebecca makes a strong argument about the benefits of holding claims. Moreover, I have long advocated in favor of holding claims for the patient’s deductible. For these reasons, I would understand if ambulance suppliers elect to hold claims for the patient deductible. However, I would question the wisdom of holding claims pending further clarity on the status of the temporary add-ons.

My argument against holding claims for that reason boils down to a single word: uncertainty. In this context, I am referring to four specific types of uncertainty:

Uncertainty over whether the temporary add-ons will be extended.
To the extent legislation is passed extending the temporary add-ons, uncertainty as to whether the higher rates will be made retroactive to January 1, 2018.
To the extent legislation is passed extending the temporary add-ons, uncertainty as to how quickly CMS will implement the revised rates for new claims and adjust claims paid at the original, lower rates.
Uncertainty over how the various secondary payers will handle their adjustments.

With respect to the extension of the add-ons, I agree that they are likely to be included with other Medicare adjusters in the budget resolution that must pass before January 19, 2018. Likewise, at this point, there is no reason to think that these add-ons will not be made retroactive to January 1, 2018. However, there are no guarantees. It is possible that the Republicans and Democrats fail to reach agreement on the larger budgetary issues, including the status of the so-called “Dreamers”, and a government shutdown results.

My larger concern relates to how quickly CMS revises its fee schedule, and implements instructions to its contractors. As Scott noted above, the last time we faced this issue was in 2010. The Affordable Care Act was signed into law on March 23, 2010. However, CMS didn’t issue a transmittal to its contractors until May 21, 2010, and even then, didn’t instruct its contractors to start paying the higher rates until July 6, 2010.

In other words, if you elected to hold claims to avoid having them paid and then reprocessed, you would have needed to hold claims for more than 6 months.

To me, the strongest argument for holding claims is not how Medicare would handle the adjustment. I recognize the administrative burden created by having to post and then re-post the same claim once it was adjusted. However, I trust that CMS will eventually get it right (emphasis on eventually).

I have far less confidence in how the secondary payers, including State Medicaid Programs, will handle the adjustments. When this happened in 2010, we had numerous reports from A.A.A. members of secondary payers incorrectly processing the adjustment. For example, some State Medicaid Programs didn’t simply issue a supplemental check for the higher copayment. Instead, the Medicaid Program took back its initial payment, and then reprocessed the claim in its entirety. Unfortunately, in some instances, the Medicaid rates changed in the interim, and Medicaid then repaid a lower amount. In other instances, they failed to repay the patient’s deductible. Similar issues were noted with commercial secondary payers, Medicaid managed care organizations, etc.

In sum, if your company has historically held claims during the first few weeks of the year for the patient’s deductible, I see no reason to discontinue that practice. If, however, you historically submitted claims without regard to the patient’s deductible, I see little benefit to holding claims pending action by Congress on our add-ons.

PAAW Ambulance Service Spotlight

Wed, 10 Jan 2018 19:47:03 GMT

Share your story through our Spotlight feature!

Help your fellow PAAW members get to know you by sharing your story through the PAAW member Spotlight. Simply fill out the interview form below and, if your submission is selected, your responses may be compiled and featured on our website, social media or other PAAW publications.

Thank you for agreeing to be sponsored in one of the upcoming PAAW Spotlights! Please contact samantha@paaw.us if you have any questions.

Complete our short interview form!

Midwest EMS Expo Deadline Extended!

Fri, 05 Jan 2018 14:59:29 GMT

Great news! Early bird rates for the #MidwestEMSExpo are still available! Register your team today to learn from top national and regional experts in La Crosse May 2–3. Register now►

New Year brings change and new opportunities for PAAW

PAAW Administrator — Thu, 14 Dec 2017 16:58:49 GMT

PAAW Board of Directors and Leadership

The upcoming New Year brings new opportunities for the Professional Ambulance Association of Wisconsin, to include board of director and leadership changes, as well as uniting with the AAA and MAA in launching a joint conference, Midwest EMS Expo, "Leaders Training Leaders", May 2 and 3 in La Crosse.

Dana Sechler recently took over as PAAW president following the leadership of Patrick Ryan, who made significant progress in that responsibility from 2006 to 2017. In addition, Chris Anderson and Cody Doucette, vice president and secretary respectively, move into their new responsibilities with the New Year.

At the end of December, PAAW Executive Director Joe Covelli concludes his employment with the association. He's been with PAAW since 2010. The American Ambulance Association takes over PAAW management responsibilities under the leadership of Amanda Riordan. PAAW also hired Samantha Hilker to write content and produce the association's podcast, EMS Live in Wisconsin.

According to PAAW President Dana Sechler, “The Midwest EMS Expo conference offers 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.

PAAW is a member-based organization dedicated to healthy, sustainable ambulance service delivery in Wisconsin.

Executive Officers

President - Dana Sechler

Vice President - Chris Anderson

Secretary - Cody Doucette

Treasurer - Tom Tornstrom

Board of Directors

Government / Municipal Ambulance Services

Jay Steuer, Director, Valders Ambulance, Valders, WI

Mark Fredrickson, Executive Director, Gold Cross / Brillion Ambulance Service, Menasha, WI

*Dana Sechler, EMS Chief / Director, Baraboo District Ambulance, Baraboo, WI

For Profit Ambulance Services

Patrick Ryan, President, Ryan Brothers Ambulance, Madison, WI

*Chris Anderson, Operations Director, Bell Ambulance, Milwaukee, WI

Larry Knuth, Vice President, Paratech Ambulance, Milwaukee, WI

Not-For-Profit / Nonprofit Ambulance Services

David Rae, Operations Director, Gold Cross / N.E.W. Paramedic Service, Menasha, WI

*Tom Tornstrom, Executive Director, Tri-State Ambulance, La Crosse, WI

*Cody Doucette, Operations Manager, Divine Savior EMS, Portage, WI

* Denotes Executive Officer

PAAW Leadership

Amanda Riordan, PAAW Senior Director of Marketing and Membership

Samantha Hilker, PAAW Content and Podcasts

Dr. Mark Westfall, Medical Director Consultant

Attorney Thomas Shorter, Healthcare and Legal Consultant, Godfrey & Kahn Law Firm, Madison, WI

Michael Brozek, Government Relations and Registered Lobbyist, Midwest Strategies, Madison, WI

Community EMS is officially law in Wisconsin

PAAW Administrator — Wed, 13 Dec 2017 14:33:43 GMT

EMS Live in Wisconsin Podcast

By Joe Covelli, PAAW Executive Director

>> Click to download podcast and listen now!

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.

Community EMS Bill signing, November 27, State Capitol, Madison

This podcast was recorded live on Tuesday, December 12 and went 35 minutes. Our guests included PAAW President Dana Sechler and Pete Carlson and Dr. Pete Tenghe, both with North Memorial Medical Center, Minneapolis.

We discussed 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, completing a community assessment and more. Minnesota has been using Community Pararmedicine programs the past five years and is credited with giving Wisconsin the framework to start from.

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 recognition 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 trained to drop in war areas to render first aid, so we called our trained fire personnel who received medical training 'Paramedics', and the name stuck”.

>> Click to download podcast and listen now!

We are stronger together

PAAW Administrator — Sat, 09 Dec 2017 03:53:14 GMT

Legislative Outreach

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 3^rd 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/#

Patient face sheets made easy through WISHIN records for billing purposes

PAAW Administrator — Wed, 06 Dec 2017 12:00:00 GMT

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/

Stars of Life honorees meet Governor Scott Walker

PAAW Administrator — Thu, 30 Nov 2017 14:29:50 GMT

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.

Community EMS Bill Signed Into Law

PAAW Administrator — Mon, 27 Nov 2017 18:17:37 GMT

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.

POTUS Signs DEA Standing Orders Bill into Law

PAAW Administrator — Wed, 22 Nov 2017 16:40:09 GMT

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.”

Congratulations, Wayne Jurecki and Tom Tornstrom!

Tue, 21 Nov 2017 14:44:19 GMT

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.

He Could Have Been The Marlboro Man

PAAW Administrator — Thu, 16 Nov 2017 14:26:48 GMT

Standby for Tones Blog

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.

EMS Compliance: The Importance of Documentation

PAAW Administrator — Tue, 14 Nov 2017 13:59:18 GMT

>> 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!

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

PAAW Administrator — Wed, 08 Nov 2017 13:50:17 GMT

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.”

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.

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

PAAW Administrator — Wed, 08 Nov 2017 12:00:00 GMT

>> 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.

Governor announces Rural Public Safety Support Initaitives for EMS

PAAW Administrator — Sat, 04 Nov 2017 13:23:08 GMT

The last week in October, Governor Scott Walker released his Rural Initiatives 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.

PAAW leadership changes announced

PAAW Administrator — Sat, 04 Nov 2017 12:59:07 GMT

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.

A Day at the State Capitol

PAAW Administrator — Sat, 04 Nov 2017 12:16:03 GMT

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 31^st -- 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, 3^rd 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/#

Current copy of bills / LRB / summary sheets

Cover letter/contact information for collaborating professional associations

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

PAAW Administrator — Wed, 01 Nov 2017 12:19:12 GMT

State Capitol

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.

Wisconsin EMS Day brings together 100 participants to complete legislative visits

PAAW Administrator — Tue, 31 Oct 2017 13:21:34 GMT

State Capitol

On Wednesday, November 1, over 100 people have registered to participate in the first Wisconsin EMS Day at the State Capitol in Madison. Participants will receive a briefing in the morning and then in the afternoon complete legislative visits.

This is a critical time for EMS. Volunteerism is down, levy limits and dwindling reimbursements are affecting funding to EMS, and services are struggling to keep ambulances staffed and their doors open. The goal on November 1 is to talk with legislators about:

Tax incentives to recruit and retain volunteers
Lifting levy limits for EMS services
Reducing unnecessary calls through use of Community Paramedics and Community EMT's

Wisconsin EMS Day Agenda - November 1

10:00 am Welcome History: Legislative Study Committee, EMS Day Committee, reasons for EMS Day.

10:30 am Legislative speaker panel - Rep. Shankland, Rep. Loudenbeck, Rep. Kolste

11:00 am Advocacy 101 - what a visit looks like

11:30 am Go through meeting packets

12:00 pm Lunch served and dismissal to legislative visits

Community Paramedicine Bill reaches Senate for vote

PAAW Administrator — Tue, 31 Oct 2017 13:20:57 GMT

State Capitol

Today, AB151, the Assembly's version of the Community Paramedicine Bill, reaches the Senate floor for a vote. Last week the Bill passed 5-0 in the Senate's Committee on Health and Human Services Executive Session. AB 151 passed unanimously in the Assembly last spring. Once it passes the Senate, it heads to the Governor's desk.

>> Click here for AB 151 Bill details and text.

Community Paramedicine Bill passes 5-0 out of the Health Committee's Executive Session

PAAW Administrator — Fri, 27 Oct 2017 12:35:16 GMT

State Capitol

AB151, the Assembly's version of the Community Paramedicine Bill, passed yesterday 5-0 in the Senate's Committee on Health and Human Services Executive Session. AB 151 will next be scheduled on the Senate floor for discussion and vote. Once it passes the Senate, it heads to the Governor's desk.

>> Click here for AB 151 Bill details and text.

Public hearing held on Community Paramedicine Bill

PAAW Administrator — Wed, 18 Oct 2017 12:18:58 GMT

State Capitol

Public hearing was held on Tuesday, October 17, at the State Capitol in Madison on the Community Paramedicine bills currently before the Senate and Assembly.

The Community Paramedicine bill unanimously passed the Assembly earlier in the year and is expected to be introduced soon in the Senate for discussion and vote. Click the blue highlighted links below for each respective bill to review bill text and history.

Proposal: AB151 (-0116) View Bill History
relating to: community paramedics, community emergency medical technicians, community emergency medical services providers, and services provided by emergency medical technicians.

10/17/2017: Public hearing held

Proposal: SB149 (-2435) View Bill History
relating to: community paramedics, community emergency medical technicians, community emergency medical services providers, and services provided by emergency medical technicians.

10/17/2017: Public hearing held

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

PAAW Administrator — Wed, 18 Oct 2017 11:56:06 GMT

Advocacy

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.

Seeing Benefits with Video Laryngoscope at Sun Prairie EMS

PAAW Administrator — Wed, 11 Oct 2017 03:33:00 GMT

EMS Live in Wisconsin Podcast

>> 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.

Helpful resources to download:

>> Podcast talking points

>> 300.02 Rapid Sequence Airway.pdf

>> AIRWAY BAG.docx

>> RSA Card2.pdf

>> Click to listen to this podcast.

Wisconsin EMS Day at the State Capitol is Nov. 1

PAAW Administrator — Thu, 05 Oct 2017 12:24:44 GMT

Next EMS Live in Wisconsin Podcast

EMS Live in Wisconsin Podcast
Wisconsin EMS Day Plans at the State Capitol Nov. 1

Special podcast reviewed EMS Day plans and talking points

>> To listen to this podcast, go to http://tobtr.com/10314789.

On Friday, October 6, PAAW completed a special podcast to discuss the upcoming Wisconsin EMS Day at the State Capitol in Madison on November 1. Our guests included Wisconsin Office of Rural Health Executive Director John Eich, Baraboo EMS Chief Dana Sechler and Ryan Brothers President and PAAW President Patrick Ryan. The program was hosted by PAAW Executive Director Joe Covelli.

According to Covelli, "EMS providers don't get involved in their local ambulance service to lobby their local legislators. However, EMS does a great job sharing stories about what they do and the pride they have in taking care of patients. Those messages can translate into action by state government. Legislators want to help local EMS, but they need input. They need to hear from their constituents. Wisconsin EMS Day offers that platform".

John, Dana and many others have been instrumental in organizing Wisconsin EMS Day. The podcast offered insight into the day's plans and how you can be involved.

Tax incentives to recruit and retain volunteers
Lifting levy limits for EMS services
Reducing unnecessary calls through use of Community Paramedics and Community EMT's

Join the group on Wednesday, November 1st, at 9 am, in Madison’s Central Library for EMS Day at the Capitol. The Associations representing Wisconsin EMS are united in holding this event. The Professional Ambulance Association of WI, the Professional Fire Fighters of WI, the WI EMS Association, and the WI State Fire Chiefs Association will all be there--and we invite you to come stand alongside them.

Register now (Click here), so we know how many EMS providers are coming to participate, and can provide a box lunch for everyone. Let’s show the legislators what EMS means to Wisconsin.

Wisconsin EMS Day Agenda - November 1

10:00 am Welcome (Partner Panel) - History, goals for today, key talking points and bills

10:30 am Legislative speaker panel - Sen Nass, Rep Kremer, Rep Shankland, Rep Loudenbeck all invited

11:00 am Lobbying 101, what it looks like, what to expect

11:20 am Lobbying Packet Review

11:40 am The Legislative “Asks”

12:00 pm Lunch served and walk to Capitol building for visits

Wisconsin EMS Day State Capitol HQ, 2nd floor North Hearing Room. Water and snacks available, drop off feedback and requests for follow-up.

>> To listen to this podcast, go to http://tobtr.com/10314789.

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

PAAW Administrator — Mon, 25 Sep 2017 14:03:14 GMT

Stars of Life

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.

backwards

PAAW Administrator — Mon, 25 Sep 2017 11:23:23 GMT

His VFW jacket is deceptive on his small frame, and the corresponding ball cap on his head is similarly boxy. He’s currently occupying a ditch alongside a small pickup truck where a few moments ago he was a passenger. Now he’s meeting my partner and I, so obviously his day has gone downhill. Literally.

They go up this hill every day, he’s telling the passerby who is seated next to him in the tall summer grass, keeping him company before all the sirens went from distant to loud, then finally silent here at the scene. The garish lights are strobing up the countryside but they are held to a dim minimum on this sunny summer day. Him and his buddy go down this hill every day to see another buddy, and then back up the hill to the ridgetop they call home. He never thought this would happen today. They were headed up the hill when the gentleman in the VFW jacket thought the engine sounded funny, “Like it was slipping gears, ya know”. Soon the driver told my patient, “I got some bad news for ya. I think we’re gonna crash.” My patient thought it best then to click on the seatbelt he’d removed to access his smokes in an inner pocket of the VFW jacket, and no sooner did the seatbelt click home than the engine did die. Within short order the steering and brakes left as well and they ended up somehow going back down the hill backwards. As my patient tells it, “after about five minutes, we rolled over. Just once I think but it’s hard to say, ya know.”

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

>> Click to read more on Crystal's blog page.

Join Wisconsin EMS Day on November 1st at the State Capitol

PAAW Administrator — Wed, 20 Sep 2017 01:25:04 GMT

State Capitol - Madison

Over the past several years, bills have been written and passed by the Wisconsin Legislature that affect EMS--with little to no input from the EMS providers and stakeholders. Legislators want to help EMS, but unfortunately, the recent bills feel like short-term solutions to the perceived problems. Our elected officials need to hear from us on how to create sustainable change for EMS.

Let’s go to the Capital together to meet our representatives, so they will hear in our own words what needs to be done to provide high quality EMS in the State of Wisconsin! All four of our Associations have come together to build bridges with our Representatives and Senators, because now is the time to act. We’re wearing our uniforms and presenting a unified message about EMS.

Join us for EMS Day on November 1st. Let’s show up in a sea of uniforms, visit our legislators, and explain what we do and what we need. There are over 16,000 of us in Wisconsin - if a fraction of that showed up at the Capital, it would be a movement that they couldn’t ignore.

This is a critical time for EMS. Volunteerism is down, levy limits and dwindling reimbursements are affecting funding to EMS, and services are struggling to keep ambulances staffed and their doors open. It’s time to stand up and speak out for our needs. Let’s talk with legislators about:

Tax incentives to recruit and retain volunteers
Lifting levy limits for EMS services
Reducing unnecessary calls through use of Community Paramedics and Community EMT's

Join us on Wednesday, November 1st, at 10 am, in Madison’s Central Library for EMS Day at the Capital. The Associations representing Wisconsin EMS are united in holding this event. The Professional Ambulance Association of WI (PAAW), the Professional Fire Fighters of WI (PFFW), the WI EMS Association (WEMSA), and the WI State Fire Chiefs Association (WSFCA) will all be there--and we invite you to come stand alongside us.

Register now (Click here), so we know how many EMS providers are coming to participate, and can provide a box lunch for everyone. Bring someone with you. Carpool to the Capital. Let’s show the legislators what EMS means to Wisconsin.

We’ll see you there.

Kenosha Fire Department Seeks Medical Director

PAAW Administrator — Thu, 14 Sep 2017 14:45:22 GMT

The Kenosha Fire Department recently posted an RFP for Medical Director.

The overall medical responsibility is planning, implementation, operation, and monitoring of the emergency medical services provided by the Kenosha Fire Department. The successful candidate has medical and legal responsibility for the EMS system operations and for all medical services provided by the department as outlined in the department’s EMS operational plan.

Additional responsibilities, include:

Supervision, direction and management of pre-hospital medical care provided by the department, and

EMS continuous quality improvement program and is actively engaged in the training and education of the department’s EMS providers.

It is estimated that the department Medical Director would perform services ten hours per week or forty hours per month.

>> Click to review RFP.

Sealed proposals should be sent directly to Fire Chief Charles Leipzig, City of Kenosha Fire Department, 4810 60th Street, Kenosha, Wisconsin 53144 on or before Friday, October 6th, 2017 at 4:30 P.M.

Podcast : Help Wanted - Paramedic Hiring Shortage

PAAW Administrator — Thu, 14 Sep 2017 13:19:58 GMT

>> Click to download and listen now!

Recently, Executive Director Mark Fredrickson at Gold Cross Ambulance, Menasha, raised concerns about a Paramedic and EMT hiring shortage. On May 30th, PAAW President Patrick Ryan mailed a letter identifying the Paramedic hiring shortage to State of Wisconsin EMS Section Director James Newlun. >> Click to review the letter from PAAW.

According to Mark, "The Paramedic and EMT shortage is bigger than what most may think. We had waiting lists and could pick and choose the best candidates. Now, we find ourselves with no waiting list or even applicants coming in looking for work".

Mark attributes the problem to two main items. One, the technical colleges are not producing enough resources to fill the demand and, two, we cannot effectively recruit out of state with the current reciprocity process assuring new hires a license in a timely manner. Additionally, hospitals, clinics and some factories are recruiting Paramedics and EMTs, which further depletes the pool that all ambulance providers try and recruit from.

>> Click to download and listen now!

Don't miss a beat of Wisconsin EMS action. Listen to EMS Live in Wisconsin the second and fourth Tuesday every month starting at 9:00 a.m. and lasting 30 minutes. >> Click for more information.

Two WARDS training classes added by EMS Office

PAAW Administrator — Mon, 11 Sep 2017 01:50:45 GMT

The Wisconsin EMS Office has added two more Wisconsin Ambulance Run Data System (WARDS) Elite Training sessions.

The first will be held at the Janesville Fire Department, 303 Milton Ave., Janesville. This course will be a daytime course held on Monday, September 18 from 8 am to 5 pm. Registration will start at 7:30 AM.

The second session will take place Wednesday & Thursday, September 27 and 28 in the Community Room of the Wausau Fire Department, 515 Grand Ave., Wausau. This session will start at 6:00 pm and go until 10:00 pm each evening with registration starting at 5:30 pm.

Register through >> WI-Train. For both sessions you will need to register for course #1049572 using your personal account. Just choose the session you wish to attend. The course will cover a variety of topics, including functions required to maintain the ambulance service account, how to create and schedule reports, modify forms, add supplemental questions and set up CQI reviews.

Wisconsin Office of Rural Health introduces new EMS resource tool

PAAW Administrator — Sat, 26 Aug 2017 23:22:27 GMT

The Wisconsin Office of Rural Health recently introduced a new resource information tool to benefit EMS.

According to Executive Director John Eich, "We've created a “Virtual Library”, with the “EMS” filter already applied, so users can see all our reports, maps, and other resources for EMS". To access the Virtual Library, go to >> http://worh.org/library?keys=&field_category_tid%5B%5D=52

In addition, WI-ORH put together several EMS resources from a variety of websites. To review the information, go to >> http://worh.org/ems.

Home Sweet Home

PAAW Administrator — Sat, 26 Aug 2017 22:59:08 GMT

Standby for Tones Blog

The first thing I register is the officer’s words as he gives report to my partner. “…hasn’t taken meds in six months…hasn’t been out of the apartment in six months…hasn’t eaten in three weeks…” The officer continues to fill in the blanks, that she lives with a roommate but that he is bipolar and hadn’t thought these things were concerning. The report complete, my partner and I enter the residence.

The second thing I register is the haze. I’m no stranger to odors but as we walk into the apartment, my lungs physically rebel at roughly the one minute mark. The apartment is literally foggy with acrid, dense cigarette smoke. I follow my partner’s grey shirt in front of me, sizing up our surroundings as we advance. I register a synthetic “feather” duster on the stove, between the electric burner and a frying pan, but the light indicating a hot stovetop isn’t lit. The duster isn’t smoldering, and so I continue towards the back bedroom, entering just after my partner. I’m already coughing, thanks to the lung issues I’ve been slowly coming to terms with. Last December my primary care provider tells me my seventeen years of smoking have had some impact on me even now, six years after smoking cessation. Each room we’ve passed now, in this apartment, has had at least one overflowing ashtray and my lungs are registering the effects.

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

>> Click to read more on Crystal's blog page.

Former LifeQuest Billing CEO dies in auto accident

PAAW Administrator — Sat, 26 Aug 2017 19:33:20 GMT

Jerry Miller, age 59, of Wautoma, died suddenly on Tuesday, August 22, as the result of an automobile accident in the Township of Newton, Marquette County.

Jerry was a 1976 graduate of Gillett School in Gillett, WI. He attended UW-Oshkosh and studied Police Science. He completed Paramedic training at Fox Valley Tech and was then employed at Shawano Rescue. Later, he relocated to Wautoma where he served as Waushara County EMS Director for over 19 years. Jerry was the founder of LifeQuest of Wautoma in 1992 and operated the business until 2013.

Jerry was an advocate for people struggling with addiction. He and his wife recently established Livingstone Bistro and Ministry of Wautoma in support of that effort.

PulsePoint, Citizen Response to CPR events

PAAW Administrator — Wed, 23 Aug 2017 11:46:11 GMT

>> Click to listen now!

This EMS Live in Wisconsin podcast was about PulsePoint - a trained citizen alert smartphone app for CPR events.

Our podcast guest was Samantha Hilker with Gold Cross Ambulance, Menasha, Wisconsin. She recently introduced PulsePoint to the Fox Valley area. They've had over 1,000 followers signup to receive alerts.

Talking Points:

PulsePoint is currently in use in 2,400+ communities around the country, and has been operating for seven years. The experience in those communities has been extremely positive with no negative consequences. The people who respond sincerely want to help. In many situations, responders are off-duty EMS and healthcare professionals. The PulsePoint website is >> www.PulsePoint.org.
Having citizen responders is critical. Gold Cross serves the entire region - 1,200 square miles of portions of Outagamie, Winnebago, Calumet and Waupaca counties. That's a lot of territory to cover. The more people who are able and willing to respond, the better.
Although the app is free, users have to stipulate they know CPR when downloading the app, indicating that if alerted they will respond within the context of their training.
The alert only goes to PulsePoint users within a 1/4 mile radius of the patient, so that's a limited group of people who understand they may be alerted, and want to offer aid.

Questions to be discussed:

1. What is it?

2. How does it work?

3. Are strangers going to show up at my house if I call 911?

4. What about HIPAA?

5. Will I be sued if I help someone?

>> Click to listen now!

Don't miss a beat of EMS action - listen to EMS Live in Wisconsin!

PulsePoint, Citizen Response to CPR events

PAAW Administrator — Tue, 22 Aug 2017 12:06:38 GMT

EMS Live in Wisconsin Podcast

>> Click to listen live!

Live podcast Tuesday, August 22, starting at 9:00 a.m.

The next EMS Live in Wisconsin live podcast discussion is about PulsePoint - a trained citizen alert smartphone app for CPR events. Listen live by dialing 646-929-1081, or on any internet connected device at >> http://tobtr.com/10222925. The program will run live until 9:30 a.m. (30-minutes).

Our podcast guest is Samantha Hilker with Gold Cross Ambulance, Menasha, Wisconsin. She recently introduced PulsePoint to the Fox Valley area.

Talking Points:

PulsePoint is currently in use in 2,400+ communities around the country, and has been operating for seven years. The experience in those communities has been extremely positive with no negative consequences. The people who respond sincerely want to help. In many situations, responders are off-duty EMS and healthcare professionals. The PulsePoint website is >>www.PulsePoint.org.
Having citizen responders is critical. Gold Cross serves the entire region - 1,200 square miles of portions of Outagamie, Winnebago, Calumet and Waupaca counties. That's a lot of territory to cover. The more people who are able and willing to respond, the better.
Although the app is free, users have to stipulate they know CPR when downloading the app, indicating that if alerted they will respond within the context of their training.
The alert only goes to PulsePoint users within a 1/4 mile radius of the patient, so that's a limited group of people who understand they may be alerted, and want to offer aid.

Questions to be discussed:

1. What is it?

2. How does it work?

3. Are strangers going to show up at my house if I call 911?

4. What about HIPAA?

5. Will I be sued if I help someone?

>> Click to listen live!

Don't miss a beat of EMS action - listen to EMS Live in Wisconsin!

PSOW conference agenda announced, registration open

PAAW Administrator — Mon, 21 Aug 2017 12:40:47 GMT

The Paramedic Systems of Wisconsin will host its 30th annual conference in Green Bay, September 20 to 22. The conference is specifically designed for Service Directors, Medical Directors and Training Centers.

The program will start at 10:00 AM on Wednesday morning September 20 with initial individual and provider introductions. Thursday and Friday will continue with excellent presentations that will have everyone talking all year long.

The conference agenda is listed below with daily registration fee noted. For more information or to register, go to >> www.PSOW.org.

Wednesday, September 20 (Daily Registration Fee - $75.00, includes meals/break items)

8:00 a.m. Registration open

10:00 a.m. Presentation of Colors EMS Honor Guard

10:05 a.m. Welcome and introductions

10:20 a.m. Ambulance service introductions and initiatives

12:00 noon Lunch*

1:00 p.m. Ambulance service introductions and initiatives (continued)

2:00 p.m. Provider Stress and Wellness (Rick Barney, MD)

3:00 p.m. Break in vendor area*

3:30 p.m. “Hot Topics” (Moderated by Dan Williams)

4:30 p.m. Hospitality with vendors*

6:00 p.m. Dinner on your own

Thursday, September 21(Daily Registration Fee - $95.00, includes meals/break items)

7:00 a.m. Breakfast*

7:30 a.m. Registration open

8:00 a.m. Addiction is a Brain Disease (Rick Barney, MD)

9:00 a.m. Exclusive vendor hour*

10:00 a.m. Shared Community Paramedic Project (Josh Finke)

11:00 a.m. Advanced EMS and Stroke Protocols (Kerry Ahrens)

12:00 noon Lunch*

1:00 p.m. Fraud, Abuse and Compliance (Wendy Arends, Attorney)

2:00 p.m. “Hot Topics (continued) (Moderated by Dan Williams)

3:00 p.m. Break*

3:30 p.m. Ask the Doc’s (Panel Discussion)

5:00 p.m. Cocktails

6:00 p.m. Banquet Dinner and Wisconsin Stars of Life Program*

Friday, September 22 (Daily Registration Fee - $25.00, includes meals/break items)

7:00 a.m. Breakfast*

8:00 a.m. Summary and discussion on earlier topics (Dan Williams)

8:30 a.m. State Medical Director’s Report (Suzanne Martens, MD)

9:15 a.m. State-of-the-State questions and answers (James Newlun)

10:30 a.m. Conference wrap-up

*Meals and vendor break snack items included in registration fee

Aladtec Named to Inc. Magazine’s 5000 Fastest-Growing Private Companies

PAAW Administrator — Mon, 21 Aug 2017 12:08:41 GMT

Wisconsin-based company ranked on list at No. 2897

Recently, Inc. magazine released their 36th annual Inc. 5000 list, the nation’s most prestigious ranking of the fastest-growing private companies in the United States. Aladtec, Inc. moved up 20 spots, moving from No. 2917 last year to No. 2897 this year. The company ranked No. 3197 in 2015. Only one in five businesses on the list achieve the accolade of appearing on the list three times.

The annual list highlights the most successful independent small businesses based on growth. Previous companies who are now household names first appeared as honorees on Inc. 5000 - including Microsoft, Dell, Domino’s Pizza, Pandora, Timberland, LinkedIn, Yelp, Zillow, and many others. Ranking number one this year is San Francisco based Skillz - a popular mobile-gaming platform.

Aladtec was founded in 2005 and is headquartered in River Falls, Wisconsin. They provide online employee scheduling and workforce management software solutions to over 1,900 organizations primarily within the Public Safety Sector. Nearly 120,000 people use the system and a half-billion hours have been scheduled using Aladtec.

"We are extremely honored to be on the Inc. 5000 list for the third year in a row,” states Aladtec Founder, and President, David Feyereisen. “But we don't seek growth just for the sake of growth. We strive to provide the hometown heroes in Public Safety with the finest workforce management solution money can buy, at a price any department can afford. Our staff is dedicated to that goal and our continued growth is a result of that dedication.”

2017 Wisconsin Stars of Life Honorees Announced

PAAW Administrator — Tue, 08 Aug 2017 14:59:23 GMT

The Professional Ambulance Association of Wisconsin is pleased to announce the 2017 Wisconsin Stars of Life. Each person was nominated by their local ambulance service, and will be presented with Stars of Life recognition and honors for their dedication and commitment. The Stars of Life celebration is the most rewarding and exciting Wisconsin event in our field and is modeled after the American Ambulance Association's National Stars of Life.

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

The 2017 event will be the tenth time PAAW has proudly presented the Wisconsin Stars of Life program. This special event recognizes and honors the dedication of ambulance service professionals - people that stand out in every area of our field.

Schedule of Events

2017 Wisconsin Stars of Life honorees will be recognized at a series of events, to include a welcome reception, banquet dinner and awards program during the Paramedic Systems of Wisconsin Conference, Thursday, September 21, Green Bay, and sometime in October or November at the State Capitol, Madison.

One person from the group of 2017 honorees will be selected and advance to represent Wisconsin. This individual will be recognized at the National Stars of Life program in Washington, D.C., June 11 to 13, 2018. PAAW will provide a $750 travel voucher, and the American Ambulance Association Foundation will provide a grant for hotel and event registration fees for the Star, Star's guest, and host (employer).

>> Click for more on Wisconsin Stars of Life.

Podcast: Discussion on Three EMS Legislative Bills

PAAW Administrator — Tue, 08 Aug 2017 12:59:27 GMT

>> Click to listen now for on-demand playback.

This EMS Live in Wisconsin podcast was recorded live on August 8.

Dana Sechler, EMS Director at Baraboo District Ambulance and PAAW Board of Director member, testified on August 2 during a public hearing before the legislative Assembly's Committee on Health at the State Capitol, Madison.

The public hearing regarded the three bills noted below.

Assembly Bill 310 relating to funding for first responder and emergency medical technician training and certification and making an appropriation. >> Click for Bill history.

Assembly Bill 311 relating to upgrading service levels for ambulances in rural areas. >> Click for Bill history.

Assembly Bill 356 relating to licensure or certificate renewal for certain emergency medical services personnel and ambulance service providers. >> Click for Bill history.

>> Click to listen now for on-demand playback.

Those nominated to receive state honor to be announced during August 8 live podcast

PAAW Administrator — Mon, 07 Aug 2017 13:19:37 GMT

Wisconsin Stars of Life

Twenty-seven emergency medical practitioners were nominated by their local ambulance service to receive Wisconsin Stars of Life honors. The nomination period closed August 1.

The class of 2017 Wisconsin Stars of Life honorees will have their names announced during the live EMS Live in Wisconsin podcast on Tuesday, August 8 starting at 9:00 a.m. To listen live, dial-in using 646-929-1081, or on any internet connected device at http://tobtr.com/10188847.

Honorees will be recognized at a series of events beginning with a dinner and awards banquet on September 21 in Green Bay.

Wisconsin Stars of Life has been proudly produced by the Professional Ambulance Association of Wisconsin since 2006. >> Click for more information on the Wisconsin Stars of Life program.

Public Hearing Scheduled August 2 for Three EMS Related Bills

PAAW Administrator — Mon, 31 Jul 2017 16:47:06 GMT

On Wednesday, August 2, the Assembly's Committee on Health will hold a public hearing on three EMS bills outlined below. The public hearing is scheduled to begin at 11:00 a.m. in room 328 Northwest at the State Capitol, Madison. >> Click for meeting agenda.

Assembly Bill 310 relating to funding for first responder and emergency medical technician training and certification and making an appropriation.
>> Click for Bill history.

Assembly Bill 311 relating to upgrading service levels for ambulances in rural areas. >> Click for Bill history.

Assembly Bill 356 relating to licensure or certificate renewal for certain emergency medical services personnel and ambulance service providers. >> Click for Bill history.

Randolph Mantooth and Dr. Eugene Nagel: The rise of paramedics

PAAW Administrator — Sat, 22 Jul 2017 16:17:15 GMT

EMS Live in Wisconsin Podcast Archive

Our most popular podcast ever just reached 2,500 downloads!

>> Click for on-demand download and listen now!

On Monday, May 4, 2015, PAAW completed a special EMS Live in Wisconsin podcast with guests Dr. Eugene Nagel, Randolph Mantooth and Nancy McFarland.

The 60-minute program was dedicated to discussing the start of Paramedic systems, those responsible for its rise in the 1960's and 70's, the determination and vision it took, and based on their experiences how they see the industry evolving into Community Paramedicine!

Eugene Nagel is a retired anesthesiologist. He was an innovative pioneer who served as medical director for the City of Miami Fire Department's rescue operation from 1964 to 1974. During those 10 years, Dr. Nagel developed the first paramedic program utilizing telemetry and voice medical control. The biophone or “orange box” was a familiar piece of equipment on the TV show EMERENCY! The TV show’s unit now resides on display at the Smithsonian Institute.

Randolph Mantooth is an actor, producer and speaker. Widely known for his role as Paramedic John Gage in the TV series EMERGENCY! -- the show that transformed America's perception and approach to emergency medical care in the 1970s and introduced millions to the word "paramedic" for the first time. Mr. Mantooth is a popular speaker at Fire and EMS events, and an advocate for firefighter health and safety. His website is www.RandolphMantooth.com.

Nancy McFarland is a retired LA County Fire Museum board director and Chair of the Pioneers of Paramedicine Committee. Ms. McFarland was instrumental in uniting the four doctors credited with starting the first (fire-based) paramedic programs in the United States in the late 1960s for taped interviews and a Lifetime Achievement Awards Gala in May of 2010. The Pioneers of Paramedicine website and video is located at >> http://pioneersofparamedicine.com/

>> Click for on-demand download and listen now!

EMS Live in Wisconsin is broadcast live on the phone and via the internet the second and fourth Tuesday every month starting at 9:00 a.m. and typically running 30 minutes.

Don't miss a beat of the action - listen to EMS Live in Wisconsin.

teachable moment

PAAW Administrator — Wed, 19 Jul 2017 12:43:09 GMT

Standby for Tones Blog

It’s hot, and she’s not dressed for it. Sweatshirt and sweatpants, tee shirt and socks with laced up tennies. She’s currently sitting in the rear of a squad car, guzzling on a bottle of Sprite that is sweating only slightly less than she is.

Passersby found her, she was down on the ground and it was pretty clear she’d fallen. Someone helped her up, but then she fell again. So they called it in, the nice officer who responded scoped out the clothing situation and her speech, and activated EMS non-emergent. Now we’re here, and I lead my student across the street from our parking spot towards the black and white. My partner updates MedComm that we are on location, and brings up the rear. On this initial evaluation we’ve got the cardiac monitor. The bag is feet away should we need anything.

The lady was assisted out of her sweatshirt by the officer prior to our arrival. Pink and white camouflage, it’s more at home in a rural environment than here in the city but I guess you never know where people hail from originally. Little bits of home from all over converge in any metropolis, and you get what you get. The only constant is that the kaleidoscope keeps moving, the bits and pieces keep on tumbling.

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

PSOW conference registration now open

PAAW Administrator — Wed, 19 Jul 2017 12:31:55 GMT

The Paramedic Systems of Wisconsin will be hosting its 30th annual conference in Green Bay, September 20 to 22. The conference is specifically designed for Service Directors, Medical Directors and Training Centers.

The program will start at 10:00 AM on Wednesday morning September 20 with initial individual and provider introductions. Thursday and Friday will continue on with excellent presentations that will have everyone talking all year long. The conference agenda and list of topics and presenters will be made available sometime in August.

For more information or to register, click here or go to PSOW.org.

Wisconsin EMS office follows FDA guidance, allows use of drugs beyond expiration dates

PAAW Administrator — Tue, 18 Jul 2017 13:28:52 GMT

Recently, the U.S. Food and Drug Administration (FDA) provided guidance on certain drugs that can be used beyond the manufacturer's labeled expiration date. At this time, the drugs listed below can be used during the shortage or while available. Per the FDA, to ensure patient safety, these products should have been—and should continue to be—stored as per labeled conditions. >> Click for FDA information on drug shortage.

The medications included in this expiration date waiver include the following drugs manufactured by Hospira Inc, a Pfizer company:

Epinephrine Injection, USP 0.1 mg/mL; 10 mL ABBOJECT syringe (NDC 0409-4921-34)
Dextrose 50% Injection, USP, 50 mL ABBOJECT Syringe (NDC 0409-4902-34)
Atropine Sulfate Injection, USP 0.1 mg/mL; 10 mL ABBOJECT syringe (NDC 0409-4911-34)
Atropine Sulfate Injection, USP 0.1 mg/mL; 5 mL ABBOJECT syringe (NDC 0409-4910-34

The Wisconsin EMS Office recommends practitioners work with their local medical director to determine the most appropriate response to these drug shortages. In addition, the Department of Health Services and Department of Transportation (DOT) discussed these shortages and the DOT ambulance inspector will not cite for these identified expired medications. However, all other expired medication dates will be subject to DOT enforcement action. EMS services will not be required to submit drug shortage protocols but will need to follow FDA recommendations.

The memo issued on this will be in effect until December 31, 2017. >> Click to read memo 17-04.

EMS' role in the opioids battle

PAAW Administrator — Tue, 27 Jun 2017 16:25:28 GMT

>> Click to listen now for on-demand playback.

This EMS Live in Wisconsin podcast was recorded on Tuesday, June 27. Program guests from the Milwaukee County Office of Emergency Management, included Director Christine Westrich, Dr. Colella and EMS Division Director Ken Sternig.

Wisconsin is not immune from the national opioid epidemic and spike in deaths related to overdoses. According to the Wisconsin Opioid Task Force, opioid-related overdose deaths more than tripled in Wisconsin from 194 deaths in 2003 to 622 deaths in 2014. >> Report: Governor's Task Force on Opioid Abuse

EMS is on the front-line in responding to these calls in both urban and rural areas of the state.

>> Wisconsin Naloxone/Narcan Rebate Program

>> Click to listen now for on-demand playback.

Chris Anderson appointed by Governor to State's EMS Advisory Board

PAAW Administrator — Sat, 24 Jun 2017 16:53:59 GMT

Wisconsin EMS Advisory Board

The Governor's Office notified Chris Anderson, Operations Director at Bell Ambulance, Milwaukee, he is the newest appointment by Governor Scott Walker to the State's EMS Advisory Board.

According to Chris, "Being involved with the EMS Advisory Board is something I've been interested in for several years. Finally, about two years ago, I realized that if I truly wanted to be involved, I had to do more than think about it, so I began the application process. I was surprised and honored to receive the call last week. I look forward to working with the other members of the board as we take Wisconsin EMS into the future."

Since 2008, Chris has been Operations Director at Bell Ambulance. He became an EMT in 1999 and a paramedic in 2004. His entire EMS career has been spent in Milwaukee, beginning with two years of full-time ambulance work, followed by various supervisory and management positions which led to his current position. In his current position, Chris oversees about 250 staff members, who respond to calls ranging from pre-scheduled to emergent and from BLS to Critical Care. Chris enjoys working with other EMS leaders to further the interests of this very unique business.

In 2011, Chris joined the Professional Ambulance Association of Wisconsin as a Board of Directors member, where he also holds an executive officer position as Secretary for the state ambulance member association.

Chris joins PAAW Board of Directors member Mark Fredrickson, Executive Director at Gold Cross Ambulance, Menasha, as the second PAAW Board of Directors member to currently be serving on the State of Wisconsin EMS Advisory Board. Mark holds the position of Vice President on the EMS Advisory Board, and has been a long serving member since 2005.

Bound Tree Medical to host conference call on national drug shortage

PAAW Administrator — Sat, 24 Jun 2017 15:35:15 GMT

National Drug Shortage Information Session

Speakers:
Stacey Barksdale Price, Senior Product Manager, Bound Tree Medical
James Augustine, MD, US Acute Care Solutions

When: Friday, June 30th at 11:00 pm (CDT)

Did you know within the last three weeks the number of products on the Bound Tree weekly backorder report has grown from 50 to 70? It appears the current national drug shortages impacting EMS agencies are very similar to the shortages experienced back in 2012.

Join our free webinar to learn more about the current drug shortages, the products involved, and coping strategies commonly seen in EMS from Stacey Barksdale Price and James Augustine, MD.

Reserve your seat now »

Governor Walker signs EMT language change bill

PAAW Administrator — Wed, 21 Jun 2017 13:14:52 GMT

On June 21, Governor Scott Walker signed Bill AB 59 regarding EMT language changes.

This bill changes the terminology for emergency medical technicians. The term “first responder" changes to “emergency medical responder." The term “emergency medical technician — basic" changes to “emergency medical technician." The term
“emergency medical technician — intermediate" does not change. The term “advanced emergency medical technician” is added to reflect the level currently in the Department of Health Services rules known as “emergency medical technician — intermediate technician.” The term “emergency medical technician — paramedic" changes to “paramedic." The term “emergency medical technician" currently refers collectively to emergency medical technicians — basic, emergency medical
technicians — intermediate, and emergency medical technicians — paramedic, and that term changes to “emergency medical services practitioner" under the bill and includes advanced emergency medical technicians.

At the invitation of the Governor, Baraboo District Ambulance Chief and PAAW Board of Directors member Dana Sechler, third from the left in the photo insert, represented PAAW at the bill's signing ceremony.

>> Click to read bill AB 59.

There are several other EMS bills currently being reviewed and considered at the State Capitol, to include flexible staffing, changing license renewals from two to every three years, and community paramedicine to name a few. A lot of the recent legislative activity is due in part to last year's work by the Legislative Study Committee on Volunteer Firefighter and EMT Shortages, which led to bill recommendations by the Joint Legislative Council.

Epi shortage, FDA extending labeled expiration dates

PAAW Administrator — Tue, 20 Jun 2017 14:38:14 GMT

Pharmaceuticals

Due to the ongoing critical shortages of injectable drugs used in critical care, the FDA is alerting health care professionals and emergency responders of updated dates through which some of these injectable drugs, manufactured by Hospira Inc, a Pfizer company, may be used beyond the manufacturer’s labeled expiration date. A few days ago, the FDA announced extending expiration dates on Pfizer Atropine, D50 and epi. >> Click for related article.

Bound Tree Medical will be hosting a conference call on Friday, June 30 regarding the epi shortage. PAAW will pass along the call-in information once received.

FDA approves new, cheaper rival to EpiPen
U.S. regulators have approved new competition for EpiPen, the emergency allergy medicine that made Mylan a poster child for pharmaceutical company greed. Last summer, the company came under fire for repeatedly raising the price of EpiPens and CEO Heather Bresch was grilled by a Congressional panel.

Mylan hiked the price of a pair of EpiPens from $94 in 2007, when the company acquired the product, to $608 last year. The devices need to be replaced each year, adding to the financial sting. Analysts and others have estimated that it costs less than $20 to produce a pair of EpiPens.

The Food and Drug Administration on June 15 approved Adamis Pharmaceuticals Corp.'s product, which should go on sale later this year. The "Symjepi" is a syringe prefilled with the hormone epinephrine, which helps stop life-threatening allergic reactions from insect stings and bites, foods such as nuts and eggs, or certain medications. Adamis said it is still lining up a distributor so it hasn't set the exact price for its product, which will be sold in pairs like EpiPen. >> Click for related news item.

Telemedicine perfectly suited for Community Paramedicine

PAAW Administrator — Tue, 13 Jun 2017 14:44:37 GMT

EMS Live in Wisconsin Podcast

>> Click to listen now!

This podcast was recorded on Tuesday, June 13. Our guest was Dr. Alex Sommers with Astia Health in Marathon, Wisconsin.

Dr. Sommers designed telemedicine hardware and software perfectly suited for Community Paramedicine applications for in-home, out of hospital applications. In this webcast we learned more about his approach to patient care using the community paramedicine telemedicine model.

Dr. Sommers' website is https://astiahealth.com/.

Co-hosts included Patrick Ryan and Joe Covelli.

>> Click to listen now!

Recognize your EMS star at statewide event!

PAAW Administrator — Mon, 12 Jun 2017 13:06:18 GMT

Wisconsin Stars of Life

Nomination period open until August 1, 2017.

Take this opportunity to reward and celebrate an employee, volunteer, or community citizen who exemplifies the everyday spirit and commitment of a Star of Life.

Each person nominated is presented with Wisconsin Stars of Life honors! You do not need to be a member of PAAW to submit a nomination application. All nominations are welcome.

Stars of Life 2017 honorees will be recognized at a series of events, to include a welcome reception and banquet dinner and awards program during the Paramedic Systems of Wisconsin Conference, Thursday, September 21, Green Bay, and sometime in November at the State Capitol, Madison.

>> Click for the schedule of events.
>> Click for the nomination application (due no later than August 1, 2017).

Reach-A-Child draws in EMS providers to distract children

PAAW Administrator — Tue, 06 Jun 2017 13:30:06 GMT

EMS to the Point Podcast

>> Click for on-demand playback to listen now!

Reach-A-Child, a Madison, Wisconsin based nonprofit, distributes "reach bags" to children ages 2 to 12 in distressed situations. Police, fire and EMS agencies can purchase a set of "reach bags" for a modest amount of money. However, funds to purchase a set of "reach bags" is typically raised through community partners.

The drawstring "reach bag" contains age appropriate books. They present an easy and clean replacement to traditional stuffed animals commonly carried on emergency vehicles.

Reach-A-Child's goal is to have a "reach bag" on every first responder vehicle in Wisconsin. They plan to distribute 20,000 "reach bags" in 2017. Last year, 9,600 "reach bags" were handed out to Wisconsin children and, in 2005, 6,400 "reach bags" were distributed. "Reach bags" are given free of charge to children at scenes and traumatic events where family is involved in an auto accident, house fire or other incident police, fire or EMS are summoned for help.

Reach-A-Child is endorsed by the Professional Ambulance Association of Wisconsin (PAAW).

EMS Live in Wisconsin Podcast: Advancing your career to EMS leader and manager

PAAW Administrator — Wed, 24 May 2017 14:29:28 GMT

>> Click to listen now.

This EMS Live in Wisconsin podcast was recorded on Tuesday, May 23. The topic was dedicated to advancing your career to EMS leader and manager. Our guests included Dan Williams and Jim Singer.

Both Dan and Jim recently announced their retirements from their respective EMS leader positions. With over 70 years of combined EMS experience, they offered an excellent perspective on advancing your EMS career into a leader and manager position. Their recommendations included working with a mentor, advancing your career, leadership and interviewing suggestions and defining company culture.

Dan has over 40 years experience in EMS and recently retired from Emergency Services of Door County where he was director for over 30 years. Dan also was State of Wisconsin EMS Section Chief, Director at MedFlight in Madison and held previous positions with Flight For Life and Paratech Ambulance, both in Milwaukee. For fourteen years, Dan was chairman of Wisconsin's EMS Advisory Board. He continues as conference director for Paramedic Systems of Wisconsin Conference and as an EMS consultant.

Jim recently concluded a 31-year career with Flight For Life, Milwaukee. He was hired in 1986 as a flight nurse and in 1991 was promoted to chief flight nurse. Jim transitioned to System Transport Director in 2001, a position he held until his retirement. Jim was responsible to purchase new aircraft, made significant upgrades to the fleet and managed a system that completed over 33,000 safe flights.

The program was hosted by Chris Anderson and Joe Covelli.

>> Click to listen now.

Standby for Tones Blog EMS Week 2017: "Always, In Service"

PAAW Administrator — Wed, 24 May 2017 13:28:27 GMT

I’m 27, and I have no idea how profoundly this class will affect me. The ways in which it morphs who I am into a better version of myself. The people I will be honored to care for, the things I will witness. The ways those things I witness will impact me for months and years to come. I have no inkling that my appreciation for life itself will grow, deepen and become a nearly measurable entity.

I simply know that I am taking a class, an EMT-Basic class. It meets two evenings a week, from 6-10pm in a town roughly half an hour away from the bank at which I then worked. A nice customer from the bank also is taking the class, and we carpool. His wife is funny and kind and I look forward to those visits at their house before we hit the road, off to class. One day we get to town a little earlier than usual, and we swing by a used car lot just to kill some time. Before you can say SAMPLE, I’m the owner of a lipstick red Camaro just a few days later. In my young mind I think it’s funny to pay extra for a license plate that reads CTCH ME.

We graduate, I continue banking. But something has changed. As the pager I’m given goes off, my heart rate accelerates in a sympathetic nervous system response, and now that I mention it, I’m not certain it’s ever quite gone back to normal. The more I see, the more I am frustrated by the limited ways in which I can help.

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

Community Awareness: EMS STRONG: “Always in Service”

PAAW Administrator — Sun, 21 May 2017 13:29:16 GMT

National EMS Week May 21 to 27

National EMS Week is being celebrated nationwide this year Sunday, May 21 to Saturday, May 27. Emergency Medical Services for Children (EMSC) Day is Wednesday, May 24.

The opportunity brings with it local awareness of emergency medical services, and quite often includes community open houses, volunteer recruitment and hiring drives, and opportunities for appreciation, recognition and goodwill.

The 2017 theme is "EMS STRONG: Always in Service".

EMS Week is celebrated nationally and throughout Wisconsin too. >> Click to read Governor Scott Walker's EMS Week Proclamation.

To help communities, elected officials, and stakeholders better understand EMS, NAEMT has created a new What Is EMS? informational brochure. >> Click to download brochure.

National EMS Week was established by the American College of Emergency Physicians (ACEP), and is in partnership with the National Association of EMTs.

For more information, go to >> http://www.emsstrong.org/.

Standby for Tones: Blog Sneakers & small humans

PAAW Administrator — Wed, 17 May 2017 13:19:30 GMT

The children outside are curious, playing but in a sense of studied nonchalance. Not that any of them look old enough to know the nuance of the word, but innate in them as in all of us lays the gist of the word’s implication

The fire apparatus is already curbside ahead of us, lights silently announcing to anyone watching that activity is happening within this building, this day. My partner takes the cardiac monitor from me and I keep the jump bag over my right shoulder. Dropping their pretense of play, the children fall still, openly checking out our accoutrements. One brave boy calls out, “hey, whatcha got there? What’s that big bag for?” My partner returns, “helping people”. Simplified, yet valid.

Inside, a middle aged man with an air of importance around him meets us, gives us a short layman’s report. It is remarkably succinct, and with nearly all necessary components I could’ve asked for if making a list. We continue on in the direction indicated, where ahead a small group of people can be seen gathered in the cafeteria. It’s after hours, at this school, and yet the gathering is modest. I see fire ahead, and a slight woman with grey hair barely visible in the middle of the navy shirts, suspenders attached to turnout pants, and male muscles.

I greet the lieutenant by name and make my way around the far end of the cafeteria tables arranged in neat rows. The patient has the gathering of firemen around her as well as a couple elderly ladies and amidst all of these, a few more assorted small humans, watching with grave interest. The lieutenant was a new fireman when I was a new medic and he gives report after greeting me by name.

“Patient was getting up, caught her sneaker” <I remember thinking, “Jimmy said sneaker, who says sneaker? Have to tease him later on at some point”> “on the bench and fell, hitting her head. She did lose consciousness. Her blood pressure is low; she was very pale when we got here. Her heart rate is very slow, blood sugar is 92.”

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

State EMS Advisory Board Sub-committee application deadline May 26

PAAW Administrator — Wed, 17 May 2017 12:59:51 GMT

The Wisconsin EMS Advisory Board Subcommittees are formed to address specific areas and develop recommendations. There are four subcommittees that meet regularly in Madison during EMS Advisory Board meetings.

The sub-committees include:

EMS System Quality and Data

EMS Education and Training

EMS Systems Development and Management

EMS Physician Advisory Group

If interested to serve on a sub-committee an application is required. The deadline to apply is noon on Friday, May 26. Elections will take place at the June 7 EMS Board meeting.

>> Click to download the memo regarding the application process.

Direct any questions to the Wisconsin EMS office at 608-266-1568 or dhsemssmail@wisconsin.gov.

EMS STRONG: “Always in Service”, National EMS Week May 21 to 27

PAAW Administrator — Wed, 17 May 2017 12:33:50 GMT

National EMS Week is being celebrated nationwide this year Sunday, May 21 to Saturday, May 27. Emergency Medical Services for Children (EMSC) Day is Wednesday, May 24.

The 2017 theme is "EMS STRONG: Always in Service".

To help communities, elected officials, and stakeholders better understand EMS, NAEMT has created a new What Is EMS? informational brochure. >> Click to download brochure.

National EMS Week was established by the American College of Emergency Physicians (ACEP), and is in partnership with the National Association of EMTs.

For more information, go to >> http://www.emsstrong.org/.

Medicare Fraud, Whistleblowers and Steps to Reduce False Claims Act Risk

PAAW Administrator — Tue, 09 May 2017 17:00:19 GMT

EMS Live in Wisconsin Podcast

Ways to avoid unintended consequences in billing compliance.

>> Click for on-demand playback and listen now!

This podcast episode was recorded on May 9 and was dedicated to discussing Medicare Fraud, whistleblower protection and steps to reduce your False Claims Act risk.

Recently, Madison attorney Wendy Arends with Godfrey & Kahn authored an article involving a $12.7 million settlement in a whistleblower Medicare fraud case against MedStar Ambulance in Massachusetts. The former billing manager was the whistleblower in this case and reported the wrongdoing.

MedStar Ambulance is alleged to have: (1) billed for transports that were not medically reasonable and necessary; (2) billed for higher levels of services than patients’ conditions necessitated; and (3) billed for higher levels of services than were actually provided.

Besides the MedStar case, we also discussed how to reduce an ambulance service's Fraudulent Claims Act risk with internal policy and procedures, to include policies that address: conducting internal audits and monitoring, designating a compliance officer, a process to investigate potential violations or patient complaints, whistleblower protection, etc. Even if your ambulance service uses a third-party billing company to process runs, code them and bill Medicare, it doesn't release you as the ambulance company from liability, compliance, completing audits and any unintended consequences that may arise.

In addition to Wendy Arends as our guest we were also joined by Tom Tornstrom, Executive Director at Tri-State Ambulance in La Crosse, who offered some excellent points, to include Chapter 10 (Ambulance Services) of the Medicare Benefit Policy Manual that every ambulance service director should read.

>> Click to download Wendy's article regarding the MedStar Ambulance Medicare fraud settlement case.

>> Click to download Medicare Benefit Policy Manual - Chapter 10 (Ambulance Services).

Don't miss a beat of the action - listen to EMS Live in Wisconsin!

>> Click for on-demand playback and listen now!

Milwaukee County Puts End to Hospital ER Diversions by Ambulances

PAAW Administrator — Tue, 25 Apr 2017 21:25:30 GMT

EMS Live in Wisconsin Podcast

Successful report tied to core value of patient-centered EMS delivery

>> Click for on-demand playback and listen now!

What started decades ago throughout Milwaukee County EMS as a seemingly well-intended policy to divert ambulances to less crowded hospital emergency departments now represented an opportunity to realign patient-centered EMS delivery within the context of a changing health care landscape.

According to Milwaukee County EMS Medical Director Dr. Mario Colella, "In the era of diversion, we noticed when one hospital went on diversion other surrounding hospitals soon followed, patient satisfaction diminished and ambulances were forced to drive further away from their communities. Most importantly, patients that were sick were denied access to the closest emergency care".

With the phased in policy, ambulance diversion officially ended April 1, 2016, in Milwaukee County. Now, a report has been authored on the outcomes from the policy change. >> Click to review the report's executive summary.

The podcast was recorded on April 25. Guests included Milwaukee County Emergency Management Director Christine Westrich, Milwaukee County EMS Medical Director Dr. Mario Colella and Milwaukee County Emergency Management Program Director Ken Sternig. >> Click for on-demand playback and listen now!

The following questions were discussed:

What is the history of Hospital Diversion and why is "non-diversion better?
How did Milwaukee County coordinate this among paramedics, hospitals, etc.?
Did you stage the approach or go cold-turkey on the actual operations?
Did the data show what you expected -- has there been any fallout or successes?
What's next for the Milwaukee County EMS System?

EMS Live in Wisconsin is broadcast live on the phone and via the internet the second and fourth Tuesday every month starting at 9:00 a.m. and typically running 30 minutes.

Don't miss a beat of the action - listen to EMS Live in Wisconsin. >> Click for past show archive.

Assembly votes unanimously to approve Community Paramedicine Bill

PAAW Administrator — Wed, 05 Apr 2017 14:15:02 GMT

State Capitol

Bill now moves to the Senate, to hold public hearing soon.

The Community Paramedicine Bill, >> AB151, received unanimous vote of approval by the full Assembly at the State Capitol on April 4. Assembly Amendment 1 was adopted and passed. >> Review Community Paramedicine Bill - Assembly Amendment 1.

During the Assembly's Committee on Health public hearing on March 22, Dana Sechler, EMS director at the Baraboo District Ambulance Service, said "Community EMS fills the "gaps or voids where there is a need. Their efforts can help hospitals avoid penalties for re-admissions".

Captain Michael Wright of the Milwaukee Fire Department shared with members of the Assembly's Committee on Health that he helped develop the city's community paramedic program three years ago. The department, which has about 30 trained paramedics, focuses not only on preventing re-admissions, but also to help those who frequent emergency rooms for their healthcare. The program is funded by the city of Milwaukee. He said the program was needed because "there's so many gaps."

Captain Wright, photo insert, stated during the public hearing, "For eighteen years, I've been responding to people and knowing that they needed more. They weren't getting it from the hospitals, they weren't getting it from the doctors. They couldn't get it from us because we don't have time. The program helps provide that care, he said".

According to PAAW Lobbyist Michael Brozek, "This is a very, very fast tracked piece of legislation...unusually fast."

Minnesota Ambulance Association Lobbyist Buck McAlpin also shared on news about the Assembly's vote, "Very few states have formalized this (Community Paramedicine) into law - a very nice win." McAlpin was instrumental in Minnesota passing Community Paramedicine legislation in 2011.

Now, the bill heads to the Senate. The companion bill in the Senate is known as >> SB149. It was read for the first time before the full Senate on March 29, and then referred to the Committee on Health and Human Services for a public hearing.

Full Assembly to vote on Community Paramedicine Bill Tuesday, April 4

PAAW Administrator — Mon, 03 Apr 2017 14:30:39 GMT

State Capitol

Senate to hold first public hearing on Thursday, April 6.

The Community Paramedicine Bill received a public hearing on March 22 and unanimous vote of approval on March 29 from the Assembly's Committee on Health. Now, the bill goes before the full Assembly at the State Capitol and is scheduled for a vote on Tuesday, April 4. The bill is known as AB151 and is sponsored by Rep. Amy Loudenbeck.

It is anticipated the Assembly will vote in favor of the Community Paramedicine Bill. The companion bill in the Senate, known as SB24, is tentatively scheduled for a public hearing in the Senate on Thursday, April 6. >> Click to download Senate Community Paramedicine Bill SB149.

Recent Podcast on Community Paramedicine

>> Click to listen now.

This EMS Live in Wisconsin podcast was recorded on Tuesday, March 28, and was dedicated to Community Paramedicine. Guests included Minnesota Ambulance Association Legislative Lobbyist Buck McAlpin and PAAW President Patrick Ryan. >> Download the podcast at http://tobtr.com/9900319.

Community Paramedic Training Program - Offered by the University of Wisconsin - Milwaukee

Using the North Central EMS Curriculum, a Community Paramedic Program is offered through the University of Wisconsin - Milwaukee. The program provides all required content for the Community Paramedic including:

Core content specific to the Role of the Community Paramedic
Content specific to Community and Public Health
Cultural Competency Community Assessment
Chronic Disease Assessment, Teaching and Management

For more information >> click here or contact Dr. Kim Litwack, Program Director at 414-229-4189 or email litwack@uwm.edu.

Assembly's Committee on Health to vote on Community Paramedicine Bill

PAAW Administrator — Mon, 27 Mar 2017 16:35:04 GMT

State Legislation

Following a public hearing on March 22 at the State Capitol, the Assembly's Committee on Health called an executive session to vote on AB151, the Community Paramedicine Bill. The executive session is scheduled for Wednesday, March 29 starting at 11:00 a.m. in room 328 Northwest at the State Capitol. >> Click for the meeting agenda.

The Wisconsin Department of Administration (DOA) recently released a report detailing the fiscal impact to the Department of Health (DHS) in adding an endorsement for Community EMT and Community Paramedic. According to the report, to implement the endorsement, provide training and maintain the standard of 60 days or less to process licenses, operation plans and protocols, DHS would require one additional full-time coordinator at $80,300 GPR. In addition, there are two minor one-time setup fees totaling $7,500. >> Click to review the DOA fiscal estimate.

The Community Paramedicine / Mobile Integrated Healthcare Bill is sponsored by Rep. Amy Loudenbeck. >> Click for the Community Paramedicine Bill (AB151).

According to PAAW President Patrick Ryan, "PAAW, along with State stakeholders have worked long and hard to get this important legislation to this point. We are optimistic about support throughout the state for the establishment of a framework for the development of Community Paramedic programs across the state".

For current insights into what EMS Today conference attendees had to recently share about Community Paramedicine and Mobile Integrated Healthcare program ideas, click here.

Upcoming Podcast on Community Paramedicine - Tuesday, March 28 at 9:00 a.m.

The next EMS Live in Wisconsin podcast on Tuesday, March 28, is dedicated to Community Paramedicine. Guests include Minnesota Ambulance Association Legislative Lobbyist Buck McAlpin and PAAW President Patrick Ryan. Listen live by calling 646-929-1081, or on the internet at this link >> http://tobtr.com/9900319. The program is broadcast live from 9:00 to 9:30 a.m.

Minnesota is a leading state in Community Paramedicine, with its bill signed into law in 2011. McAlpin was instrumental in the bill passing in Minnesota, and has consulted with PAAW and other ambulance services in Wisconsin intending to deliver Community Paramedicine in the badger state. McAlpin's employer, North Memorial Medical Center, Brooklyn Park, Minnesota, offered a two-day class in September 2015 for Wisconsin's ambulance services and other healthcare providers to review their operation and stats, to meet those delivering out-of-hospital Community Paramedicine care, and help these organizations begin to lay the groundwork for Community Paramedicine in their own community.

24 EMTs could lose jobs with potential transfer

PAAW Administrator — Mon, 27 Mar 2017 15:36:21 GMT

Western Wisconsin EMS News

More than 20 St. Croix EMS emergency medical technicians could lose their jobs if the city of Hudson decides to transfer the service to the Hudson Hospital and HealthPartners. City commissioners emphasized negotiations are still ongoing and no decision has been made.

Lakeview Vice President of Ancillary Services Nathan Pulscher, one of HealthPartners’ representatives at the meeting, said the Hudson Hospital would use the two-paramedic model that other HealthPartners organizations do, as it has found the model to be successful. Under this model, Hudson Hospital would offer all current St. Croix EMS paramedics employment, but the model has no role for current EMTs.

St. Croix EMS employs 24 EMTs and 12 paramedics, though some employees in both positions already work for HealthPartners as well.

Pulscher said HealthPartners and Hudson Hospital would be willing to talk about supporting current EMTs in being trained as paramedics.

Currently the hospital and city have not landed on an answer for who will serve as first responders to the community if the transfer is approved.

Council Member Tom McCormick said the city is dedicated to public safety in the community. Services would still be based in Hudson.

“We want to have a successful EMS system,” McCormick said.

McCormick said the city has approved retention bonuses for most EMS staff that would provide incentive for workers to stay on and ensure the service can continue to operate up until the transfer point, if the transfer is approved.

Source: Hudson Star-Observer

Germany - & "Irish mayonnaise"

PAAW Administrator — Mon, 27 Mar 2017 15:04:16 GMT

Standby for Tones Blog

They only moved here a month ago, she says. It’s quite dark outside and you can’t tell it’s foggy unless you catch a glimpse of the misty haze in the glow of the passing small town streetlights. From another part of the state, they loved the topography of the bluffs that line the mighty Mississippi in our driftless region. The coulees stretch fingers up among the gentle swells of the bluffs, and in the warmer months the surface of the water is glassy and rippling, in turns. They knew exactly where they wanted to move when they retired, and just under a month ago they made my region of Wisconsin their permanent home. When she speaks of the views she enjoys from their new home, her face lights up and she beams. The joy is incongruous in its juxtaposition next to the ecchymosis evident on her eyelid and surrounding tissues which occlude her vision on one side.

The Badgers played awhile back and lost the game to the Gators in the last 4 seconds. She and her hubby haven’t really met anyone here yet, so they enjoyed a couple beers at home. Unused to the unfamiliar home, she stumbled in the dusk afterward and lost her footing. A retired healthcare provider, she chalked up her subsequent pain and stiffness as just a result of tumbling down some stairs. Time went by, the sun rose, she began to admit that it was more than pain and stiffness. Listening to her history of the events, I’m struck by her strength. The paperwork accompanying her lists a fracture as well as an anteriorly displaced shoulder dislocation – in the same upper extremity as the ecchymosis. A reduction attempted was unsuccessful due to some myoclonus and trismus evidenced after administration of etomidate. I’m currently transporting her to a larger facility for further care.

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

EMTs, firefighters need guns, Texas lawmaker says

PAAW Administrator — Mon, 27 Mar 2017 14:37:16 GMT

Texas Legislation Introduced

Texas lawmakers introduced legislation last week to allow the state’s first responders to carry a handgun while on duty, KXAN reported.

The proposed legislation would make it possible for firefighters and Emergency Medical Services personnel who have firearms permits to carry their guns during normal shifts.

“You never really know what you’re getting into,” said Capt. Rick Rutledge, of the Austin-Travis County EMS. “There are certainly risks.”

House Bill 435 also allows for volunteer emergency workers to carry guns. The bill, according to the station, will not require any further training for those who are already licensed to carry firearms.

“You have to assume it’s like a driver’s license,” said State Rep. Dan Flynn, a Republican. “You know how to drive before you get a license; you know how to shoot a gun before you get a license.”

Still, Rutledge questions if the bill will really help the state’s first responders to remain safe.

“Protecting that weapon, limiting liability, knowing when to use and not use that. It is a specialized area and a course of training that we haven’t had,” Rutledge said.

Chris Barron, the executive director of the State Firefighters’ and Fire Marshals’ Association of Texas, echoed the sentiment: “We are not trained in law enforcement.”

Flynn told KXAN that “hostility towards first responders” is the reason for the bill.

“What we’re finding out is often, someone will set up an attack, they’ll set up a fire just to go after people that they don’t like,” he said.

Panel Selected to Facilitate Development of EMS Agenda 2050

PAAW Administrator — Sat, 25 Mar 2017 17:26:29 GMT

National EMS News

Members will engage the national EMS community in creating a vision for the future

What could be the role of EMS in our nation's healthcare, public health, and public safety systems in three decades? What do we have to do now to make that happen? EMS Agenda 2050, a two-year project with a mission to write a new Agenda for the Future, has selected 10 members to serve as the Technical Expert Panel (TEP), which will work with the EMS community to answer these and other questions.

The panel will take ideas and suggestions from the EMS, public safety, and healthcare communities, as well as the general public, to create a path for a comprehensive system of emergency care integrated with the broader healthcare continuum.

The 10 TEP members bring to the project diverse backgrounds and perspectives, including experience at local, state and national levels, a history of innovative thinking and a passion for making a difference in the lives of patients and providers.

The members of the EMS Agenda 2050 TEP are:

Derek Bergsten, MPA, CFO, CEMSO, MIFIreE, Fire Chief, Rockford Fire Department (Rockford, IL)
Marianne Gausche-Hill, MD, FACEP, FAAP, FAEMS, Medical Director, Los Angeles County EMS Agency (Los Angeles, CA)
Andy Gienapp, MS, NRP, Manager, Wyoming Office of EMS, Wyoming Department of Health (Cheyenne, WY)
Alexander Isakov, MD, MPH, FACEP, FAEMS, Professor of Emergency Medicine, Emory University School of Medicine (Atlanta, GA)
William Leggio, EdD, NRP, Paramedic Program Coordinator and Clinical Faculty, Creighton University (Omaha, NE)
Grace Mandel, MPH, EMT, Project Manager, Baltimore City Department of Health (Baltimore, MD)
Kevin G. Munjal, MD, MPH, MSCR, Assistant Professor, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai (New York, NY)
Kyra Neeley, M.Ed., EMT-P, Lieutenant, Fire Commissioner Liaison, Fire Department of New York EMS (New York, NY)
Ernesto Rodriguez, MA, EMT-P, Chief, Austin-Travis County Emergency Medical Services (Austin, TX)
YiDing Yu, MD, Founder and CEO, Twiage; Instructor, Department of Population Medicine, Harvard Medical School (Boston, MA)

For more information about EMS Agenda 2050, please visit emsagenda2050.org.

National EMS Week May 21 - 27

PAAW Administrator — Sat, 25 Mar 2017 15:36:48 GMT

Community Awareness

National EMS Week will be celebrated nationwide this year Sunday, May 21 to Saturday, May 27. Wednesday, May 24 is Emergency Medical Services for Children (EMSC) Day.

The 2017 theme is "EMS STRONG: Always in Service".

National EMS Week was established by the American College of Emergency Physicians (ACEP), and is in partnership with the National Association of EMTs.

For this year's planning kit or more information, go to >> http://www.emsstrong.org/.

Two respected Wisconsin EMS icons announce retirements

PAAW Administrator — Wed, 22 Mar 2017 17:32:21 GMT

Opinion

By Joe Covelli, PAAW Executive Director

We've all attended luncheons, potlucks and parties when co-workers leave their current jobs for something else - an internal promotion, another company, retirement or next adventure. I usually get mixed emotions at events like this, because it means things will never be the same. As is customary, you extend well wishes and good luck on their next endeavor. People, events and circumstances change - and so must we. Some change is for the better, but other change I wish never happened.

In the past couple of months, I've received emails from two individuals I've admired and respected for a number of years - not only professionally in EMS, but in their personal character too. Jim Singer and Dan Williams, two Wisconsin EMS icons in my humble opinion, recently announced their retirements. They've both dedicated their life's work and careers to EMS - Jim with 31 years of service to Flight For Life, Dan with over 45 years in EMS. EMS in Wisconsin is in a better place because of their leadership, vision and commitment.

Jim Singer recently announced his retirement, effective March 31, as System Transport Director following a 31-year career at Flight For Life, Milwaukee.

Jim joined Flight For Life in 1986 as a Flight Nurse. He became the Chief Flight Nurse in 1991 and transitioned to his current position in 2001. Under Jim’s tenure, Flight For Life has purchased new aircraft, made significant upgrades to its remaining fleet and added an additional base of operations in the City of Fond du Lac Wisconsin. Flight For Life has completed over 33,000 safe transports since it began operations as the first air medical service in Wisconsin in 1983.

Dan Williams retired as Director at Emergency Services of Door County in Sturgeon Bay, on January 12, 2017.

In 2013, he announced early retirement as Director at UW Health's MedFlight, Madison, and relocated to Sturgeon Bay. Soon after his early retirement was announced from MedFlight, Dan was asked to serve again as Director at Emergency Services of Door County - a familiar location to him since he was their director for 30 years. He's held previous leadership positions with Flight For Life and Paratech Ambulance Service, both in Milwaukee, and for a number of years has provided EMS consulting to many Wisconsin ambulance services.

Dan was instrumental in shaping EMS through his leadership as state of Wisconsin EMS Advisory Board chairman from 1992 to 2005, a Governor appointed position, and as State of Wisconsin EMS section chief.

Since 1986, Dan has been a lead organizer of the Paramedic Systems of Wisconsin (PSOW), an annual conference for those with ambulance service and EMS leadership responsibilities as administrators, owners, chiefs, officers, directors, managers and medical directors. The September 2017 conference will mark the 30th anniversary for PSOW.

Community Paramedicine Bill Introduced in State Assembly, Referred to Committee on Health

PAAW Administrator — Mon, 20 Mar 2017 16:31:56 GMT

Legislation

The long-awaited Community Paramedicine / Mobile Integrated Healthcare Bill was read for the first time before the Wisconsin Assembly at the State Capitol on March 17, and then referred to the Committee on Health. The bill is sponsored by Rep. Amy Loudenbeck. Wisconsin's fire and EMS stakeholder groups, to include PAAW, have worked diligently the past three or more years on drafting the bill. >> Click for the Community Paramedicine Bill (AB151).

According to PAAW President Patrick Ryan, "PAAW, along with State stakeholders have worked long and hard to get this important legislation to this point. We are optimistic about support throughout the state for the establishment of a framework for the development of Community Paramedic programs across the state".

The Community Paramedicine Bill, known in the Assembly as AB151, now moves to the Committee on Health for review and public comment. The first public hearing is scheduled for Wednesday, March 22, starting at 10:00 AM in room 225 Northwest. >> Click for the Committee on Health's public hearing agenda.
Upcoming Podcast on Community Paramedicine - Tuesday, March 28 at 9:00 a.m.

The next EMS Live in Wisconsin podcast on Tuesday, March 28, is dedicated to Community Paramedicine. Guests include Minnesota Ambulance Association Legislative Lobbyist Buck McAlpin and PAAW President Patrick Ryan. Listen live by calling 646-929-1081, or on the internet at this link >> http://tobtr.com/9900319. The program is broadcast live from 9:00 to 9:30 a.m.

Minnesota is a leading state in Community Paramedicine, with its bill signed into law in 2011. McAlpin was instrumental in the bill passing in Minnesota, and has consulted with PAAW and other ambulance services in Wisconsin intending to deliver Community Paramedicine in the badger state. McAlpin's employer, North Memorial Medical Center, Brooklyn Park, Minnesota, offered a two-day class in September 2015 for Wisconsin's ambulance services and other healthcare providers to review their operation and stats, to meet those delivering out-of-hospital Community Paramedicine care, and help these organizations begin to lay the groundwork for Community Paramedicine in their own community.

EMS care of the kidney dialysis patient

PAAW Administrator — Tue, 14 Mar 2017 13:49:28 GMT

EMS Live in Wisconsin Podcast

>> Click to listen now!

March is Kidney Awareness Month. Our guest on the March 14th EMS Live in Wisconsin podcast was Dr. Ashraf El-Meanawy, Director of Dialysis at Medical College of Wisconsin, Milwaukee.

Even though only .5% of the population is diagnosed with kidney disease, these patients account for 4% of the federal Medicare budget.

We discussed:

What makes a dialysis patient different from a regular pre-hospital EMS patient?
Are dialysis patients at higher risk for cardiac arrest and why?
What are pit-falls EMS personnel can fall into when responding to a call for a dialysis patient?

>> Click to listen now!

Don't miss a beat of the action - listen to EMS Live in Wisconsin!

Podcasts focus on federal and state EMS priorities, funding, proposed legislation

PAAW Administrator — Wed, 01 Mar 2017 16:44:37 GMT

Wisconsin EMS Advisory Board update from Chairman Jerry Biggart and committee member Dana Sechler. Patrick Ryan discussed Community Pararmedicine legislation being introduced soon at the State Capitol. >> Click to listen now!

Making Medicare "Add-on Payments" Permanent with American Ambulance Association Senior VP of Government Affairs Tristan North, Washington, D.C. Medicare payments account for a minimum of 50% of an ambulance service's payer mix. >> Click to listen now!

State EMS Office Updates about new regional coordinators, changes to FAP funding with State EMS Director James Newlun. >> Click to listen now!

Listen live to EMS Live in Wisconsin podcasts the second and fourth Tuesday every month starting at 9:00 a.m. and running thirty minutes. >> Click for the past show archive.

Don't miss a beat of the action - listen to EMS Live in Wisconsin.

Hello, my name is....

PAAW Administrator — Sat, 25 Feb 2017 19:48:05 GMT

Standby for Tones Blog
Hello, my name is...

He’s seen a few presidents, and he’s known a few good decades. Right now, he’s hanging out with me, because his head laceration is impressive. Fire did a great job of bandaging the wound up, but no one’s addressed the puddle of blood just yet. His speech is slurred, refined but slurred. I’m making his acquaintance as I put on my three lead, take my first blood pressure, scope out the oxygen saturation level. Everything checks out within normal parameters, so I press on. No odor of alcohol, blood sugar also within what I’d like to see. He cocks his head, then, looks at me.

“I sound funny.”

“Funny ha, ha?” I ask lightly, carefully watching him.

“My words – like I’ve been drinking. I haven’t been.”

There it is, then. Altered from his baseline – and he knows it. Assessment continues, he denies loss of consciousness, denies any neck pain, CMS is intact, on down the line. Cervical collar in place, we assist him to a standing position and with the cot positioned behind, guide him to be seated. Securing him with straps, wheeling him to the truck, loading him within. Once inside, transport begins as secondary assessment shows no new findings. Eyes equal, round and reactive to light – I go on down the familiar road of assessment. I keep up a light banter about the weather, the circumstances surrounding the purpose of my arrival at his home today. I circle back around some details so he ends up re-answering questions he’s already answered. His answers remain on point, consistent.

>> 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.

Joint Legislative Council meets, votes on draft bills to remedy EMT shortage

PAAW Administrator — Wed, 08 Feb 2017 14:50:49 GMT

Following five months of meetings by the Legislative Study Committee on Volunteer Firefighter and EMT Shortages, the very group that created the Study Committee, the Joint Legislative Council, acted on the Study Committee's recommendations February 1.

In the end, seven pieces of draft bill legislation were considered by the Joint Legislative Council, with six bill drafts approved for introduction to the full legislature by the Joint Legislative Council. The only bill draft to not be approved involved creation of a fire service district authorizing the district to levy a property tax and impose special charges. >> Click to review draft bill legislation voted on by the Joint Legislative Council.

According to PAAW Executive Director Joe Covelli, "It is apparent anything with a fiscal note or tax wasn't being considered or moved forward, so that really handcuffed the Study Committee. The legislative bill drafts to address the EMT volunteer shortage are largely centered around three main themes: license renewal, income tax and length of service credits, and adding first responders to the Funding Assistance Program. These measures may help if they become law, but is it enough to increase firefighter and EMT recruitment and retention? Time will tell." Covelli added, "I think we still need to look at how EMS is delivered and better resource management. That's on us as an industry to work together and figure out".

Naloxone (Narcan) rebate renewed for an additional 12-months by Wisconsin Dept. of Justice

PAAW Administrator — Wed, 08 Feb 2017 13:53:11 GMT

EMS Product Savings

Deadline to submit recent three-month purchase rebate is March 31, 2017

Attorney General Brad Schimel announced February 1, he has renewed the State’s agreement with Amphastar Pharmaceuticals, which established a rebate program for the heroin and prescription painkiller antidote naloxone. Naloxone, often branded as Narcan, can be administered as a nasal spray or injection and works within minutes to reverse the effects of an opioid overdose.

“When an individual has overdosed on prescription painkillers or heroin, we only have a few minutes to intervene and save that person’s life,” said Attorney General Schimel. “I appreciate Amphastar’s willingness to partner with the State and provide those on the frontlines of this battle with financial relief.”

Amphastar Pharmaceuticals has agreed to continue providing a $6 rebate for each Amphastar naloxone syringe purchased by public entities in Wisconsin from now until February 1, 2018.

“Since 2013, we have been working to expand access to lifesaving opioid antagonists like naloxone,” said Rep. John Nygren. “While these medications can be expensive, our state has worked with Amphastar on an agreement that ensures the affordability of these important medications. Measures like this save lives, and I’m looking forward to working with my legislative colleagues, the medical community, law enforcement and the Attorney General, and recovery advocates statewide on more efforts that will help combat Wisconsin’s opioid epidemic.”

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 (PAAW) was instrumental in bringing the Narcan rebate program to Wisconsin in 2016, and working closely with Attorney General Brad Schimel's office.

More information can be obtained from the DOJ website at https://www.doj.state.wi.us/news-releases/ag-schimel-renews-rebate-agreement-manufacturer-lifesaving-opiate-antidote

Purchases made between November 1, 2016, and January 31, 2017, qualify for the rebate under the previous contract; however, to receive a rebate check a DOJ approved form must be submitted no later than March 31, 2017. To claim the rebate or learn more about it, refer to the links below.

>> Amphastar Pharmaceuticals, Inc. Contract
>> Naloxone Rebate - Press Release
>> Naloxone Rebate Instructions
>> Naloxone Rebate Account Form
>> Naloxone Purchase Summary Rebate Form (Quarter 4 - Nov, Dec, Jan)

Wisconsin Attorney General Brad Schimel announced the first rebate program on March 23, 2016, during a press conference at Ryan Brothers Ambulance, Madison.

>> Click for more information about the DOJ announcement and rebate program.

Podcast Interview: State EMS Director James Newlun shares updates on regional coordinators, FAP funding

PAAW Administrator — Mon, 06 Feb 2017 14:35:12 GMT

State EMS Section Updates

>> Click to listen now on-demand.

On January 24, State of Wisconsin EMS Director James Newlun, photo insert, joined PAAW Executive Director Joe Covelli for an EMS to the Point podcast. The podcast is just over 25 minutes.

The interview offers an update on several important topics. They discussed:

Changes to the Funding Assistance Program (FAP),
Adding two new regional coordinators to staff and changing staff responsibilities to operate in regions versus past practice by level of license,
Recent work by the Legislative Study Committee and pending introduction of EMS legislation by the Legislative Council,
EMT and First Responder renewals, and
Upcoming deadlines in transitioning to WARDS Elite.

>> Click to listen now on-demand.

EMS Office announces next bi-enium licensing deadlines and refresher requirements

PAAW Administrator — Tue, 31 Jan 2017 02:19:30 GMT

State Licensing

The Wisconsin Department of Health Services (DHS) EMS Office will open the 2018-2020 Provider Renewal process on August 1, 2017, through June 30, 2018. Individual providers must complete all educational requirements prior to completing and submitting the 2018-2020 Provider Renewal application.

The deadline to complete the 2018-2020 Provider Renewal application is June 30, 2018, to obtain a current certification or license that is valid until June 30, 2020.

All Wisconsin EMS provider applications are completed in the E-Licensing system. The important renewal dates to remember for 2018-2020, are:

July 1, 2016, through June 30, 2018, is the standard renewal period to complete educational requirements.
July 1, 2018 through December 31, 2018, will be the late renewal period and incurs a $50 late renewal administrative fee, per DHS 110.16 (1) (a).
January 1, 2019, through June 30, 2020, will be the reinstatement period and incurs a $75 reinstatement administrative fee, per DHS 110.16 (1) (b).

A license or certification that has been expired for two years or more may only be reinstated by successful completion of the initial education, training and examination requirements.

All continuing education is a personal responsibility. >> Click to review Memo 1701 that provides information and re-certification requirements.

Naloxone (Narcan) purchases eligible for rebate

PAAW Administrator — Tue, 24 Jan 2017 20:11:35 GMT

EMS Product Savings
Deadline to submit recent three-month purchase rebate is March 31, 2017

A statewide program to reimburse ambulance services and other qualifying agencies $6.00 per vial of Narcan is soon approaching, according to the one-year agreement between Wisconsin's Department of Justice (DOJ) and Narcan manufacturer Amphastar Pharmaceutical. The Professional Ambulance Association of Wisconsin (PAAW) was instrumental in bringing the rebate to Wisconsin, which is valued at approximately $6.00 per syringe, or a 25% savings.

Purchases made between November 1, 2016, and January 31, 2017, qualify for the rebate, but to receive a rebate check a DOJ approved form must be submitted no later than March 31, 2017. To claim the rebate or learn more about it, refer to the links below.
>> Amphastar Pharmaceuticals, Inc. Contract
>> Naloxone Rebate - Press Release
>> Naloxone Rebate Instructions
>> Naloxone Rebate Account Form
>> Naloxone Purchase Summary Rebate Form (Quarter 4 - Nov, Dec, Jan)

Wisconsin Attorney General Brad Schimel announced the rebate program on March 23, 2016, during a press conference at Ryan Brothers Ambulance, Madison.

>> Click for more information about the DOJ announcement and rebate program.

Wisconsin EMS Office: Two regional EMS coordinators hired

PAAW Administrator — Thu, 12 Jan 2017 14:07:08 GMT

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.

MTM, Wisconsin's Medicaid patient ambulance transportation broker

PAAW Administrator — Tue, 10 Jan 2017 19:41:46 GMT

EMS Live in Wisconsin Podcast

>> 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:

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.
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.

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

PAAW Administrator — Tue, 10 Jan 2017 18:42:37 GMT

"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 Tuesday, 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.

Wisconsin EMS Office: Two regional coordinators hired

PAAW Administrator — Tue, 10 Jan 2017 18:10:56 GMT

The official announcement from the state's EMS Office is forthcoming; however, two regional coordinators have been hired to buildup staff numbers and tackle the amount of work and requirements coming through the office to manage the state's EMS system. The statewide system is comprised of over 600 ambulance services, emergency first responders, and training centers, and16,500 individual licensed providers.

Governor appointments announced

PAAW Administrator — Mon, 09 Jan 2017 14:51:34 GMT

Wisconsin EMS Advisory Board

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. Medical issues are referred to the Physician Advisory Committee. EMS Advisory Board members are appointed by the Governor.

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.

Standby for Tones Blog: Unexpected

PAAW Administrator — Mon, 09 Jan 2017 14:37:36 GMT

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...

Effort to Create New EMS Agenda Underway

PAAW Administrator — Mon, 26 Dec 2016 17:51:32 GMT

EMS Agenda for the Future

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.

WARDS Elite Update

PAAW Administrator — Mon, 26 Dec 2016 16:51:55 GMT

State EMS Office Memo 1606

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.

Bob Sternhagen honored for his EMS work

PAAW Administrator — Fri, 23 Dec 2016 19:53:35 GMT

Tribute

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.

Minnesota Dept. of Health produces Community Paramedicine Toolkit

PAAW Administrator — Fri, 23 Dec 2016 18:01:14 GMT

Community Paramedicine/MIH

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.

Critical Care Paramedic Training

PAAW Administrator — Fri, 23 Dec 2016 17:22:41 GMT

Advanced 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.

EMS Supervisors "Boot Camp"

PAAW Administrator — Fri, 23 Dec 2016 17:02:03 GMT

Leadership Training

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.

Legislative Study Committee members vote on recommendations, send to Joint Legislative Council

PAAW Administrator — Wed, 21 Dec 2016 14:56:47 GMT

EMS Live in Wisconsin Podcast

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 Tuesday, 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.

brindle bodyguard

PAAW Administrator — Mon, 21 Nov 2016 13:56:03 GMT

Standby for Tones Blog

He called 911 when the symptoms began. He explained that he was a diabetic and he was not feeling well. By the time we were knocking on his door along with the fire rescue crew, things had gone downhill. When there was no response, we opened the door and entered. And stopped, all of us. Three firemen, my partner, and finally myself. I recall walking directly into the back of my partner as he abruptly stopped. Peering around him, I saw that the group of firemen had all stopped as well. Peering further, I saw the source of our sudden collective halt.

His dog was very large, and very protective, and very unhappy with the group of strangers who had just entered her human’s house. Her human who would not wake up. She stood over him, and the low sound in her throat didn’t need any extra volume. It meant business. The caller, our patient, was now unresponsive. I was thanking God I did not have care on this call, and that my partner that day was a senior medic. Unhurried in speech and manner, he was just the ticket to teach the brand new medic that I was on this winter day. Eight months in to my career, I stood, dumb struck at this spectacle in front of me.

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

Post election results and what it means for EMS

PAAW Administrator — Thu, 10 Nov 2016 15:27:46 GMT

>> Click for on-demand playback.

On November 10 we did a special edition of EMS Live in Wisconsin about the recent Wisconsin and national election outcomes, and more specifically zeroed in on what this means for EMS in the state. Our guest was PAAW lobbyist Michael Brozek with Midwest Strategies in Madison.

According to program host and PAAW Executive Director Joe Covelli, "Michael offered excellent insight and perspective into state and national races. The business side of EMS is closely tied to government from an operation, licensing and funding perspective, especially with Medicare and Medicaid dollars, so we need to pay attention to these things".

In Wisconsin, the Republicans maintain control, and actually picked up seats in both the Assembly and Senate. On the national stage, President-elect Donald Trump has vowed to change or repeal the Affordable Care Act. Congressman Paul Ryan of Janesville won reelection and again is Speaker of the House.

The upcoming 2017 Wisconsin legislative session that begins in February will include Community Paramedicine legislation, and most likely legislation that comes out of the Legislative Study Committee on Volunteer Firefighter and EMT shortages that has been meeting every month since July, and will continue to meet until the end of the year.

>> Click for on-demand playback.

Don't miss a beat of the action - listen to EMS Live in Wisconsin.

PSAP pre arrival cards developed by state EMS board

PAAW Administrator — Tue, 25 Oct 2016 13:02:55 GMT

EMS Live Podcast

>> Click for on-demand playback.

This EMS Live in Wisconsin podcast was recorded on Tuesday, October 25 and lasted 30 minutes.

Our guest was Josh Finke with the State of Wisconsin EMS Advisory Board subcommittee for EMS System Management.

The EMS Advisory Board recently developed a set of guidelines for local dispatch centers to use during certain high acuity calls. These simple flow charts can make a major difference in the outcomes of patients. This process has been used in other parts of the State with great success.

The cards give Public Service Answering Point (PSAP) and 911 dispatchers flow charts for pre arrival instructions for on hands only CPR, choking, AED instructions and bleeding control. If your ambulance service's dispatch center is not using pre arrival instructions the EMS Advisory Board recommends these instructions be utilized. The three types of patients involved in these guidelines are low frequency and high acuity. The pre arrival instructions given by dispatchers truly can be lifesaving.

>> Click to download pre arrival cards.

>> Click for on-demand playback.

Legislative Study Committee listserv email created

PAAW Administrator — Thu, 20 Oct 2016 11:54:54 GMT

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.

Legislative Study Committee on Volunteer Firefighter and EMT Shortages

PAAW Administrator — Thu, 20 Oct 2016 11:19:40 GMT

EMS Live Podcast

Guests included committee members Dana Sechler and John Eich

>> Click for on-demand playback.

On Tuesday, October 11 EMS Live in Wisconsin podcast guests included Legislative Study Committee members Dana Sechler and John Eich.

Wisconsin has been riding along as firefighter and EMT staffing shortages have grown year-over-year, and were foretold back when two state legislative study committees were convened in the 1990s to address the topic twenty years ago. Nothing was done either time - and actually the State's EMS Office shelved the Wisconsin EMS Advisory Board's recommendations. Just a couple years ago, Wisconsin had over 22,000 licensed First Responders, EMTs and Paramedics. As of July 2016, that number decreased to 16,500.

Committee member John Eich mentioned during the podcast, "We don't have volunteer police officers in Wisconsin, and fire and EMS are part of the public safety net too."

Door County Emergency Services Director Dan Williams, who also served as chairman of the Wisconsin EMS Advisory Board in the 1990s and 2000s, the same board that offered recommendations to the two Legislative Study Committees in the 1990s, testified before the current Study Committee in August. "We have to watch this very carefully. We have to be very, very careful it is the right legislation. This is a crucial problem - we have to get it right.", according to Williams. >> Click to review William's presentation and recommendations.

The committee recently met on Tuesday, October 18. Most of the discussion regarded testimony by a representative with the National Registry of EMTs, and reviewing in detail a memo authored by staff attorney Margit Kelly. The memo provided a highlight of ideas from previous committee discussions. >> Click to review Kelly's memo.

It seems the group is headed toward narrowing in on their recommendations based on what they've heard in testimony and various ideas or suggestions that have been offered. Four different sets of legislation have already been proposed by legislators.

>> Click for on-demand playback.

Don't miss a beat of Wisconsin EMS action - listen to EMS Live!

Legislative Study Committee on Volunteer Firefighter and EMT Shortages

PAAW Administrator — Mon, 10 Oct 2016 15:10:11 GMT

Podcast guests include Committee members Dana Sechler and John Eich

The next live podcast of EMS Live in Wisconsin is Tuesday, October 11 starting at 9:00 a.m. Our guests include Legislative Study Committee members Dana Sechler and John Eich. The dial-in number is 646-929-1081, or listen on the internet at http://tobtr.com/9496619.

The Legislative Study Committee on Volunteer Firefighter and EMT Shortages has been meeting every month since July, listening to testimony and receiving correspondence from industry experts, fire and EMS leaders and elected officials on the subject. Wisconsin has been riding along as firefighter and EMT staffing shortages have increased year-over-year, and were foretold back when two state legislative study committees were convened in the 1990s to address the topic twenty years ago. Nothing was done either time - and actually the State's EMS Office shelved the Wisconsin EMS Advisory Board's recommendations.

According to Committee member Dana Sechler, "Eighty percent of the time legislative action comes out of a Study Committee".

Join the live program on Tuesday, October 11 starting at 9:00 a.m. and lasting 30 minutes. The dial-in number is 646-929-1081, or listen on any internet connected device at http://tobtr.com/9496619.

Don't miss a beat of Wisconsin EMS action - listen to EMS Live!

DNR Scene Calls, MTM Concerns, PSOW Highlights

PAAW Administrator — Thu, 22 Sep 2016 19:50:37 GMT

EMS Live Podcast

This podcast was recorded on Tuesday, September 27.

Have you ever been on a scene call where a patient's family states they have a DNR order for do-not-resuscitate, but they can't produce paperwork or the DNR bracelet isn't on the patient? How about family wants to change the DNR order and states you must start CPR? What if a DNR order is on a patient from a different state - is it valid in Wisconsin? DNR authority by EMS practitioners and potential misunderstanding, wrongful application and confusion on scene calls involving DNR paperwork happen. Listen to this podcast as Helen Pullen with the State of Wisconsin EMS Office discusses DNR and POA.

MTM is Wisconsin's Medicaid broker to arrange medical patient transportation for beneficiaries, to include ambulances. For the past many months, PAAW has been working diligently behind the scenes to resolve a longstanding problem in ambulance services being denied payment by MTM for approved services, or suffering the consequences of lengthy delays in payment that totals hundreds of thousands of dollars. During the podcast PAAW President Patrick Ryan offered an update.

Finally, the Paramedic Systems of Wisconsin conference was held in Green Bay in mid-September. What were some of the hot topics and highlights? Conference director Dan Williams shares a list of items that were important to ambulance service leaders.

>> Click for on-demand playback.

Don't miss a beat of Wisconsin EMS action - listen to EMS Live!

PAAW Holds Board of Director and Officer Elections

PAAW Administrator — Thu, 22 Sep 2016 18:38:01 GMT

All incumbent board members with positions up for re-election ran unopposed at the Association's recent Annual Meeting. Re-elected for another three-year term included, for profit ambulance seat Chris Anderson, Bell Ambulance, Milwaukee; government/municipal ambulance seat Mark Fredrickson, Gold Cross Ambulance, Brillion; and nonprofit ambulance seat Tom Tornstrom, Tri-State Ambulance, La Crosse. Anderson and Tornstrom were also voted in as executive officers during their term as secretary and treasurer, respectively.

According to PAAW President Patrick Ryan, "The Board has shown stability and strength in several important areas, and Tom, Mark and Chris renewed their commitment through continuing in their board responsibilities. We are grateful for their on-going service to PAAW and its members."

An example of this is Tom Tornstrom testified before the state Committee on TRIP, and Mark Fredrickson met with Gov. Scott Walker on TRIP days before the Governor signed the bill into law that directly benefited ambulance billing. Chris Anderson was part of a contingent earlier in the year that met with Congressional House Speaker Paul Ryan.

Wisconsin First Responder Grant Funding

PAAW Administrator — Thu, 22 Sep 2016 16:19:07 GMT

Each year the Wisconsin Department of Transportation (WI DOT), Bureau of Transportation Safety, has provided EMS First Responder grant funding to communities around the state. This year funds will be provided to local communities for the initial equipment necessary for newly licensed and credentialed first responders to provide rural first responder EMS services to the communities they serve. This grant is specifically for EMS medical bags, non-disposable equipment and safety devices with these goals:

To decrease traffic deaths in Wisconsin.
To work in support of the “Zero in Wisconsin” initiative. http://www.zeroinwisconsin.gov/index.html
To provide funds for first responder EMS equipment.
To provide funds for initial education of first responders.
To collaborate with the community to gain buy-in, and develop an action plan to encourage more involvement with the EMS system and the valuable services provided.

Applications must be posted marked no later than September 30, 2016. Grants will be awarded starting September 30, 2016.

>> Click here for grant funding information and application.

Draw up EPI now an option at EMR level

PAAW Administrator — Tue, 13 Sep 2016 12:25:32 GMT

Recently, the EMS Board and the Physicians Advisory Committee (PAC) discussed and recommended the use of draw up EPI (Epinephrine) at the Emergency Medical Responder (EMR) level.

Department of Health Services has reviewed the EMS Board and PAC recommendations and approves the use of draw up EPI at the EMR level.

Any EMR Service wanting to use draw up EPI will need to first complete an Advanced Skills form (F- 00987C) prior to starting deliver of this new option. >> Click for the Advanced Skills form (F-00987C).

Wisconsin scores well in health system rankings

PAAW Administrator — Tue, 13 Sep 2016 11:30:00 GMT

PAAW ambulance service members part of these high-performing systems

This 2016 edition of The Commonwealth Fund’s Scorecard on Local Health System Performance assesses the state of health care in more than 300 U.S. communities from 2011 through 2014, a period when the Affordable Care Act was being implemented across the country. In comparing health care access, quality, avoidable hospital use, costs of care, and health outcomes, the Scorecard shows that many U.S. communities experienced improvements: fewer uninsured residents, better quality of care in doctors’ offices and hospitals, more efficient use of hospitals, and fewer deaths from treatable cancers, among other gains. Still, the persistence of widespread differences between areas is a reminder that many local health systems have yet to reach the potential attained elsewhere in the country.

Using the most recent data available, the Scorecard ranks 306 regional health care markets known as “hospital referral regions” on four main dimensions of performance encompassing 36 measures. Top-ranked regions in Hawaii, the Upper Midwest, New England, and the San Francisco Bay area have been performance leaders over time, and they offer achievable improvement benchmarks for policymakers, health system leaders, and community stakeholders. >> Click for article.

National Ranking - Wisconsin Health Care Market Ranking (overall performance):

Rank 5 - Appleton

Rank 13 - Madison

Rank 15 - La Crosse

Rank 19 - Green Bay

Source: Commonwealth Fund, 2016 Edition

Advanced Certification for Critical Care Paramedics

PAAW Administrator — Mon, 29 Aug 2016 12:20:42 GMT

EMS Live in Wisconsin Podcast

>> Click for on-demand playback.

This EMS Live in Wisconsin podcast was streamed live on Tuesday, August 23 and lasted 30 minutes. Our guests were Tyler Christifulli and Sam Ireland with LifeStar EMS in West Bend, Wisconsin. We discussed critical care paramedic advanced training and certification options.

Recently, LifeStar EMS created an advanced internal critical care level that requires an advanced board certification (FP-C, CCP-C) . Their goal is to have their critical care paramedics meet all the same requirements as helicopter EMS services like Flight For Life and Med Flight. These are advanced certifications through the Board of Critical Care Transport Paramedic Certification (BCCTPC); exams are extremely tough and have a 20% pass rate.

The goal at LifeStar EMS is to encourage their critical care paramedics to keep taking steps forward to improve their knowledge.

For more information on certification and testing, refer to the BCCTPC website at https://www.ibscertifications.org/roles/critical-care-paramedic.

>> Click for on-demand playback.

Legislative Study Committee on Firefighter and EMT Volunteer Shortages to meet August 30

PAAW Administrator — Sat, 27 Aug 2016 21:23:17 GMT

The second meeting of the Legislative Study Committee on Firefighter and EMT Volunteer Shortages is scheduled for Tuesday, August 30 starting at 9:30 a.m. in Room 412 East at the State Capitol, Madison. >> Click for meeting agenda. The first meeting was held on July 26, and additional meetings are scheduled monthly until the end of the year.

>> Click for information regarding the Legislative Study Committee, to include member names, meeting minutes and information, PowerPoint presentations, audio recordings and more.

The Study Committee is directed to examine issues related to the shortage of volunteer firefighters and emergency medical technicians (EMTs) in the state, particularly in rural areas, and propose measures to address the shortage. Specifically, the Study Committee shall study all of the following: (a) the magnitude of volunteer shortages, the areas of the state most affected, and the potential impact of shortages on public health and safety and economic development; (b) whether current training and continuing education requirements contribute to the shortage; (c) relationships between full-time and volunteer emergency response departments and the impact that the shortage of volunteers has on nonvolunteer departments in neighboring communities; and (d) whether the creation of organizations, particularly in rural areas, may help address the shortage. The committee shall develop legislative options to meet needs identified.

Naloxone (Narcan) purchases eligible for rebate

PAAW Administrator — Sat, 27 Aug 2016 19:02:26 GMT

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

Dr. Jon Krohmer named as next director of NHTSA's Office of EMS

PAAW Administrator — Sat, 27 Aug 2016 15:30:00 GMT

The National Highway Traffic Safety Administration (NHTSA) is pleased to announce the appointment of Dr. Jon Krohmer as the Director of the Office of Emergency Medical Services (OEMS). Chosen from a field of more than 30 candidates, Dr. Krohmer comes to this position with a wealth of EMS experience and expertise and will lead NHTSA's collaborative efforts to improve emergency care across the nation.

Board certified as an emergency physician, Dr. Krohmer has been actively involved in EMS for over 30 years, first in his home state of Michigan, and then at the national level, as an active member of the American College of Emergency Physicians (ACEP) and president of the National Association of EMS Physicians (NAEMSP). Dr. Krohmer's federal service began as the Deputy Assistant Secretary for Health Affairs and Deputy Chief Medical Officer for the Department of Homeland Security (DHS). He went on to become the Director of the Health Services Corps for Immigration and Customs Enforcement at DHS and for the past year has provided medical expertise to the U.S. Coast Guard.

"Jon Krohmer's extensive expertise in EMS and experience in federal service will be great assets to the NHTSA EMS program," said Jeff Michael, NHTSA Associate Administrator for Research and Program Development. "His collaborative and patient-centered approach is very important for the EMS Program, which depends on partnerships to achieve its goals. We're very excited to have Jon as part of our NHTSA family."

Dr. Krohmer's first day at NHTSA will be on Tuesday, September 6th. You can learn more about NHTSA's Office of EMS and contact the office at www.ems.gov.

PSOW Conference announces agenda, registration open

PAAW Administrator — Thu, 18 Aug 2016 13:10:13 GMT

The Paramedic Systems of Wisconsin (PSOW) Conference agenda was just released. >> Click here for agenda. The 29th annual conference will be held September 14 to 16 in Green Bay at Tundra Lodge Hotel & Convention Center.

The Conference, best known for its service introductions and initiatives recap offered by all attendees, will also feature presentations on community paramedicine, compliance, legislative council on EMT volunteer shortages panel discussion, HIPAA 2016, community CPR project, state EMS office updates and various other timely content. The event features an exhibit area and social opportunities.

Paramedic Systems of Wisconsin Conference exists to provide continuing education for administrators and managers at all Wisconsin ambulance service provider levels, and to share information and work together for the betterment of Emergency Medical Services in Wisconsin. For additional conference information or to register, go to www.PSOW.org.

Wisconsin Coverdell Stroke Program

PAAW Administrator — Thu, 18 Aug 2016 12:31:50 GMT

EMS Live in Wisconsin Podcast

>> Click to listen now!

How does your ambulance service manage stroke patients? What are your local or regional health care system options for advanced care and treatment? Did you know there are twenty Wisconsin ambulance services subscribed to the Coverdell Stroke Program? Learn how you can join the program in this podcast.

This live podcast was recorded on August 9 and included guest David Fladten, who manages the Wisconsin Coverdell Stroke Program.

In this podcast we discussed:

Appropriate Pre-hospital Assessment and Management of the Stroke Patient
EMS and Destination Determination - In-hospital care of the Stroke Patient
Coverdell EMS Partners program

We also discussed updates on the Wisconsin Legislative Study Committee on Firefighter and EMT Volunteer Shortages, Paramedic Systems of Wisconsin Conference and MTM/Medicaid.

>> Click to listen now!

Stay on top of Wisconsin EMS action - listen to EMS Live!

Next live streamed podcast is Tuesday, August 23 starting at 9:00 a.m.

The next EMS Live in Wisconsin podcast is Tuesday, August 23 starting at 9:00 a.m. and lasting 30 minutes. Our guest is Tyler Christifulli. We'll discuss critical care paramedic advanced training and certification options. Listen either on the phone at 646-929-1081, or on any internet connected device at http://tobtr.com/9218799.

semper memoria

PAAW Administrator — Wed, 17 Aug 2016 12:22:26 GMT

Standby for Tones Blog: Written by Crystal Wallin

It’s hot, and we’re a small group in a parking lot waiting for a group of strangers who are on a wonderful mission. The National EMS Bike Ride is coming thru La Crosse today and the riders will be going to visit the UW Health MedFlight memorial bench at Gundersen Health Systems.

On May 10, 2008 MedFlight lifted off from refueling at the La Crosse airport and sustained an impact with terrain while flying under visual flight rules. There were no survivors. UW Madison Hospital has a beautiful memorial and Gundersen – the receiving facility for the last transported patient flown by the crew that night – has a peaceful garden with a memorial bench.

The National EMS Memorial Bike Ride web page states “The National EMS Memorial Bike Ride, Inc. (NEMSMBR) honors Emergency Medical Services personnel by organizing and implementing long distance cycling events that memorialize and celebrate the lives of those who serve every day, those who have become sick or injured while performing their duties, and those who have died in the line of duty.” >> Click to read more...

Reducing pediatric anxiety during EMS care and transport, new pediatric ambulance stretcher safety restraint

PAAW Administrator — Mon, 08 Aug 2016 12:13:03 GMT

EMS Live in Wisconsin Podcast - Listen now!
This EMS Live in Wisconsin podcast was Tuesday, July 26. >> Listen on-demand at http://tobtr.com/9111793.

Our guests included Ben Eithun and Mary Jean Erschen-Cooke, both with the University of Wisconsin Hospital and Clinics in Madison, and Josh Thibault at J&B Medical Supply.

Pediatric ambulance calls can be challenging. Ben and Mary Jean offered suggestions to reduce pediatric patient anxiety during care and transport.

J&B Medical Supply just announced they closed a deal with the state of Michigan for 2,000 ambulance stretcher child safety restraints. Find out more about this new stretcher attachment.

Stay on top of Wisconsin EMS action - listen to EMS Live!

>> Listen on-demand at http://tobtr.com/9111793.

Wisconsin Legislature: Fire and EMS Study Committee to hold first meeting July 26

PAAW Administrator — Mon, 25 Jul 2016 13:33:30 GMT

The Legislative Council Study Committee on Volunteer Firefighter and EMT Shortages will hold their first meeting on Tuesday, July 26. The meeting will be held in Madison, and will begin with a briefing session for public members at 8:30 a.m., and the full study committee at 9:30 a.m. The study committee was convened by the Wisconsin legislature. >> Click here to see who is a member of the Study Committee.

The last time a study committee was created to address an EMS issue was 1996, and before that 1992.

To listen to a recorded webcast with Dr. Marv Birnbaum (picture insert) on Wisconsin's history with EMS study committee's, and past recommendations that included EMS regionalization, click here to listen now.

Standby for Tones Blog: Saws and Sunsets

PAAW Administrator — Mon, 25 Jul 2016 12:29:07 GMT

Her hair is flaming orange-red, eyes bright and lively and her baby a masterpiece of tiny humanity. Barely hitting the five foot mark, she has on an emerald dress, black simple shoes and a white bonnet perched atop the sunset that are her locks. The baby girl is wearing a miniature navy blue dress with the same simple lines. Even the wee puffed sleeves are the same as her mama’s – and (I can hardly bear the overload of cute) her tiny head has an impossibly adorably tiny white bonnet.

But I’m here for the husband, and I tear my eyes away with what I hope is professionalism as I continue introducing myself to everyone behind the curtain in bay 6. Curly hair tops his face and the beard of a married Amish man fringes his chin. Homemade black pants, simple black shoes and a teal shirt also handmade complete his traditional garb. His right hand is elevated and wrapped within an inch of its life. Bright red blood has soaked thru a patch roughly one inch by one inch.

He tells the story of slipping at work – work is in a local shop crafting the traditional Amish furniture us English people are happy to pay good money for, knowing it will last for generations upon generations. With a crooked grin, he denies pain. I tell him there is no shame in pain medicine, and point out that he is slightly pale. He feigns astonishment and points to his chest with eyes exaggeratedly elevated. She giggles. His top lip curls as he waves away an imaginary syringe. He’s fine. >> Click to read more of the story...

Using the backboard less. EMT re-licensing period concluded June 30

PAAW Administrator — Wed, 20 Jul 2016 12:32:33 GMT

EMS Live in Wisconsin Podcast

Being an EMT or first responder has nonetheless given you the uncomfortable opportunity to be strapped to a backboard, most likely during your initial training or refresher classes. But, have you ever been strapped to a backboard, placed on an ambulance stretcher and driven down a bumpy two lane road to the hospital? If not, it might be worth your time to do so on a return trip to the station. It's probably not as bad as being accidentally shocked by the AED, but I'd put it in the top 5 most uncomfortable treatments we offer in EMS.

During our streamed EMS Live in Wisconsin podcast on Tuesday, July 12 our guests included EMS medical director and author Dr. Keith Wesley on using the backboard less and selective c-spine immobilization, and State of Wisconsin EMS Licensing Manager Helen Pullen with an update on the recent statewide EMT re-licensing period that concluded June 30.

>> Listen to this podcast on-demand at http://tobtr.com/9081129

Don't miss a beat of the action - listen to EMS Live in Wisconsin.

EMS Regionalization

PAAW Administrator — Thu, 07 Jul 2016 13:31:06 GMT

EMS Live in Wisconsin Podcast

By Joe Covelli, PAAW Executive Director

Our most recent EMS Live in Wisconsin podcast regarded EMS regionalization, a topic that has been discussed over the years, but may get new traction with the recent emergence of an appointed legislative council. The council, which was created under authority of the Wisconsin Legislature, is charged with studying the volunteer firefighter and EMT shortages. Their first meeting is Tuesday, July 26, with additional meetings scheduled monthly until the end of the year. >> Click to see who's on the Study Committee.

In 1992, and again in 1996, a legislative council was convened to study the EMT shortage. The Wisconsin EMS Advisory Board was tasked with writing a report and offering recommendations. The study and report took six months to write and was delivered on-time to the Wisconsin EMS Bureau. The Board's recommendation centered around EMS regionalization. Does EMS regionalization present a solution today? >> Find out by listening to this podcast.

Our podcast guests included Gold Cross Ambulance Executive Director Mark Fredrickson and Dr. Marv Birnbaum, a longtime advocate for EMS regionalization.

>> Click here to listen now.

EMT and First Responder State License Renewal Deadline is June 30

PAAW Administrator — Wed, 29 Jun 2016 12:22:18 GMT

If you'll miss the June 30 deadline you can still re-certify by paying a modest late fee

The 2016 - 2018 Provider License Renewal application for the current two-year biennium is quickly coming to a close as it concludes on June 30. If you do not renew your EMT or First Responder license by then with the State of Wisconsin EMS Office, you can no longer work on an ambulance, function as an EMS provider or provide patient care.

A person acting or advertising as an EMT or First Responder without a license or certificate issued by the department or without appropriate credentialing may be subject to department action under sub ch. V or s.256.15 (11) (c), (d), or(f), Stats., as applicable."

Any application received after June 30, will be considered a late renewal under DHS 110.09(1): "An individual may renew a license or certificate that has been expired for less than 6 months by applying to the department for license or certificate renewal as specified under s.DHS 110.07 and submitting the late renewal fee ($50.00)specified under s.DHS 110.16 (1).

To listen to a podcast interview with State of Wisconsin EMS Licensing Coordinator Helen Pullen, >> click here.

For more information,contact the Wisconsin Department of Health Services Emergency Medical Services Section, 1 West Wilson Street, PO Box 2659, Madison WI 53701-2659, phone 608.266.1568,or go online to http://dhs.wisconsin.gov/ems/.

Patrick Ryan elected to Secretary Position with Fire & EMS Legislative Leadership Coalition

PAAW Administrator — Mon, 27 Jun 2016 12:20:41 GMT

Patrick Ryan of Madison was recently named secretary of the Wisconsin Fire & EMS Legislative Leadership Coalition.

The Coalition is made up of nine statewide public sector groups and state associations that represent all components and facets of fire and emergency medical service interests. Since 1996 the group has educated and advised policy makers on hundreds of legislative initiatives. Coalition members represent 40,000 chief officers, firefighters, EMTs, emergency services educators, fire inspectors and arson investigators.

Ryan is president and co-owner of Ryan Brothers Ambulance based in Madison, and also president of the Professional Ambulance Association of Wisconsin.

Wisconsin Department of Health Services Secretary Kitty Rhoades passes away

PAAW Administrator — Mon, 20 Jun 2016 12:37:15 GMT

Secretary Rhoades was a strong advocate for EMS

Wisconsin Department of Health Services Secretary Kitty Rhoades died Saturday in Madison after falling ill last week, Governor Scott Walker announced.

Rhoades became the Department of Health Services secretary in February 2013. Before joining the health agency in January 2011 as its deputy secretary, Rhoades represented the Hudson area as its Assembly representative from 1999 until 2010. She was co-chairwoman of the powerful Joint Finance Committee is 2007 and 2008.

According to PAAW Executive Director Joe Covelli, "Secretary Rhoades was a friend and strong advocate for emergency medical services for 17 years. She could fluently discuss the issues. One of her sons is a volunteer first responder in Minnesota, and through him she felt a connection to EMS".

When serving as Assembly representative, Rhoades was credited with leading the single paramedic legislative effort in the early 2000's. The eventual law allowed municipalities the option to staff one paramedic per ambulance, not two as was required back then. "I recall our conversations about this and how she told me she wasn't giving up this fight to help rural Wisconsin residents get paramedic level care", according to Covelli. He added, "Once the single paramedic bill became law, she shared with me her Assembly counterparts gave her the nickname "bulldog", because she didn't give up on this issue. Her devotion to state government and interest in advocating for EMS will be missed". (Picture insert: Then DHS Deputy Secretary Kitty Rhoades welcomes Stars of Life honorees to the State Capitol in October 2011).

Rhoades, 65 years old and a native of Hudson leaves behind a husband and three adult sons.

Community Paramedicine expanding at Milwaukee Fire Dept.

PAAW Administrator — Tue, 14 Jun 2016 15:33:22 GMT

EMS Live in Wisconsin Podcast

New partnership announced with Children's Community Health Plan

>> Click here to listen now!

This EMS Live in Wisconsin podcast was streamed live on Tuesday, June 14.

Our guests included Captain Michael Wright with the Milwaukee Fire Department, Interim President Ibrahim Massalha with Hayat Pharmacies, and Director of Health Plan Clinical Services Lynn Kryfke with Children's Community Health Plan.

Milwaukee Fire Department has positioned Community Paramedicine (CP) as a means to be proactive and address its high-utilizer population. They've focused on committing MFD resources and continuum of patient care, but it hasn't come without its challenges. In developing their Community Paramedicine program, they have done a remarkable job in creating partnerships in areas they needed expertise, resources and data. We learned details in how they directly included pharmacy in their care program, and announced a new initiative with Children's Community Health Plan.

Captain Michael Wright and his counter-parts at MFD have championed CP concepts, while staying in their scope of practice, and continue to lay the ground work for others to consider.

The next EMS Live in Wisconsin Podcast is Tuesday, June 28 starting at 9:00 a.m. central time. The topic is EMS Regionalization. Our guests include Gold Cross Ambulance Executive Director Mark Fredrickson and Dr. Marv Birnbaum, a longtime advocate for EMS Regionalization.

Don't miss a beat of the action - listen to EMS Live in Wisconsin.

Wisconsin EMS Office announces listening sessions

PAAW Administrator — Thu, 09 Jun 2016 12:55:00 GMT

The State of Wisconsin EMS Office will be offering Listening Sessions across the state beginning in June, with additional dates and locations to be announced.

According to Wisconsin EMS Director James Newlun in an email sent to providers, "We would like to get your input on what is working, what is not and suggested improvements that can help meet our mission ...to ensure that the highest quality and standards of pre-hospital emergency medical care is available to all citizens of and visitors to Wisconsin".

The first Listening Session will take place on June 20th in Shawano. It will be held in the Community Room of the Shawano City Hall, 127 S. Sawyer Street, Shawano, WI 54166. >> Click for agenda.

The next Listening Session will take place on June 27th in Fennimore. This one will be held in Rooms 492-493 Southwest Technical College (SWTC) 1800 Bronson Blvd, Fennimore, WI 53809. >> Click for agenda.

Three more Listening Sessions are planned in other locations with dates to be announced.

CP Data Results are in at Milwaukee Fire Dept.

PAAW Administrator — Thu, 09 Jun 2016 12:26:31 GMT

Next EMS Live in Wisconsin Podcast

Milwaukee Fire Department has positioned Community Paramedicine (CP) as a means to be proactive and address its high-risk population with heart history, diabetes, and high infant mortality rates.

Captain Michael Wright with MFD has championed CP concepts, and now the data is in on what they have realized thus far. Captain Wright is our guest during the next EMS Live in Wisconsin podcast. He'll be joined by two company representatives they have worked closely with in pharmacy, and a new CP initiative Captain Wright will announce publicly for the first time during the streamed podcast.

Make sure to join us for the next EMS Live in Wisconsin podcast on Tuesday, June 14 starting at 9:00 a.m. central time and lasting 30 minutes. Listener questions are invited.

Some of the questions we plan to discuss, include:

What has changed with Milwaukee Fire Dept.'s program since our last update?
What has been the most difficult aspect in your efforts to build your program?
Why has your company chosen to collaborate with the Milwaukee Fire Department's CP/MIH program.
What does your partnership with Milwaukee Fire Dept. represent to your organization?
What does the future look like for CP/MIH?

Listen to the live streamed podcast starting at 9:00 a.m. on Tuesday, June 14 via the telephone at 646-929-1081, or on the internet at this link: http://tobtr.com/8899259

Don't miss a beat of the action - listen to EMS Live in Wisconsin.

Marcy and Deanna

PAAW Administrator — Fri, 03 Jun 2016 12:38:53 GMT

Standby for Tones Blog

The officer meets us in the garage, and fills us in. It’s my partner, the medic student I’m precepting today, and myself.

The patient inside is 96 years old and fell around noon. It’s nearly 4pm now, and the officer is concerned about not just the skin tear on the elbow after the fall, he’s concerned about the heat of the house’s interior. He’s worried the patient may have dehydration issues. He tells us that the patient’s wife is a resident of a local nursing home and he always goes to see her at 12:30pm. Every day. For the entire four years since she became a resident there. Today, 12:30 came and went and he did not appear. Staff members became concerned, and went to the house. The officer got them inside, and together the three of them discovered our patient on the floor.

We enter the garage and make our way past the large four door mid 1980s sedan parked sedately inside. Winding our way past paneled walls, we climb the three stairs from the finished garage stall to the vintage kitchen. Spotless. Everything our eyes touch, from the countertops and cabinets of the kitchen, to the antiquated appliances and on into the bedspread visible through the doorway off the kitchen – every single thing is pristine, and centered. Meticulously up kept. Winding our way past more paneling to the front living room of the shotgun home, we find our patient.

And Marcy. And Deanna. >> Click to read more.

HIPAA Compliance: What's changed?

PAAW Administrator — Wed, 25 May 2016 11:37:48 GMT

EMS Live in Wisconsin Podcast
During the EMS Live in Wisconsin podcast on Tuesday, May 24, our guest was Jeff Grady, Senior Director with Three Pillars Security Solutions in Madison.

>> Click to listen to this podcast.

HIPAA compliance has moved well past simply handing the patient a HIPAA brochure explaining their rights and getting a signature. HIPAA stands for Health Insurance Portability and Accountability Act.

Conducting a periodic HIPAA Security Risk Analysis is definitely a required mandate of HIPAA compliance for ambulance services as the organization and its employees and volunteers come in contact with ePHI (electronic patient health information).

The developing best practice is to complete a Security Risk Analysis on an annual basis (or after any significant change in your technology environment) due to some relatively recent pronouncements that apply to those organizations who need to comply with ‘meaningful use’ reporting requirements.

Some of the questions discussed, include:

HIPAA has been around for quite some time now – what’s changed and why is there a renewed sense of urgency in making sure you’re compliant?
What are some basic differences between meeting compliance with the HIPAA Security Rule as compared to the Privacy Rule of HIPAA?
What is ‘willful neglect’ and why is it critical to avoid the potential of being found in ‘willful neglect’ under HIPAA?
If your Electronic Health Record (EHR) vendor states that they meet HIPAA compliance – does that meet your obligation under HIPAA?
What would be the key steps to make sure that you’re meeting “today’s” HIPAA compliance standards?

Co-hosts include Chris Anderson, Joe Covelli, Patrick Ryan, Dan Williams. >> Click for more information.

Statewide Survey Announced by WI EMS Office

PAAW Administrator — Mon, 23 May 2016 12:03:37 GMT

Information collected will be used to identify EMS agency needs and target support and funding.

On May 20, State of Wisconsin EMS Director James Newlun announced the Wisconsin Office of Rural Health and the Wisconsin EMS Section were collaborating to perform a sweeping “snapshot” of EMS in Wisconsin by conducting a statewide survey.

The survey was developed by a national group of EMS providers and partners to assess 18 attributes of a successful ambulance service. The data from the survey will be used by the Wisconsin Office of Rural Health and the Wisconsin EMS Section to obtain baseline information to better target support and funding.

In his email to EMS professionals Newlun wrote, "We will be transparent with survey results. We will report state averages, regional numbers, service type results, etc., which will allow your (ambulance) service to benchmark statewide and regional results against similar service types". The assessment will provide data to help answer some questions that would not be possible with anonymous data.

Every patient transporting EMS/EMT/First Responder provider is encouraged to complete the survey, not just the Service Director. The survey will take about 15 minutes to complete.

>> Click to start the survey.

EMS Grant Writing 101 Virtual Conference in June

PAAW Administrator — Mon, 23 May 2016 11:40:11 GMT

The National Organization of State Offices of Rural Health is offering a 3-part “EMS Grant Writing 101 Virtual Conference” in mid to late June. Rural EMS agencies and other interested partners will learn how to write and submit a complete grant proposal, understand rural relevant data important to EMS and identify funding opportunities.

>> Click for more information and how to register.

EMS Grant Writing 101 Virtual Conference

June 15, 22 & 29, All classes 2:00 to 3:00 central time

Session 1: June 15 - Getting Started: Understanding Need, Collecting Data and Developing Community Support

Session 2: June 22 - Building Your Proposal: Telling Your Story

Session 3: June 29 - Connecting with Funders to Submit a Successful Proposal

Adams County ambulance service shut down during state investigation

PAAW Administrator — Sat, 21 May 2016 14:06:16 GMT

An Adams County ambulance service has been shut down, leading the county to scramble to cover 911 services.

The State Department of Health Services confirmed there is an investigation into Adams County Emergency Services, a private ambulance company that contracts with eight municipalities in central Adams county for 911 service.

A DHS spokeswoman said the investigation involves several agencies, including the Wisconsin Department of Transportation, the U.S. Drug Enforcement Administration and local law enforcement. The company was directed to cease operation and not to respond to calls.

>> Click to read more.

HIPAA Compliance: What's changed?

PAAW Administrator — Fri, 20 May 2016 11:31:45 GMT

EMS Live in Wisconsin Podcast

Join us for our next live podcast of EMS Live in Wisconsin on Tuesday, May 24, 2016. The program is streamed live over the phone and via the internet. The dial-in number is 646-929-1081, or listen on any internet connected device at this link: http://tobtr.com/8835299.

Our guest is Jeff Grady, Senior Director with Three Pillars Security Solutions in Madison, WI.

Conducting a HIPAA Security Risk Analysis is definitely a required mandate of HIPAA compliance if an entity or business associate is in contact with ePHI (electronic patient health information) – technically the law and HIPAA regulations state it must be performed periodically.

The developing best practice trend and recommendation is to conduct one on an annual basis (or after any significant change in your technology environment) due to some relatively recent pronouncements that apply to those organizations who need to comply with ‘meaningful use’ reporting requirements – which do require those entities conduct a Security Risk Analysis on an annual reporting basis. More commentators and practitioners are picking up on this as setting the standard for all and being promoted as a recommended practice trend -- that all entities subject to compliance with the HIPAA Security Rule adopt an approach which provides for an annual conducting/review of the ‘periodic’ security risk analysis.

Co-hosts include Chris Anderson, Joe Covelli, Patrick Ryan, Dan Williams. >> Click for more information.

Call for Comments of Performance Measures for Cardiac Arrest and Stemi

PAAW Administrator — Fri, 20 May 2016 10:49:25 GMT

EMS Compass, a national initiative dedicated to creating data and analytic measures for EMS, has released a new set of performance measures for public comment in the areas of cardiac arrest and STEMI. All members of the EMS community are encouraged to view the measures and provide comments. The public comment period for these measures is open through June 3, 2016.

>> Click to provide comment.

EMS agencies at the local, regional and state levels are encouraged to evaluate these measures immediately and to provide feedback on how important these measures will be for improving patient care and outcomes. Specific questions about the measures should be sent to EMS Compass Project Manager Nick Nudell at nick@nasemso.org.

National EMS Memorial Bike Ride Routes Through WI

PAAW Administrator — Fri, 13 May 2016 11:22:40 GMT

The 2016 Midwest Route of the National EMS Memorial Bike Ride beginning in Chicago, IL is a special bicycling event to honor and celebrate the lives of EMS providers who were dedicated to EMS or have died while performing their duties. Funds raised during this ride benefit the families of fallen EMS practitioners through the Fallen Angel Fund.

The ride starts in Chicago, IL June 26 and ends June 30 with a Memorial Service at 3:30p at Woodbury Public Safety, 2100 Radio Drive in Woodbury, MN. Routes along the way include Milwaukee, Green Bay and La Crosse, June 26 to 29. This cycling event raises awareness of fallen Emergency Medical Services (EMS) personnel. The week concludes with a memorial service to which all participants, local EMS personnel, and friends and families of the honorees participate. Shuttling of riders and bikes will be done.

>> Click for event information and details.

Chief Deonne Eske Presented with National Star of Life Award

PAAW Administrator — Wed, 11 May 2016 12:23:22 GMT

National Stars of Life, Washington D.C.

Ashippun Fire and EMS Chief Deonne Eske was presented National Stars of Life honors and recognition at an event in Washington D.C., April 11-13, which was produced by the American Ambulance Association. At the event, the AAA recognized 103 Stars of Life honorees from 29 states and 90 communities. Eske was presented her award by AAA President Mike Hall.

According to Eske, “What an amazing, awesome experience at the National Stars of Life awards. It was a highlight of my EMS and fire career”.

Eske, an EMT-Basic, has been involved in fire and EMS for 33 years. She has been a volunteer EMT/firefighter, lieutenant, captain and is currently chief.

Eske was named Wisconsin’s representative to attend the National Stars of Life awards by the Professional Ambulance Association of Wisconsin at its state event this past September. She advanced from a group of 26 Wisconsin Stars of Life honorees, individuals nominated by their local ambulance service for outstanding achievements or work performance.

The next Wisconsin Stars of Life event will be produced in September 2017 by the Professional Ambulance Association of Wisconsin. The nomination period will be open from July to August 2017. Watch the Association’s website for updates.

>> Click for the 2015 Wisconsin Stars of Life dedicated webpage.

Madison firefighters issued body armor

PAAW Administrator — Tue, 10 May 2016 01:38:49 GMT

At the end of April, Madison firefighters began having bullet-resistant vests assigned to them for added protection on any calls posing a higher risk for gunfire.

The new gear -- totaling 90 vests, weighing 20 pounds a piece and lined with heavy ceramic plates to stop rounds from handguns to high-powered rifles -- will be required for all Madison Fire Department personnel responding with police to provide medical help where bullets are or might be flying.

>> Click to read more.

New director named to Wisconsin Office of Preparedness and Emergency Healthcare

PAAW Administrator — Tue, 03 May 2016 11:41:32 GMT

The Division of Public Health announced that Bill Oemichen joined the division on May 2 to serve as Director of the Office of Preparedness and Emergency Healthcare. The announcement was made by Wisconsin EMS Section Director James Newlun.

Oemichen has a broad background in public health, health care and consumer protection. His experience includes leading Minnesota's food safety program where he oversaw major food safety investigations, and serving as a commissioned Officer of the U.S. Food & Drug Administration. Oemichen also served for five years as Administrator of the Wisconsin Trade and Consumer Protection Division at DATCP.

Oemichen also has extensive experience working with partners across sectors. During his 14 years as President & CEO of Cooperative Network, Oemichen worked closely with the Rural Wisconsin Health Cooperative, HealthPartners HMO, Group Health Cooperative of South Central Wisconsin (GHC-SCW), Group Health Cooperative of Eau Claire and Wisconsin Rx.

The Anti-Kickback Statute and Its Application to Private and Municipal EMS Providers

PAAW Administrator — Tue, 26 Apr 2016 12:39:03 GMT

Upon reading this article, you will be able to answer the following questions.

What is the Anti-Kickback Statute?

Who is affected by the Anti-Kickback Statute?

What are the penalties for a violation of the Anti-Kickback Statute?

Are there any exceptions to a violation of the Anti-Kickback Statute?

What can EMS providers do to help avoid a violation of the Anti-Kickback Statue?

The Anti-Kickback Statute and Its Application to Private and Municipal EMS Providers

As municipal departments become more involved in providing emergency medical services and inter-facility transports, discounts or provision of free services or items that result in charges below cost may trigger the federal Anti-Kickback Statute (“Anti-Kickback Statute”). Because of the complexity of the Anti-Kickback Statute, EMS providers—whether privately owned or municipal—are encouraged to carefully evaluate proposed transactions and arrangements for fraud and abuse compliance.

The Anti-Kickback Statute

The Anti-Kickback Statute was enacted in 1972 to protect patients and federal health care programs from fraud and abuse. The Anti-Kickback Statute makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce or reward referrals of items or services reimbursable by a federal health care program. The statute assigns criminal liability to parties on both sides of an impermissible “kickback” transaction where the required elements are met, including that of intent. For purposes of the Anti-Kickback Statute, “remuneration” includes the transfer of anything of value, directly or indirectly, overtly or covertly, in cash or in kind.

Any person or entity in a position to generate federal health care program business for an ambulance supplier, directly or indirectly, is a potential referral source, including, but not limited to, 911 or equivalent emergency medical dispatch systems, responders, hospitals, nursing facilities, assisted living facilities, home health agencies, physician offices and patients. EMS providers furnishing ambulance services may also be sources of patient referrals for hospitals, other receiving facilities, and second responders.

Due to the broad range of transactions potentially implicated by the Anti-Kickback Statute, there are several statutory exemptions for certain types of payments, and the U.S. Department of Health & Human Services’ Office of Inspector General (“OIG”) has adopted certain “safe harbors” to exempt arrangements from the Anti-Kickback Statute, provided that they fall within parameters defined to minimize the risk for potential fraud and abuse. Some of the safe harbors include: (1) ambulance restocking arrangements; (2) personal services and management contracts; (3) employees; (4) certain investment interests; (5) space rentals; (6) equipment rentals; and (7) discounts.

OIG Advisory Opinions

A request for an OIG Advisory Opinion may be requested by the parties to a proposed arrangement. OIG’s response may offer insight into how it may view a particular transaction or arrangement under the Anti-Kickback Statute, but it may only be relied upon by the requestor(s) of the Advisory Opinion. Also note that some Advisory Opinions speak to the lack of enforcement of an Anti-Kickback Statute violation, which is distinct from whether the arrangement itself presents an Anti-Kickback concern. Below are some summaries of some relevant OIG Advisory Opinions.

Ambulance Provider Discounts

In a 1999 Advisory Opinion, an EMS provider proposed to provide inter-facility transports at a discount to a skilled nursing facility (“SNF”). See Advisory Opinion 99-2 (Mar. 4, 1999), available at http://oig.hhs.gov/fraud/docs/advisoryopinions/1999/ao99_2.htm. The EMS provider planned to charge Medicare for Part B transports at full Medicare rates. In concluding that the proposed deal was not acceptable under the Anti-Kickback Statute, the OIG noted that arrangements providing discounts to potential referral sources that are also not provided to Medicare are suspect, especially where the discounts result in charges below the cost of providing services, or where discounted rates are only offered to those who also offer the opportunity for non-federal health care program business. In other words, discounts that are below the ambulance provider’s cost or other types of discounts may independently give rise to an inference that the ambulance provider and the facility (such as a SNF) may be “swapping” discounts on Medicare Part A business in exchange for more profitable Medicare Part B business, from which the ambulance provider can recoup losses incurred on the discounted business potentially through overutilization or abusive billing practices.

Municipal Arrangements for EMS Services

Municipalities may provide EMS services through a local fire department or a private EMS company. Because fraud and abuse issues may arise in an arrangement with a municipality, all EMS providers are encouraged to carefully evaluate proposed arrangements for compliance with the Anti-Kickback Statute. Examples of issues that EMS providers have sought guidance on from OIG include whether copays or deductibles may be waived by an EMS provider, and whether services or items may be provided at or below cost.

In 2001, a municipal fire department that owned and operated an ambulance service requested an advisory opinion from OIG regarding whether its treatment of local taxes as payment of EMS transport copayments and deductibles violated the Anti-Kickback Statute. The fire department provided emergency medical services free of charge to residents and did not bill the residents or their insurers; however, the fire department billed non-residents and their insurers for EMS. The fire department sought OIG guidance as to whether it could bill its residents and their insurers only to the extent of their insurance coverage (commonly referred to as “insurance only” billing), including federal health care programs, and whether it could treat the revenues received from local taxes as payment of copayments and deductibles otherwise owed by residents. The OIG stated that the proposed insurance only billing by a state or local government entity, such as a municipal fire department, is not viewed as furnishing free services. Accordingly, since Medicare does not require the fire department to collect copayments or deductibles from residents, OIG concluded that the arrangement did not violate the Anti-Kickback Statute. See Advisory Opinion 01-10 (July 20, 2001), available at http://oig.hhs.gov/fraud/docs/advisoryopinions/2001/ao01-10.pdf.

In another 2001 Advisory Opinion, the OIG found a similar arrangement potentially impermissible and subject to sanctions under the Anti-Kickback Statute because it differed in one significant respect: the municipality was contracting with a private EMS company for the provision of services to residents, rather than providing the services itself. In this Advisory Opinion, the municipality required the private ambulance company to waive copayments and deductibles, including those for Medicare, for residents and the OIG found that this could violate the Anti-Kickback Statute. See Advisory Opinion 01-12 (July 20, 2001), available at http://oig.hhs.gov/fraud/docs/advisoryopinions/2001/ao01-12.pdf.

OIG, in a 2006 Advisory Opinion, found that an exclusive arrangement between a city and an EMS provider to provide non-emergency inter-facility ambulance transport services presented low risk of fraud or abuse of federal health care programs. The EMS provider proposed to pay the city an annual set fee of $50,000 that would partially offset the city’s costs of operating inter-facility dispatch services and of monitoring/supervising of the ambulance provider’s inter-facility transport services. The OIG found that the risk of fraud and abuse was low since the proposed arrangement was not likely to increase federal health care program costs, would not result in steering of business since patients were being transported between prearranged facilities, and the arrangement served the public, rather than private interests. See Advisory Opinion 06-12 (Sept. 25, 2006), available at http://oig.hhs.gov/fraud/docs/advisoryopinions/2006/Adv-Opn06-12B.pdf.

A 2013 OIG Advisory Opinion concluded that an EMS provider’s response to a city’s RFP for an exclusive contract for ambulance and inter-facility transport services potentially could violate the Anti-Kickback Statute due to its inclusion of items or services at no charge or nominal value, such as free defibrillators and free EMS training and classes for city personnel. This Advisory Opinion serves as a reminder for ambulance companies to be on the lookout for potential inducements in RFPs and contracts—particularly ones that call for free or discounted items or services to be provided by the ambulance company to the municipality as a condition of being awarded the contract. See Advisory Opinion 13-18 (Nov. 21, 2013), available at http://oig.hhs.gov/fraud/docs/advisoryopinions/2013/AdvOpn13-18.pdf.

Penalties for Anti-Kickback Violations

Criminal penalties for violating the Anti-Kickback Statute may result in fines up to $25,000 and imprisonment for up to five (5) years per violation. See 42 U.S.C. § 1320a-7b(b). Criminal conviction also results in mandatory exclusion from participation in federal health care programs. See 42 U.S.C. § 1320a-7(a). Even absent a criminal conviction, individuals who violate the Anti-Kickback Statute may still face exclusion from federal health care programs at the discretion of the Secretary of Health and Human Services. See 42 U.S.C. § 1320a-7(b).

The government may also assess civil money penalties for violation of the Anti-Kickback Statute. Civil penalties may result in treble damages plus $50,000 per violation. See 42 U.S.C § 1320a-7a(a)(7). False Claims Act liability may also be implicated. Although the Anti-Kickback Statute does not afford a private right of action, a violation of the Anti-Kickback Statute serves as a vehicle whereby individuals may bring qui tam actions. See 31 U.S.C. §§ 3729–3733.

Potential transactions and arrangements involving EMS providers and other entities—whether they are municipalities or private health care providers—pose opportunities for growth and improved patient quality of care, but may also face an increased risk of scrutiny due to the regulated nature of health care and the Anti-Kickback Statute. A robust compliance plan and employee training, coupled with careful review of any proposed transactions and arrangements (including, if necessary, working with legal counsel to seek guidance or an OIG Advisory Opinion) may help ensure that your company does not get tripped up by an unintentional violation of the Anti-Kickback Statute.

For additional assistance or to have your individual questions answered, contact attorney Wendy Arends at 608-257-3911.

The April 26, 2016 EMS Live in Wisconsin podcast interviewed attorney Wendy Arends about the Anti-Kickback Statute as it relates to private and municipal ambulance services. >> Click to listen now.

About the Authors

Thomas Shorter is a shareholder in the firm's Madison office and Chair of the Health Care Team. Tom represents hospitals, physicians' groups, research institutions and health care related organizations, as well as other businesses, providing counsel on health care, corporate, labor and employment and regulatory matters.

For clients in the health care industry, Tom handles matters regarding Medicare compliance, Health Insurance Portability and Accountability Act (HIPAA), Emergency Medical Treatment and Labor Act (EMTALA), Physician Self-Referral (Stark), and Anti-Kickback.

Additionally, Tom is also called upon by other organizations to handle management-side legal corporate and employment issues, including the Family and Medical Leave Act (FMLA), Fair Labor Standards Act (FLSA) compliance, Individuals with Disabilities Education Act (IDEA), Section 504, and Americans with Disabilities Act (ADA).

Wendy Arends is a senior associate in the firm’s Madison office where she advises businesses, organizations and trade associations regarding their interactions with local, state and federal government. Her practice focuses on matters involving antitrust and consumer protection, health care, and international trade compliance. Prior to joining Godfrey & Kahn, Wendy practiced for more than four years at a large national law firm in Washington, D.C. where she worked on a variety of complex commercial litigation and regulatory matters.

Wisconsin ambulance Narcan rebate in the media

PAAW Administrator — Mon, 18 Apr 2016 12:23:00 GMT

More than 800 Wisconsinites died of prescription narcotic painkiller and heroin overdoses in 2013, the most recent year for which there is data available, and drug overdose is now the leading cause of injury death in the United States.

The Professional Ambulance Association of Wisconsin and Wisconsin Attorney General Brad Schimel teamed up to announce details of a new rebate program for Naloxone, the opiate antidote, that will be administered by the Wisconsin Department of Justice for qualifying organizations. Wisconsin ambulance services are eligible to apply for the rebate. >> Click for more information.

Narcan rebate announced for Wisconsin ambulance services; Stemi drug therapy

PAAW Administrator — Wed, 13 Apr 2016 12:29:46 GMT

EMS Live in Wisconsin Podcast

>> Click to listen now!

This EMS Live in Wisconsin podcast was recorded on Tuesday, April 12.

The program began with an announcement regarding a $6.00 rebate negotiated between Wisconsin Attorney General Brad Schimel and Naloxone (Narcan) manufacturer Amphastar. Wisconsin ambulance services are eligible, but must file their rebate within 60 days of each quarter's end. The Agreement expires February 1, 2017. For more on the rebate program, go to >> http://paaw.us/Amphastar-narcan-rebate.

The second part of the program, starting at 6:00 minutes, included a discussion on stemi drug therapy with guests Dr. Michael Rosenberg, Medical Director-Cardiovascular Services, Holy Family Memorial Hospital, Manitowoc, Valders Ambulance Director Jay Steuer, and Baraboo Area Ambulance Chief Dana Secular. Holy Family Memorial Hospital was recently named one of 50 top hospitals in the nation regarding its stemi EMS system.

Milwaukee County hospitals ready for new policy of ambulance diversions

PAAW Administrator — Mon, 11 Apr 2016 11:26:05 GMT

An emergency room clogged with patients is an unwelcome sight for everyone involved — patients, doctors and other caregivers alike.

Hospitals responded in the past by sending incoming ambulances to other hospitals, sometimes 10 to 15 critical minutes away.

But under a policy that took effect this month, hospitals in Milwaukee County are no longer allowed to divert ambulances when their emergency departments have a high volume of patients.

"We needed to do better for the patients," said M. Riccardo Colella, director of medical services for the Milwaukee County Office of Emergency Management. >> Click to read more...

Standby for Tones Blog: All in a day's work with La Crosse Paramedic Crystal Wallin

PAAW Administrator — Sat, 02 Apr 2016 13:55:03 GMT

“501 please respond for a male subject who is turning yellowish-orange”

“Copy, 501 en route”

Two females seated in kitchen, one teary. 40s male seated on couch, Mt Dew at hand and completely unconcerned. Denies any symptoms, no medical history of any kind, no medications, and no desire to be seen in the ER.

Wife, brow furrowed; “maybe it’s because I haven’t seen him in daylight in so long”

Mother in law, bent forward with hands on hips, nose inches from patient’s face, inspecting his eyes; “what you maybe need is to go out on the deck and just have a cigarette in the sunlight”

Neighbor arrives, hugs wife tearfully, says to fire personnel; “last time I was catatonic I was going thru my friend’s drawers, almost pulled out my nose ring. That was after I had the grand mal and then went tonic clonic.”

Wife, helpfully; “he isn’t even a drug user!” >> Click to read more...

Attorney General Schimel reaches Narcan rebate agreement with manufacturer of lifesaving opiate antidote

PAAW Administrator — Thu, 24 Mar 2016 03:08:25 GMT

PAAW influential in bringing discount to Wisconsin

Standing alongside members of the Professional Ambulance Association of Wisconsin (PAAW), Attorney General Brad Schimel announced on March 23 details of a rebate program for the heroin and prescription opioid antidote naloxone, also known as Narcan.

“Heroin and prescription narcotic painkillers are contributing to more deaths in Wisconsin each year than car crashes,” said Attorney General Schimel. “The Wisconsin Department of Justice is doing, and will continue to do, everything it can to make access to naloxone as easy and cheap as possible.”

Amphastar Pharmaceuticals has agreed to provide a $6 rebate for each Amphastar naloxone syringe purchased by public entities in Wisconsin from now until February 1, 2017. Amphastar Pharmaceuticals has reached similar agreements with other states, including Ohio and New York. PAAW brought these similar state agreements to Attorney General Schimel's attention, which led impart to Wisconsin crafting a rebate with the manufacturer.

“Naloxone, often branded as Narcan, can be administered as a nasal spray or injection and works within minutes to reverse the effects of an opioid overdose,” said Patrick Ryan, President of the Professional Ambulance Association of Wisconsin (PAAW). “Our public safety and EMS partners across Wisconsin are incredibly grateful for the Amphastar naloxone rebate agreement and believe it will increase access and use of this lifesaving drug, especially when mere minutes could be the difference between life and death once an emergency responder arrives on the scene of an overdose.”

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 Wisconsin Department of Justice is also exploring rebates with other manufacturers of naloxone.

Naloxone rebate instructions and all necessary forms are available below.

>> Amphastar Pharmaceuticals, Inc. Contract
>> Naloxone Rebate - Press Release
>> Naloxone Rebate Instructions
>> Naloxone Account Form
>> Naloxone Purchase Summary

Announcement Media Coverage
>> Wisconsin State Journal, Madison
>> WBAY-TV, Green Bay
>> Fox 6-TV, Milwaukee
>> WKOW-TV, Madison
>> WISC-TV/Ch. 3000, Madison
>> WMTV-TV, Madison
>> Wheeler Report, Wisconsin Representative Nygren

EMS to the Point Audio Webcast State EMS Office Issues Memos for First Responders and Mutual Aid, Online Ops Plan Submission Process Coming Soon

PAAW Administrator — Thu, 17 Mar 2016 18:27:18 GMT

>> Click to listen to this audio webcast.

Last year was a busy year for EMS at the state capitol with three bills passing the Senate and Assembly and ultimately being signed into law by Governor Scott Walker. New laws that quickly come to mind include the Tax Refund Interception Program (TRIP) spearheaded by PAAW, as well as laws allowing First Responders to operate as one member of a two-person legal ambulance crew, and cross border mutual aid and coverage agreements.

In July 2015 James Newlun took the helm as the State of Wisconsin EMS Director.

James oversees the state’s EMS Office, which is truly the nerve center for anything and everything EMS. There are a lot of moving parts that include review of operation plans, event plan approvals and individual, provider and training center licensing requests and renewals. Wisconsin is a large and robust statewide EMS delivery system that includes over 800 ambulance services and first responder groups and 22,000 licensed individuals.

Recently, PAAW Executive Director Joe Covelli had the opportunity to discuss with James two memos his office released in January about First Responders and mutual aid and coverage agreements. He’s also working to streamline the way ambulance operation plan changes are submitted to the state. Once launched in the coming months, the new approach will avoid delays and just be more efficient.

>> Click to listen to this audio webcast.

Standby for Tones Blog: songs, songs of the south

PAAW Administrator — Fri, 11 Mar 2016 14:16:36 GMT

“307 please respond for an 85yr old female, chest pain, one nitro taken”

“307 copy, updated en route”

The address is located on a main thoroughfare and the fire rescue at the curb marks the spot. Generally we try to do our backing as we arrive, utilizing our partner for spotting then rather than at time of leaving. This ensures safe backing practice, since one of us will be with the patient as we leave the scene. >> Click to read more...

Updates from the Wisconsin EMS Office

PAAW Administrator — Tue, 08 Mar 2016 21:46:02 GMT

The Wisconsin EMS Office recently published two important memos and helpful checklist information for Scope of Practice and Medication List.

>> EMS Numbered Memo 16-01 describes how a service can add First Responders to function as a member of a legal crew for the service.

>> EMS Numbered Memo 16-02 explains the difference between Mutual Aid and Coverage Agreements. Each has its specific purpose and one should not be used for both situations.

Helpful Checklists

>> Wisconsin Scope of Practice
>> Medication List

EMS Live Podcast: Wisconsin's mosquitoes do not carry Zika Virus, according to DHS

PAAW Administrator — Tue, 08 Mar 2016 16:39:11 GMT

We switch gears and also discuss EMS Roaddocs

>> Click to listen to this podcast.

On Tuesday, March 8 EMS Live in Wisconsin discussed recent virus and bacteria outbreaks. The Wisconsin Department of Health Services is currently investigating into an outbreak of bloodstream infections caused by bacteria called Elizabethkingia. The Elizabethkingia infection has been detected in 44 patients located in southeastern and southern Wisconsin. >> Click for full details.

What risks do EMS responders have with the Elizabethkingia bacteria? What are the presenting signs and symptoms? What safety precautions or recommendations should be taken? What patients are at risk?

We also discussed the Zika Virus that is receiving national and international attention. The good news here is mosquitoes found in Wisconsin are not the same ones identified as a carrier of the Zika Virus.

Our guest on EMS Live Podcast was Stephanie Smiley, Director of Bureau of Communicable Diseases for the State of Wisconsin's Division of Public Health.

In addition, 20 minutes into the program we were joined by Justin Foley, who is a member with EMS Roaddocs, a motorcycle riding club in Wisconsin and Northern Illinois. EMS Roaddocs is made up entirely of full and part time people who work in emergency services, either active or retired, that includes doctors, nurses, paramedics, EMT’s and Firefighters.

>> Click to listen to this podcast.

Next EMS Live in Wisconsin Podcast March 22

Join us Tuesday, March 22 for the next EMS Live program starting at 9:00 a.m. and lasting 30 minutes. Our guests include Wisconsin DEA Supervisor Kathy Frederico and American Ambulance Association VP of Government Affairs Tristan North. The US House of Representatives is considering legislation that impacts every ambulance service that carries controlled narcotics. Dial into the program at 646-929-1081, or listen on any internet connected device at http://tobtr.com/8398779.

NAEMT announces legislative priorities

PAAW Administrator — Fri, 26 Feb 2016 16:41:21 GMT

On February 12, the National Association of Emergency Medical Technicians (NAEMT) Board of Directors determined the organization's 2016 federal legislative priorities, to include:

HR 1818/S 235 - Veterans Transition Bill
HR 2366 – Field EMS Bill
HR 4365 – DEA Bill
HR 2274 - National Emergency Medical Services Memorial in DC

>> Click here to view the legislative priorities, and obtain further details on each of the bills.

EMS On The Hill Day, April 20, Washington, D.C.
NAEMT is also hosting its annual EMS On The Hill Day April 20 (briefing April 19) in Washington, D.C. Participates personally meet with their U.S. Senators, House Representative and their Congressional staff. The event is organized to ensure that Congress fully understands EMS' diverse role — from supporting healthcare systems by managing and redirecting non-emergent patients, to responding to disasters, accidents and other calls for skilled emergency medical care. >> Click for EMS On The Hill Day information.

EMS Live Webcast: Wisconsin's Medicaid ambulance rates being discussed with state DHS leadership

PAAW Administrator — Thu, 25 Feb 2016 22:41:07 GMT

The rate hasn't changed since 2008 - and back then it was a 1% increase

>> Click to listen to this audio webcast.

Currently, one in five Wisconsin residents is on state funded Medicaid. Like other states, Wisconsin is not immune from seeing its Medicaid population rolls increase. When an ambulance is called by or for a Medicaid covered beneficiary (patient), the services paid for by the state doesn't come close to the actual cost to deliver care and transport.

Last week representatives with PAAW and the EMS System Management and Development Committee, which is part of the state's EMS Advisory Board, met with leadership from the Wisconsin Department of Health Services (DHS). Last week's meeting had a few goals regarding Medicaid reimbursement rates to ambulance services: 1. Where does the money come from?, 2. How is the payment pie allotted?, and 3. What percentage goes to ambulance services?

The state's current Medicaid budget is $9.1 billion; however, it isn't clear what percentage goes to ambulance medical care and transportation. Besides having lower ambulance reimbursement rates than many other states, Wisconsin ambulance services also saw the number of non-emergency transports decrease since 2011 when the state contracted with a broker to manage them. Besides selecting an ambulance service, typically the most expensive non-emergency option, the broker can also choose other modes of transportation, to include taxis, buses, and medical or wheelchair vans.

According to officials with DHS, a change in the ambulance reimbursement rates, or fee structure, will require either an adjustment by DHS or a legislative initiative. One of the meeting's participants included Paratech Ambulance Vice President Larry Knuth, who commented on the webcast, "DHS would like follow-up with us on this to gain an in-depth understanding and where the industry wants to be. DHS is open to discuss a future plan and any proposals".

EMS Chief Dana Sechler with Baraboo District Ambulance also attended the meeting. He commented during the webcast, "The federal Government Accountability Office (GOA) did a study in 2007 and 2012. It summarized that federal MediCARE reimbursement rates were less than the actual cost to run an ambulance call. The interesting thing is when you compare federal MediCARE to Wisconsin MediCAID rates, Wisconsin MediCAID is less than half of MediCARE." (refer to the chart below)

Nowadays, the ability for an ambulance service to meet its operational, financial sustainability and any debt obligations truly rests in a favorable payer mix, local taxes and per capita charges. If your payer mix skews more towards MediCARE and state MediCAID patients, and less on insurance and private pay, it can be a difficult road to travel financially.

Without DHS increasing the reimbursement rate or industry stakeholders pursuing legislative action, growing budget gaps caused by low Medicaid payments will continue to plague the industry and lead to a greater cost shift to other payers, increase local property taxes, or potentially result in a reduction of services.

Federal MediCARE and State MediCAID Ambulance Reimbursement Rates - 2015

Description	Federal MediCARE	Wisconsin MediCAID	Minnesota MediCAID	Illinois** MediCAID
Per Mile	$10.74*	$5.56	$7.06	$5.00
BLS Non-Emergent	$216.44	$94.90	$221.34	$127.34
BLS Emergent	$346.31	$151.84	$430.03	$127.34
ALS Non-Emergent	$259.73	$113.88	$265.60	$198.49
ALS Emergent	$411.24	$180.31	$430.03	$198.49
ALS2	$595.21	$260.97	$608.77	$198.49
SCT	$703.43	$308.42	$719.45	$273.49

*MediCARE pays $10.74/mile for the first 17 miles, then $7.10/mile thereafter.
**Illinois MediCAID rates vary by county. Lake County (borders WI) 2014 rates shown.

The webcast concluded with EMS Advisory Board Chairman Jerry Biggart reviewing several highlights and priority items the board is working on. One of the items also discussed included EMS worker protection laws, since many states' like Minnesota are drafting legislation to enact them. The good news for Wisconsin's EMS workers is protection laws already exist. >> Click for Wisconsin's EMS protection laws.

>> Click to listen to this audio webcast.

Crystal Wallin's most recent blog post reaches new all-time high!

PAAW Administrator — Wed, 17 Feb 2016 18:18:17 GMT

Over 5,600 reached on PAAW's facebook page

PAAW would like to congratulate Crystal Wallin for reaching over 5,600 on its facebook page with her newest post "cheese curds and gravel".

Crystal is a La Crosse area paramedic with a captivating style in the way she shares an EMS work life and writes about the experience.

According to PAAW Executive Director Joe Covelli, "Crystal approached us last year about writing a monthly blog post. From the very first post it has been an absolute hit with our audience, as well as those outside of the EMS industry who find her writings fascinating".

To read Crystal's blog, "Standby for Tones", a collection of her featured writings, >> click here.

University of Cincinnati to open drone flight school for emergency responders

PAAW Administrator — Wed, 17 Feb 2016 16:07:25 GMT

Whether it’s Amazon considering delivering packages by drones or regular citizens using them to film grandiose aerial footage to put on YouTube, drones are widely available and visible. Recent news reports describe how some fire and EMS agencies are integrating drones into first responder operations, too. >> Click to read more.

Second Community Paramedic Clinic Opens in Madison to Help Low-Income Residents

PAAW Administrator — Thu, 11 Feb 2016 17:35:19 GMT

To help one local community improve patient outcomes, lower healthcare costs and provide more accessible care to chronically ill patients, southern Wisconsin-based Ryan Brothers Ambulance Service last June opened the Triangle Health & Resource Center, a community paramedic clinic staffed by EMTs, paramedics and CP students undergoing clinical training.

After a local television news segment last spring spotlighted the community paramedic concept, the managers of the Brittingham Apartments in Madison’s lower-income Triangle neighborhood approached the ambulance service about bringing in a CP to provide care for more than 600 of their residents.

“We were looking for an opportunity for our community paramedics to do clinicals and provide a community service,” explains Patrick Ryan, one of the owners of Ryan Brothers. “The managers of Brittingham contacted us about staffing a health clinic that was formerly staffed by parish nurses from a local hospital. We met with them and decided to give it a try. So far it is working well and appears it will be well into the future.” >> Click to read more.

EMS Leadership Academy registration now open

PAAW Administrator — Thu, 11 Feb 2016 16:06:42 GMT

Registration is now open for the EMS Leadership Academy, sponsored by the Wisconsin Office of Rural Health and the Wisconsin Healthcare Emergency Preparedness Program. This series of four, two-day courses is intended to provide EMS staff with skills and strategies to achieve and maintain a high functioning service.

Registration is $50 each for Levels I and II (April 21-24 in La Crosse) and $45 each for Levels III and IV (June 2-5 in Weston) and will include meals. You must register separately for each two day session. A hotel room block has been reserved in La Crosse; details on the registration site.

The program is presented by Aarron Reinert and John Becknell.

For more information on the Academy and to register, >> click for Wisconsin Office of Rural Health website.

>> Click for the event flyer.

Contact Kevin Jacobson at Wisconsin Office of Rural Health, 608-261-1888, with any questions.

EMS Live Webcast: EMT license renewal, Important information for every ambulance service that carries controlled narcotics

PAAW Administrator — Tue, 09 Feb 2016 20:39:21 GMT

>> Click for webcast on-demand playback.

This webcast of EMS Live in Wisconsin was recorded on Tuesday, February 9, 2016. Co-hosts included Joe Covelli and Patrick Ryan, and the program lasted 30 minutes.

Our first guest at 5:00 minutes into the program was EMS Office Licensing Coordinator Helen Pullen with the State of Wisconsin. We discussed what is required to renew your EMT, paramedic, or emergency medical responder license as all state licenses expire as of June 30, 2016. The license renewal website is https://www.dhs.wisconsin.gov/ems/licensing/renewal.htm.

At 20 minutes into the program State of Wisconsin EMS and Trauma Medical Director Dr. Suzanne Martens joined us to explain House of Representatives bill 4365, Protecting Patient Access to Emergency Medication Act. It has been recognized that EMS technically operates outside of the current DEA rules for controlled substances for pain and seizures. The DEA has allowed this to continue, but has stated it cannot do so without a change in the actual regulations. A draft bill to change these regulations has been written and proposed. The House of Representatives is processing it, and will vote in the near future. Without this bill change, all administration of controlled substances will require radio/phone contact for an order with medical control; and the ordering and stocking of these medications will be complex and costly, with potentially every ambulance being considered an "office". Since the majority of requests for paramedic intercepts involves controlled substances, this impacts all levels of care. >> Click for the HR4365 Toolkit and how to contact your local elected federal representative.

How you can support the effort:

Locate your appropriate Representative using a zip code search and activate an email communication. >> Click to enter your zip code and submit to start the process. Copy and paste the communication below in the body of the email using the template below and adding the Representative's name at the beginning, your name at the end, and any changes you wish.

Email template:

Subject: Please Co-sponsor H.R. 4365

Dear Representative [name] ;

As an Emergency Medical Services (EMS) provider, I am writing to ask you to cosponsor the Protecting Patient Access to Emergency Medications Act of 2016, H.R. 4365. I am committed to the safety of patients; and it is out of that commitment that I request your support.

H.R. 4365 clarifies that the current practice of physician medical directors overseeing care provided in the field by paramedics and other EMS practitioners via “standing orders” is statutorily allowed and protected. The use of “standing orders” is necessary so that physician medical directors can establish these pre-set protocols which EMS practitioners follow in delivering field EMS care.

When minutes count, “standing orders” are essential to enable EMS practitioners to immediately administer controlled substances on a timely basis and save lives. In the absence of standing orders, patients would not have access to the time-sensitive and potentially life-saving interventions they so desperately need.

Accordingly, H.R. 4365 ensures patients will continue to receive these vital medications by:

Codifying the practice of standing orders by a physician Medical Director for the administration and delivery of controlled substances, maintaining physician oversight of medical decisions, while,

Making the EMS Agency liable for the receiving, storing, and tracking of controlled substances, similar to current procedure at hospitals.

I again urge you to cosponsor this important legislation. If you would like to co‐sponsor or would like more information, please contact Preston Bell in Rep. Hudson’s (R-NC) office at Preston.Bell@mail.house.gov or in Rep. Butterfield’s office (D-NC) Dennis Sills at dennis.sills@mail.house.gov.

Sincerely,

Next EMS Live webcast Tuesday, February 23

The next live show is Tuesday, February 23 starting at 9:00 a.m. the topic is Wisconsin Medicaid and ambulance reimbursement rates for patient transports. Our guests include EMS Advisory Board Chairman Jerry Biggart, Baraboo Ambulance Chief Dana Sechler and Paratech Ambulance Vice President Larry Knuth.

Don't miss a beat of Wisconsin EMS action - listen to EMS Live!

"Mini" Med-1 vehicle allows Green Bay Fire to maneuver large crowds and offer better patient privacy

PAAW Administrator — Wed, 03 Feb 2016 20:51:45 GMT

Cheese curds and gravel

PAAW Administrator — Tue, 02 Feb 2016 22:19:39 GMT

Short stories by featured EMS writer and La Crosse paramedic Crystal Wallin

It’s so far. I come from this rural county asking for mutual aid, and as we get the call for a motorcycle accident, my first thought is, “it’s so far out”. My partner jumps in the passenger seat as I drive. Often the EMT will drive but this time I do, partly to give her a break and also because I know exactly where it is.

We aren’t far out of the small town we’re based out of today, when updated dispatch information makes my mouth tighten. “CPR in progress”. Sirens are wailing, LED lights are staccato, lighting up the signs facing us, even on this sunshine-y day. Traffic parts on the two lane road and we continue on. My partner and I discuss the roles and steps we’ll individually take upon arrival, in our choreographed dance thru the chaos. Our local air medical helicopter was initially on a pad standby but they’re now making their way to the same scene we are. I ask my partner if she’s comfortable with a King airway and she answers definitively, “yep!” I’ll work on IV access and medications, she’s got airway. >> Click to read more.

>> Click to read more of Crystal's blog and featured writings.

Wisconsin Fire and EMS Legislative Coalition votes in PAAW as new member

PAAW Administrator — Tue, 02 Feb 2016 22:05:58 GMT

On January 14, the Professional Ambulance Association of Wisconsin (PAAW) was voted in as a new member of Wisconsin's Fire and EMS Legislative Leadership Coalition.

According to PAAW President Patrick Ryan, "PAAW is honored to be accepted into the Wisconsin Fire and EMS Legislative Coalition. We look forward to working with fellow members to advance and strengthen EMS in Wisconsin through legislation and collaboration. This new development is yet another example of the continually growing presence of our organization and a reflection on the dedicated efforts of our members."

Coalition Members Include:

Professional Fire Fighters of Wisconsin
Professional Ambulance Association of Wisconsin
Wisconsin Chapter: International Association of Arson Investigators
Wisconsin EMS Association
Wisconsin Fire Chief's Education Association
Wisconsin Society of Fire Service Instructors
Wisconsin State Fire Chiefs' Association
Wisconsin State Fire Inspectors Association
Wisconsin State Firefighters Association

Responding medical team hits live power lines

PAAW Administrator — Mon, 01 Feb 2016 15:00:02 GMT

Several hundred people were without power early on the morning of January 30 after a dangerous crash in Hobart, which is near Green Bay.

It happened on WIS 54 near Bay Ridge Court around 2:00AM.

A medical crew from County Rescue Service was driving west on Hwy 54, non-emergent to re-position to assist another crew working a call at an area residence. In the dark, their squad struck power lines that were draped across the roadway from a separate motor vehicle accident that had occurred moments earlier.

The County Rescue crew members sustained very minor injuries, but could not be safely removed from the squad until the power lines were de-energized some time later. The Brown County Sheriff's Office was dealing with both scenes for several hours.

According to Director of Operations Larry Ullmer with County Rescue Services, "Our staff members are fine and the squad has minor damage, and our involvement with the incident was secondary to another accident".

Newest EMS Live Webcast: "Flipping the (EMS) Classroom"

PAAW Administrator — Tue, 26 Jan 2016 18:02:12 GMT

Guests: Lifestar EMS' Assistant Training Coordinator Tyler Christifulli and Field Training Educator Sam Ireland

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

Do you need to rev up your EMS training program? Are you looking for ways to engage your staff and get attendance and the discussion to a higher level at training events? If so, then this EMS Live in Wisconsin webcast, recorded on Tuesday, January 26, is for you.

Our guests included two individuals with Lifestar EMS in West Bend, WI - Assistant Training Coordinator Tyler Christifulli and Field Training Educator Sam Ireland. They discussed how they have successfully been using field educators at their base locations, and also sending out to staff pre-training podcasts to encourage education and discussion. They call their program, "Flipping the classroom".

Lifestar's approach to EMS education included the following:

Identifying the epidemic of bad teaching practices that surround EMS.

Using old power points
Strict outlines
Crowded slides

What has Lifestar done to reinvent the way we approach education?

Field Educators
White boards
Flipping the classroom
Simplified power points and flip chart

The techniques of running a good simulation.

You don't need expensive equipment to run a good sim
Video recording and critique playback
Always succeed in simulations
Takes a lot of preparation to run an efficient and dynamic simulation.

To view and listen to the February 2016 pre-training podcast, "Patterns, Pathways, and Pain", as an example, completed by Lifestar EMS, click here.

The next live webcast is Tuesday, February 9 starting at 9:00 a.m. with State of Wisconsin EMS Office Licensing Manager Helen Pullen. All individual EMTs, paramedics and first responders must renew their individual license by June 30, 2016 to continue to operate with their local ambulance service or deliver patient care in Wisconsin. The dial-in number is 646-929-1081 or listen on any internet connected device at http://tobtr.com/8255159.

Join co-hosts Chris Anderson, Joe Covelli, Patrick Ryan, Dan Williams and call-in guests and live listeners for 40-minutes of conversation about emergency medical services and the ambulance industry in Wisconsin the second and fourth Tuesday every month.

Don't miss a beat of Wisconsin EMS action - listen to EMS Live!

Wisconsin EMS Office releases its two-year plan

PAAW Administrator — Wed, 13 Jan 2016 17:28:32 GMT

The Department of Health Services, Division of Public Health, released on January 12th its draft plan, which describes the working objectives for operation of the Wisconsin EMS system for calendar years 2016 – 2018.

>> Click to download the State's 2016 0 2018 Emergency Medical Services Plan.

The Department is holding a public hearing on January 14 in Madison. Oral and written comments will be accepted at the hearing.

Meeting date, time and location:

January 14, 2015, 3:00PM to 5:00PM, Room number B370, 1 W. Wilson Street, Madison, WI 53703.

EMS Live Webcast: Ambulance Compliance Plan

PAAW Administrator — Tue, 12 Jan 2016 17:03:05 GMT

Attorney Wendy Arends reviews important items to include in your plan

>> Click to listen to this webcast.

A New Year brings new resolutions. Maybe one of the items that should be on your 2016 to-do list is updating your ambulance service's compliance plan. Regulatory compliance continues to be a big deal, and is getting more important. Create, review or update your compliance plan to reduce your risk and protect your company.

This webcast was recorded on Tuesday, January 12, 2016.

Our guest was attorney Wendy Arends at Godfrey & Kahn in Madison. We discussed the importance of an ambulance service compliance plan and the elements to include. Reference is made during the conversation to the U.S. Department of Health Office of the Inspector General, who posted ambulance service compliance plan recommendations at: http://oig.hhs.gov/fraud/docs/complianceguidance/032403ambulancecpgfr.pdf

The next live webcast of EMS Live in Wisconsin is Tuesday, January 26, starting at 9:00 a.m. central time. The dial-in number is 646-929-1081 or on the internet at http://tobtr.com/8221163.

Our guests include two individuals with Lifestar EMS in West Bend, WI - Assistant Training Coordinator Tyler Christifulli and Field Training Educator Sam Ireland. They will discuss how they have successfully been using field educators at their base locations, and also sending out to staff pre-training podcasts to encourage education and discussion. They call their program, "Flipping the classroom".

Don't miss a beat of Wisconsin EMS action - listen to EMS Live!

Unresponsive at 6:00 a.m.

PAAW Administrator — Sat, 26 Dec 2015 15:32:23 GMT

Short stories by featured EMS writer and La Crosse paramedic Crystal Wallin

Unresponsive, at shortly after 6am, is a thing. It’s the time of day lots of folks wake up and find the spouse isn’t breathing, or moving, or generally not like usual. Unresponsive, at shortly after 6am, is a special kind of horrible thing for a medic who is deep into sleep. Waking thickly in a panic as the tones sound overhead, stumbling feet into boots while pulling sweater overhead, fumbling for glasses, tucking in shirt while hurrying to the garage. Unplugging the shore line, zipping boots, hitting garage door opener, blinking at early morning while shoving the seatbelt home to a crisp click. Blinking and reaching for the mike, putting the truck in drive and activating siren and lights while listening to the repeated dispatch info. Glancing at the Navigator screen on the tablet for the address, merging into early morning caffeinated and showered drivers while still valiantly mentally joining the rest of the world. >> Click to read more...

>> Click to read more of Crystal's blog and featured writings.

A look back at the most listened to webcasts in 2015

PAAW Administrator — Sat, 26 Dec 2015 15:00:00 GMT

By Joe Covelli, PAAW Executive Director

Producing audio webcasts has proven to be a very successful way for PAAW to deliver news, information and content to those involved in emergency medical services in Wisconsin. We know this is true because of the numbers we see downloading the content or listening live, plus the many positive comments we receive on a regular basis. Having your support and listenership is very important to us, it tells us we are doing the right thing and covering the right topics.

I really have been amazed by the response to what we've produced in 2015. An example of this is the live webcast we did on May 4 with Dr. Eugene Nagel, Randolph Mantooth, and Nancy McFarland.   That one show to-date has been downloaded over 2,800 times. Wow! If you have an appreciation for EMS history and the 1970's TV show, EMERGENCY!, then you will definitely enjoy this interview.

Since 2010, we've produced EMS to the Point. It's a recorded webcast format with one interviewer and a guest. This past year we added six new interviews to the webcast library.

In March 2015, we began hosting a live webcast, called Wisconsin EMS Live, that offers interaction between co-hosts, guests and callers. The webcast name was changed in November to EMS Live in Wisconsin. Since the beginning, I've been joined on the program by co-hosts Chris Anderson, Patrick Ryan and Dan Williams. Throughout 2015, we did the webcast live the second Tuesday every month. Because of interest, and to cover more topics more frequently, we made the decision to host the live webcast twice per month, on the second and fourth Tuesdays, beginning in January. Our first webcast using the new format is January 12 starting at 9:00 a.m. We'll be discussing ambulance compliance plans with attorney Wendy Arends.

In 2012 and 2011, I did a couple of interviews - one on EMS Pay, Wages and Volunteers with the Wisconsin Dept. of Workforce Development, and the other about Wisconsin's new conceal carry gun law and EMS. I was amazed to see these two webcasts had a number of downloads in 2015, so I included them in the list of highlights too.

As always, please write or call the Association with topics you suggest we include in our 2016 plans.  Thank you for your loyal listenership.

2015 Most Listened to Webcasts

EMS Live in Wisconsin Webcast Top Downloads:

>> Randolph Mantooth and Dr. Eugene Nagel discuss the rise of paramedics

>> Community Paramedicine and Physicians Advisory Committee

>> EMS Controlled Narcotics: Chain of Custody, Diversion, Best Practices

>> CPAP device, CHF patients and high dose nitro outcomes, and PSOW wrap-up

>> Community Paramedicine Trials in Milwaukee Co., Working Together Conf.

EMS to The Point Webcast Top Downloads:

>> Raising the Bar: A Medical Director's Quality Improvement Initiatives. Guest: Dr. Steve Stroman, Medical Director at Eagle III, Oshkosh Fire, DePere Fire and Rescue, and Oconto Falls Area Ambulance

>> Same Tool, Enhanced Use: Nasal Cannula Apneic Oxygenation. Guest: Dr. Mark Westfall, Medical Director for Gold Cross Ambulance - Fox Valley and the Professional Ambulance Association of Wisconsin

>> Finally! EMS data performance measures. Guest: Nick Nudell, EMS Compass Initiative Project Manager, National Association of State EMS Officials

>> Time to Pay Attention to EMT Wage and Labor Laws. Guest: Jim Chiolino, Director, Labor Standards Bureau, WI Dept. of Workforce Development (2012)

>> Wisconsin's New Conceal Carry Weapons Law and EMS. Guest: Sgt. Kevin Bygd, Dunn County Sheriff's Office (2011)

Minnesota bill would increase penalty for interfering with a paramedics

PAAW Administrator — Mon, 14 Dec 2015 16:50:32 GMT

An east metro lawmaker wants to increase the penalties for anyone who interferes with first responders rendering medical aid.

Rep. Pat Garofalo, R-Farmington, said Tuesday the Public Safety Personnel Protection Act will be the first bill he submits for the legislative session that begins March 8. His proposal would make it a felony to interfere with emergency personnel even if that interference doesn't reach the level of an assault. >> Click to read more...

Source: Pioneer Press, St. Paul, MN

The Uber will see you now

PAAW Administrator — Mon, 14 Dec 2015 16:05:34 GMT

Uber-delivered flu shots are just the beginning.

Someday, an Uber — not an ambulance — could appear at your door and whisk you to the hospital. Or to a doctor’s appointment. Or it could bring the doctor to wherever you are, whenever you want.

Uber doesn’t have immediate plans to do any of this, but it appears to be laying the groundwork to serve up health care at the tap of a button, just as it has rides and, more recently, food, drugstore necessities, and even kittens.

For four hours on a recent Thursday, Uber customers could summon nurses to administer flu shots for $10; the company hoped to vaccinate as many as 10,000 people across 36 U.S. cities. >> Click to read more...

Webcast: CPR Adjunct Devices and New Research Findings that will Surprise You!

PAAW Administrator — Fri, 11 Dec 2015 17:26:07 GMT

>> Click to play this webcast.

New CPR research suggests something that goes against common sense. What is it? Well, let's start out by asking a question. In what position would offer the patient the best cardiac circulation and flow to the brain when performing CPR? a) supine, b) shoulders raised 30 degrees, c) shoulders raised 90 degrees, d) both legs elevated 30 degrees? To get the answer you'll need to listen to the webcast. I must admit, this was one of the more fascinating interviews I've ever done. It's worth a few minutes of your time.

This new CPR revelation was brought to my attention by Dr. Joseph Holley, an expert in CPR resuscitation known worldwide. He is also the EMS Medical Director for the State of Tennessee and EMS Medical Director at Memphis Fire Dept.

If you are like me, and thought the mechanics, adjuncts, and delivery to CPR couldn’t be improved much more after all the other improvements we have seen over the years, well, think again.

>> Click to play this webcast.

EMS Live in Wisconsin Webcast dedicated to community paramedicine in Milwaukee County

PAAW Administrator — Tue, 08 Dec 2015 16:00:00 GMT

>> Listen at http://tobtr.com/8064951

On Tuesday, December 8, PAAW completed a one hour EMS Live in Wisconsin webcast, which was dedicated to discussing community paramedicine in Milwaukee Co. Several fire departments, along with Aurora Health System and other public health agencies, have teamed up to work in this new and emerging area of healthcare delivery for Wisconsin.

If you're wanting to learn more about community paramedicine/MIH or starting to implement these concepts, listening to this group discussion is a good use of your time.

We discussed with several fire departments and Aurora Healthcare how they have approached Community Paramedicine with their 2015 trial programs, what they have realized so far, and what's next.

Guests included:
Dan Tyk, North Shore Fire
Dan Weber, Greenfield Fire
Dave Bandomir, West Allis Fire
Michael Wright, Milwaukee Fire
Patti Pagel, Aurora Health System
Tim Kersten, West Allis Fire

Fred Hornby also discussed the upcoming Working Together Conference taking place January 26 to 31in Milwaukee. They are also offering a Community Paramedicine/MIH Symposium on one of the days.

>> Listen at http://tobtr.com/8064951

"snapshots"

PAAW Administrator — Wed, 02 Dec 2015 12:41:35 GMT

Short stories by featured EMS writer and La Crosse paramedic Crystal Wallin

The husband leads us to the basement, where she’s sitting. Trendy sweatpants and a shell shocked expression are my first impressions. He’s keeping the small ones at bay as they try to see around him, wondering “what’s wrong with Mommy?” Mommy’s stomach hurt and she was closer to the basement restroom when she sat down and she hasn’t gone far. There’s a small throw rug in front of the toilet that matches the shower curtain and the valance at the small half window. A hand towel, in keeping with the scheme, lies folded in half a short distance away. My partner, a male, steps outside at my nod and begins to get demographics. The pt and I regard each other, then the towel. >> Click to read more...

>> Click to read more of Crystal's blog and featured writings.

Spanish for EMS

PAAW Administrator — Wed, 02 Dec 2015 11:18:26 GMT

A one-day (7 hour) course designed specifically for EMTs and Paramedics

>> Click for event information flyer.

Upon completing the workshop, participants will be able to utilize Spanish to:

• Identify self and patient

• Render immediate emergency aid

• Determine patient’s chief complaint

• Issue controlling phrases and commands • Obtain pertinent information
• Explain treatments performed by EMS

• Make assessment of patient through interview • Facilitate transport of injured or ill person

• Engage in triage protocol • And much more!!!

Each participant will receive a 54-page manual with 2 accompanying CDs and a laminated quick-reference card, PLUS a Certi cate of Completion.

Where: University of Wisconsin - Whitewater, Whitewater, WI

When: Saturday January 16, 2016 8:30 AM - 4:00 PM

Cost: $99.00

Register online: www.CommandSpanish.com/schedule.html

Narcan nasal spray approved by FDA

PAAW Administrator — Fri, 20 Nov 2015 20:15:25 GMT

Combating opioid overdose epidemic, the leading cause of accidental death in the U.S., is a top FDA priority

The U.S. Food and Drug Administration recently approved Narcan nasal spray, the first FDA-approved nasal spray version of naloxone hydrochloride.

Drug overdose deaths, driven largely by prescription drug overdoses, are now the leading cause of accidental death in the U.S. — surpassing motor vehicle crashes.

"Combating the opioid abuse epidemic is a top priority for the FDA," said Stephen Ostroff, M.D., acting commissioner, Food and Drug Administration. "We cannot stand by while Americans are dying. While naloxone will not solve the underlying problems of the opioid epidemic, we are speeding to review new formulations that will ultimately save lives that might otherwise be lost to drug addiction and overdose."

>> Click to read more.

Source: EMS1

2016 CMS Ambulance Inflation Factor negative .4%

PAAW Administrator — Thu, 19 Nov 2015 13:18:18 GMT

The Centers for Medicare and Medicaid Services (CMS) has officially announced that the inflation factor for payments under the Medicare ambulance fee schedule for 2016 will be negative .4% (-0.4%). As part of the Affordable Care Act, a productivity adjustment has been part of the calculation for the last several years which for 2016 has resulted in a negative update.

The announcement basically means ambulance services, both ground and air medical, will likely see their Medicare reimbursement payments reduced.

Source: American Ambulance Association

Have you taken the EMS data survey yet?

PAAW Administrator — Tue, 17 Nov 2015 16:49:08 GMT

The National Association of EMTs (NAEMT) is currently conducting a survey that will provide a picture of the current state of EMS data, and will be used as a starting point for drafting a national EMS data strategy.

>> Click to take a few minutes to complete the survey.

Governor's signature allows First Responders to operate as legal Ambulance crew member

PAAW Administrator — Sat, 14 Nov 2015 16:37:03 GMT

Governor Scott Walker made it official on November 11, signing into law 2015 Wisconsin Act 113 / Senate Bill 143, which allows a First Responder to operate at their level of license as one member of a two-person legal ambulance crew.

The process began when Assembly Rep. Jeff Mursau from Crivitz, author of the legislation, was contacted by area emergency departments. Many fire and ambulance departments, especially in the rural areas, see utilization of first responders as the lifeline they need to get the ambulance out the door to a 911 medical call. However, there is mixed review as others in the profession see this measure as a "band-aid" fix to a larger problem and dwindling volunteers.

As drafted in the Assembly and Senate bill writing process, Act 113 signed by Gov. Walker contains a population component. Population less than 10,000 can automatically staff a first responder as a legal crew member, and doesn't require a staffing plan waiver. More than 20,000 population can't use first responders as a legal crew staffing option. Population is defined by the single largest municipality in the ambulance service's coverage area.

Population 10,000 or more but not more than 20,000 may apply to the Department of Health for a staffing plan waiver; however, certain conditions must be demonstrated to include all of the following:

The ambulance service provider has undertaken efforts to recruit and train emergency medical technicians capable of being licensed under this section.
Despite efforts under subd. 2. a., licensed emergency medical technicians are not available in sufficient numbers for staffing for the ambulance services provider.
Without a waiver under subd. 1., the municipality that the ambulance service provider serves is unable to meet staffing requirements for ambulances that require 2 emergency medical technicians on every service call.
The department shall provide a written staffing waiver to any ambulance service provider it approves under subd. 2.
A waiver under subd. 1. is valid for 48 months after the date of issuance, and an ambulance service provider may apply to renew the waiver.
An ambulance service provider with a waiver under subd. 1. shall attempt to staff an ambulance with 2 licensed emergency medical technicians whenever possible.

>> Click to listen to an audio interview with Rep. Jeff Mursau regarding First Responder legislation, the population component, and what led to drafting the legislation.

Newest EMS Live in Wisconsin Webcast now posted

PAAW Administrator — Wed, 11 Nov 2015 17:36:52 GMT

>> Click to listen now.

Topics Discussed:

At 5 minutes First Responder Legislation author Representative Jeff Mursau

At 15 minutes HealthString's innovative approach to patient transport surveys - Buck McAlpin and George Willock

At 30 minutes Savvik Buying Group contract updates with Executive Director Mickey Schulte

At 45 minutes EMS stretcher cot quilt blanket to beat cold, harsh Wisconsin winters - Alpha Medical Equipment's CEO Jeff Grasto

The live program was recorded with on-demand playback available at http://tobtr.com/8014879.

Don't miss a beat of Wisconsin EMS action - listen to EMS Live!

First Responder legislation passes Senate and Assembly, awaits Governor's signature

PAAW Administrator — Tue, 03 Nov 2015 20:06:34 GMT

There has been a flurry of activity the past six months at the State Capitol in Madison regarding First Responders, and allowing them to operate at their level of license as one member of a two-person legal ambulance crew. Many fire and ambulance departments, especially in the rural areas, see utilization of first responders as the lifeline they need to get the ambulance out the door to a 911 medical call. However, there is mixed review as others in the profession see this measure as a "band-aid" fix to a larger problem and dwindling volunteers.

Both the Senate and Assembly versions include a population component. Population less than 10,000 can automatically staff a first responder as a legal crew member, and doesn't require a staffing plan waiver. More than 20,000 population can't use first responders as a legal crew staffing option. Population is defined by the single largest municipality in the ambulance service's coverage area.

Population 10,000 or more but not more than 20,000 may apply to the Department of Health for a staffing plan waiver; however, certain conditions must be demonstrated to include all of the following:

The ambulance service provider has undertaken efforts to recruit and train emergency medical technicians capable of being licensed under this section.
Despite efforts under subd. 2. a., licensed emergency medical technicians are not available in sufficient numbers for staffing for the ambulance services provider.
Without a waiver under subd. 1., the municipality that the ambulance service provider serves is unable to meet staffing requirements for ambulances that require 2 emergency medical technicians on every service call.
The department shall provide a written staffing waiver to any ambulance service provider it approves under subd. 2.
A waiver under subd. 1. is valid for 48 months after the date of issuance, and an ambulance service provider may apply to renew the waiver.
An ambulance service provider with a waiver under subd. 1. shall attempt to staff an ambulance with 2 licensed emergency medical technicians whenever possible.

Now that the Senate and Assembly versions have passed, the bills now head to Governor Scott Walker for signature to become law.

Governor Walker, other state leaders extend their appreciation to Stars of Life during Capitol visit

PAAW Administrator — Tue, 03 Nov 2015 16:56:58 GMT

The Wisconsin Stars of Life honorees, recently inducted at two ceremonies in Green Bay this past September, found themselves on Tuesday, October 27, standing in the Office of Governor Scott Walker at the State Capitol for a meet and greet opportunity and photo with the Governor.

The daylong event also included a personalized welcome message by Department of Health Services (DHS) Administrator Karen McKeown, meetings with legislators, and topped off later that afternoon with the full Assembly adopting a resolution acknowledging the Stars, to include a standing ovation. To read the resolution, click here.

The Stars of Life program is to honor and recognize the contribution of those in EMS and the ambulance profession. Each Star honoree is locally nominated by their respective ambulance service, fire department, first responder group, or other organization. Each nominee is presented with Wisconsin Stars of Life honors. Deonne Eske with Ashippun Fire Department will advance from the group to represent Wisconsin at the National Stars of Life in Washington, D.C. in April 2016.

Wisconsin Stars of Life has been produced by the Professional Ambulance Association of Wisconsin since 2006. The next Stars event and nomination period is sometime in 2017.

>> Click to download the 2015 Wisconsin Stars of Life program booklet, which includes information on each honoree.

>> Click for the Wisconsin Stars of Life 2015 web page.

Legislators Recognized for their support of EMS

PAAW Administrator — Tue, 03 Nov 2015 15:47:24 GMT

At a Stars of Life State Capitol event on October 27, the Professional Ambulance Association of Wisconsin (PAAW) recognized Senator Sheila Harsdorf and Representative Paul Tittl for their their support of Wisconsin emergency medical services and the ambulance industry. Harsdorf and Tittl were both presented with the President's Award by PAAW President Patrick Ryan. This was the first time the award was presented by the Association.

According to PAAW President Ryan, "Both Senator Harsdorf and Representative Tittl were instrumental in the Association's efforts with the TRIP bill that Governor Walker signed into law this past August, and very supportive of our Stars of Life program".

TRIP, which stands for Tax Recovery Interception Program, allows all Wisconsin ambulance services to use the Wisconsin Department of Revenue's TRIP recovery process to attempt to collect on ambulance 911 patient transportation bills that go unpaid.

According to PAAW Executive Director Joe Covelli, "An ambulance service has a duty to act to render care and provide services, often leaving the patient’s ability to pay as a later thought. It is vitally important that your local community ambulance service remain financially strong and healthy, and the operation sustainable".

Pictured: Senator Sheila Harsdorf, PAAW President Patrick Ryan, and Representative Paul Tittl.

Wisconsin EMS Office announces provider license renewal period now open through June 30, 2016

PAAW Administrator — Tue, 03 Nov 2015 14:31:30 GMT

November 1 marked the official beginning of the state's License/Certification renewal process, which continues to June 30, 2016.

>> Click to review the Wisconsin EMS Office's Memo 1505 recently emailed to all providers about the 2016-2018 License/Certification renewal process.

All continuing education is a personal responsibility.

For the 2016-2018 License/Certification renewal process, your initial or continuing education requirements need to be completed between July 1, 2014, and June 30, 2016. Flexible continuing education may be obtained through any format, but needs to meet the requirements set forth in Administrative Code DHS 110.07.

>> Click for the renewal education refresher requirements.

Air Medical Transport Company Saves 40 Hours Per Month by Implementing Aladtec

PAAW Administrator — Tue, 03 Nov 2015 13:55:58 GMT

Life Link III® (MN) saves significant time and improves operational efficiency
by moving personnel scheduling to the cloud.

>> Click to watch the video Customer Report.

Critical thinking and efficiency are key with all air medical service organizations and they’re continually seeking ways to improve methods and procedures. With the increasing use of “the cloud” for administrative processes, air transport companies are utilizing online software to increase administrative efficiencies and employee communication.

Life Link III is a leading medical air transport company in Minnesota. Effectively scheduling 70 medical personnel at six bases on a Google calendar became a daily burden. They sought a better method and found Aladtec - an online employee scheduling and workforce management system.

“What was bad about the Google calendar was the inability to access it unless I was at a desktop computer. It was highly inefficient, created a lot of work and there was absolutely zero automation to it. Every trade and time-off request had to be entered manually. Having to allot that sort of time for simply scheduling was detrimental to completing our mission,” explains Nate Lebeck, Operations Manager/Critical Care Flight Paramedic, Life Link III, Minneapolis, Minnesota. “By switching to Aladtec I save at least 1 to 2 hours a day. Add that up, and it frees as many as 10 hours a week for me to concentrate on more important tasks.”

Since Aladtec is a cloud-based SaaS (Software as a Service) product, it’s available 24/7 from any computer, smartphone or other mobile device via the Internet. The Life Link clinicians appreciate the option of using the mobile web application. “I use the mobile app because obviously I don't have to be at a desktop. Whether you're at work or at home, it's right there in the palm of your hand,” shares Phil Nicolas, Flight Paramedic, Life Link III.

With the implementation of Aladtec, Lebeck says everything has become automated. When a clinician is hired, their shift rotations are permanently placed in the system. The responsibility to make trades and request time off is up to the employee to make within the Aladtec system. Then, their supervisor can approve it, or not approve it, with just the touch of a button. Life Link III also uses Aladtec to schedule outreach events and ride along requests.

“I really do like Aladtec. I don't say that about a lot of products but this system has really made my job much more efficient. I would absolutely recommend Aladtec to other organizations; it’s a very good fit for our industry,” Lebeck concludes.

About Life Link III®:
Life Link III operates six helicopter bases serving patients in Minnesota, Wisconsin and North Dakota. The company’s helicopter and airplane services provide on-scene emergency response and inter-facility transport for patients requiring critical care. Life Link III is a non-profit consortium and is the air medical transport program for 44 hospitals across 9 health systems. For more information, visit www.lifelinkiii.com.

About Aladtec:
They proudly provide online employee scheduling and workforce management software to over 1,500 organizations, primarily within the Public Safety Sector. These customers count on Aladtec every day to help them save time and improve efficiency. For information about their affordable industry specific options, or to try a free trial, please visit www.aladtec.com.

Auvi-Q Epi Auto Injector Recalled

PAAW Administrator — Tue, 03 Nov 2015 13:52:46 GMT

Auvi-Q (epinephrine injection, USP): Recall - Potential Inaccurate Dosage Delivery

Sanofi US is voluntarily recalling all Auvi-Q (epinephrine injection, USP). The recall involves all Auvi-Q currently on the market and includes both the 0.15 mg and 0.3 mg strengths for hospitals, retailers and consumers. This includes lot number 2299596 through 3037230, which expire March 2016 through December 2016. The products have been found to potentially have inaccurate dosage delivery. See the Press Release for product photos.

As of October 26, 2015, Sanofi has received 26 reports of suspected device malfunctions in the US and Canada. None of these device malfunction reports have been confirmed. In these reports, patients have described symptoms of the underlying hypersensitivity reaction. No fatal outcomes have been reported among these cases.

If a patient experiencing a serious allergic reaction (i.e., anaphylaxis) did not receive the intended dose, there could be significant health consequences, including death because anaphylaxis is a potentially life-threatening condition.

To download the FDA's reporting form click here or call 1-800-332-1088 to request a reporting form.

>> Click to read the MedWatch safety alert, including a link to the Press Release.

Wisconsin Stars of Life to meet Governor Walker, be recognized by DHS and legislators Oct. 27 at State Capitol event

PAAW Administrator — Fri, 23 Oct 2015 14:50:23 GMT

Photo Credit: Logan Sechler of Sechler Photography, LLC

The Wisconsin Stars of Life honorees recently inducted at two ceremonies in Green Bay last month will be recognized for their professionalism and commitment at the State Capitol in Madison on Tuesday, October 27.

The day includes a welcome message by Department of Health Services (DHS) Administrator Karen McKeown, followed by introductions and meeting with Governor Scott Walker in his office.

The Stars will also be recognized before the Senate and Assembly while in session in their respective chambers. The Senate and Assembly will each adopt resolutions recognizing the Stars; it is a moving experience of tribute and appreciation on behalf of state government's elected leaders. The resolution is read and adopted, which in the past has been accompanied by a standing ovation. To read the resolution before the Senate, click here.

The Stars of Life program is to honor and recognize the contribution of those in EMS and the ambulance profession. Each Star honoree is locally nominated by their respective ambulance service, fire department, first responder group, or other organization. Each nominee is presented with Wisconsin Stars of Life honors. Deonne Eske will advance from the group to represent Wisconsin at the National Stars of Life in Washington, D.C. in April 2016.

Wisconsin Stars of Life has been produced by the Professional Ambulance Association of Wisconsin since 2006. The next Stars event and nomination period is sometime in 2017.

>> Click to download the 2015 Wisconsin Stars of Life program booklet, which includes information on each honoree.

>> Click for Wisconsin Stars of Life 2015 dedicated webpage.

EMS Live Podcast: Innovative approach to helping CHF patients using high dose nitro, CPAP device, PSOW wrap-up

PAAW Administrator — Wed, 21 Oct 2015 15:37:43 GMT

>> Click to listen to the on-demand playback of this podcast.

During the EMS Live in Wisconsin podcast on Tuesday, October 13, co-hosts and guests discussed the following:

1. At the start of the program we received a Community Paramedicine update from PAAW President Patrick Ryan.

2. At 5:00 minutes into the program we discussed an innovative CPAP device manufactured by Pulmodyne. Click images below to enlarge.

3. At 20:00 minutes into the program we learned about a technique at Lifestar EMS to improve congestive heart failure patient (CHF) treatment and outcomes using high dose nitro. Assistant training coordinator Tyler Christifulli discussed the procedure approved by their local medical director. This procedure is outside the "standard of care" and requires local medical director approval. Tyler provided the following supporting information regarding high dose nitro for CHF:

Emcrit Podcast: http://emcrit.org/podcasts/scape/

Crashing Patients: http://crashingpatient.com/medical-surgical/cardiology/heart-failure-acute-pulmonary-edema.htm/

Annals EM 1997: http://crashingpatient.com/wp-content/uploads/2011/09/nitro-abstract.png

Piyush Mallick Study: http://emcrit.org/wp-content/uploads/2009/04/Nitro-Bolus-Abstract.pdf

Video of High Dose Nitro in action: https://www.youtube.com/watch?v=wAiJQeddf6I

4. At 40:00 minutes into the program Paramedic Systems of Wisconsin (PSOW) Conference Director Dan Williams discussed some of this year's topics and what was top of mind with EMS leaders in Wisconsin. The conference was held in Green Bay and concluded on Friday, September 25.

The next live program of EMS Live in Wisconsin is Tuesday, November 10, starting at 9:00 a.m. The dial-in number is 646-929-1081.

Join co-hosts Chris Anderson, Joe Covelli, Patrick Ryan and Dan Williams for 60 minutes of live information sharing. Don't miss a beat of Wisconsin EMS action - listen to EMS Live in Wisconsin.

>> Click to listen to the on-demand playback of this podcast.

"PR - Public Relations or Potential Recruits", newest blog post by Crystal Wallin

PAAW Administrator — Wed, 21 Oct 2015 12:30:00 GMT

The newest "Standby for Tones" blog post by featured writer and La Crosse paramedic, Crystal Wallin, was just posted, entitled "PR - Public Relations or Potential Recruits".

>> Read the blog post at: http://paaw.us/standby-for-tones

Wisconsin EMS Live to discuss CPAP device, technique to improve CHF patient outcomes and hot topics at PSOW

PAAW Administrator — Mon, 12 Oct 2015 15:12:20 GMT

The next live program of Wisconsin EMS Live is Tuesday, October 13, starting at 9:00 a.m. The dial-in number is 646-929-1081, or listen on any internet connected device at this link: http://tobtr.com/7986675

Program topics include:

1. An innovative new CPAP device manufactured by Pulmodyne. Find a couple pictures of the device below.

2. Improve congestive heart failure patient (CHF) treatment and outcomes with a technique being used at Lifestar EMS. We'll discuss further with assistant training coordinating Tyler Christifulli.

3. The Paramedic Systems of Wisconsin (PSOW) concluded September 25 in Green Bay. We'll talk with Conference Director Dan Williams about some of this year's topics and what was top of mind with EMS leaders in Wisconsin.

Join co-hosts Chris Anderson, Joe Covelli, Patrick Ryan and Dan Williams for 60 minutes of live information sharing. Caller or emailed questions are invited at 646-929-1081 or email wisconsinemslive@paaw.us.

Don't miss a beat of the action - listen to Wisconsin EMS Live.

An innovative new CPAP device manufactured by Pulmodyne. (click image to enlarge)

Community Paramedicine "draft legislation" making the rounds at State Capitol

PAAW Administrator — Thu, 01 Oct 2015 21:58:16 GMT

On a regular basis the past few months there has been a conference call to discuss Community Paramedicine (CP). Participation is open to anyone interested. These conversations took a big leap forward this past week in Madison with legislative visits the past two days, and more scheduled in the near term.

According to Professional Ambulance Association of Wisconsin President Patrick Ryan, "Our talking points about the importance of CP were very well received by everyone we spoke with. So well in fact, multiple legislators have expressed interest in introducing the legislation in the next few weeks."

Besides PAAW, the Professional Fire Fighters of Wisconsin, and Wisconsin State Fire Chiefs Association had representatives at the Sate Capitol, coordinating their efforts with legislative meetings.

To listen to the latest CP information from the October 1 conference call, click to download http://tobtr.com/7883515. The call lasted 20 minutes.

To download the latest CP legislation (draft #6 dated 9/28/2015), go to www.paaw.us/cp, look for "Legislation Draft #6" in the blog post area.

The next CP conference call is Friday, Oct. 30 starting at 9:00 a.m. Again, it's open to anyone interested and is moderated by PAAW President Patrick Ryan.

New concept for the Milwaukee Fire Dept.: Paramedics treating patients before they call 911

PAAW Administrator — Wed, 30 Sep 2015 00:52:53 GMT

A new concept for the Milwaukee Fire Department (MFD) -- paramedics treating patients before they call 911. They'll start this week, and this will help cut down on the number of emergency calls MFD gets from the same home each month.

They're called community paramedics, and they'll specialize in treating chronic conditions like asthma and chronic obstructive pulmonary disease (COPD).

"The issue with asthma is you can get the air in, but you can't necessarily squeeze it out," said Sarah Brundidge, manager of lung health services with the American Lung Association in Wisconsin.

These paramedics are training with the American Lung Association, thanks to a grant from the United Health Foundation.

"Milwaukee has some of the highest rates of asthma in the country," said Brundidge.

MFD dispatch records show 24% of calls are from individuals with 'difficulty breathing.' The same patient could call as many as 40 times in six months.

Source: Fox 6 News, Milwaukee

Wisconsin Stars of Life shine in Green Bay during two recognition events

PAAW Administrator — Sun, 27 Sep 2015 00:40:40 GMT

Photo Credit: Logan Sechler of Sechler Photography, LLC

>> Click to download the 2015 Wisconsin Stars of Life program booklet, which includes information on each honoree.

Words of congratulations and thank you, smiles, handshakes, hugs, and so much more were abundant at this year's Wisconsin Stars of Life, which recognized twenty-six honorees nominated by their respective ambulance service or an organization. The two-day event was held in Green Bay on September 23 and 24.

The celebration began at Lambeau Field with a Welcome Reception that was kicked off by VP of Marketing Gabrielle Dow, followed by a welcome message by Director of Sports Medicine Pepper Burruss, both of them with the Green Bay Packers. Wisconsin Star of Life introductions came next that included personal stories and accolades by the Stars' respective employer, co-worker or family member, to include presentation of a commemorative Star of Life lapel pin for each.

The following day the Paramedic Systems of Wisconsin Conference provided for the formal dinner and awards program, where each Star was formally introduced and inducted as a Wisconsin Star of Life honoree, and presented with a gold medallion and signed certificate of appreciation from Governor Scott Walker.

The program concluded with the announcement Fire and EMS Chief Deonne Eske with Ashippun Fire Department was chosen as Wisconsin's representative to attend the National Stars of Life program next year in Washington, D.C. National Stars of Life is produced by the American Ambulance Association.

During the past thirty-two years, Eske has been a volunteer EMT/firefighter, lieutenant, captain, and is currently chief at the department. In 2014, she attended 100% of fire and EMS meetings and over 90% of fire and rescue calls as a volunteer. In addition, Eske presents an annual fire safety program to the elderly, including calling 911 and how to prepare for the ambulance arriving. Her department's nomination also included how she follows up on patients who were recently transported by the ambulance - even cleaning and changing bed sheets before they came back home.

Wisconsin Stars of Life honorees have been invited to a one-day event at the State Capitol on Tuesday, October 27, for recognition before the Senate and Assembly in their respective chambers, as well as meet with their local legislators.

2015 Wisconsin Stars of Life honorees included:

David Allen nominated by Amherst Fire District/Portage County EMS

Susan Armstrong-Schlegal nominated by Saukville Fire Department

Dr. Charles Cady nominated by the Professional Ambulance Association of Wisconsin

Tyler Christifulli nominated by Lifestar Emergency Medical Services

Julie Dehne nominated by Valders Ambulance

Dan Diestler nominated by County Rescue Services

Marlene Dirkes nominated by Gold Cross Ambulance / Mayo Clinic Medical Transport

Clayton Emons nominated by Gold Cross Ambulance Fox Valley

Deonne Eske nominated by Ashippun Fire Department

Kelsey Esser nominated by Tri-State Ambulance

Kevin King nominated by Shawano Ambulance Service

Matthew Koepp nominated by Baraboo District Ambulance

Thomas Konieczka nominated by Greenfield Fire Department

Larry Krueger nominated by the Town of Sheboygan First Responders.

Jon Masi nominated by Paratech Ambulance

Buck McAlpin nominated by the Professional Ambulance Association of Wisconsin

Beth Morando nominated by Ryan Brothers Ambulance

James Poltrock nominated by Kenosha Fire Department

David Robbins nominated by Ryan Brothers Ambulance

Nick Romenesko nominated by Gold Cross Ambulance Fox Valley

Amy Smith nominated by Tri-State Ambulance

Dr. Steven Stroman nominated by De Pere Fire Rescue

Rebecca Versey nominated by Orange Cross Ambulance

Christoph Walters nominated by Paratech Ambulance

Amy Zehr nominated by Tri-State Ambulance

Walt Zehr nominated by Tri-State Ambulance

First Responder legislation now includes population criteria

PAAW Administrator — Sat, 26 Sep 2015 12:34:53 GMT

The past two weeks have seen swift action to make population and waiver amendments to first responder legislation now making its way through the bill writing process. The Senate version, first passed on June 9, was changed to closely mirror the Assembly's Health Committee version.

According to the amendments, population less than 10,000 can automatically staff a first responder as a legal crew member, and doesn't require a staffing plan waiver. More than 20,000 population can't use first responders as a legal crew staffing option. Population is defined by the single largest municipality in the ambulance service's coverage area.

Population 10,000 or more but not more than 20,000 may apply to the Department of Health for a staffing plan waiver; however, certain conditions must be demonstrated to include all of the following:

The ambulance service provider has undertaken efforts to recruit and train emergency medical technicians capable of being licensed under this section.
Despite efforts under subd. 2. a., licensed emergency medical technicians are not available in sufficient numbers for staffing for the ambulance services provider.
Without a waiver under subd. 1., the municipality that the ambulance service provider serves is unable to meet staffing requirements for ambulances that require 2 emergency medical technicians on every service call.
The department shall provide a written staffing waiver to any ambulance service provider it approves under subd. 2.
A waiver under subd. 1. is valid for 48 months after the date of issuance, and an ambulance service provider may apply to renew the waiver.
An ambulance service provider with a waiver under subd. 1. shall attempt to staff an ambulance with 2 licensed emergency medical technicians whenever possible.

Once the Senate and Assembly versions are officially passed in both chambers, the bill heads to Governor Walker's desk for signature to become law.

>> Click to read the Senate's version of the bill.

First Responder Bill Passes Health Committee and heads to full Assembly for Hearing

PAAW Administrator — Fri, 18 Sep 2015 15:58:12 GMT

A legislative bill allowing one first responder to be part of a two-person legal ambulance crew in municipalities of less than 10,000 population passed the Assembly's Health Committee this past week and is now headed to the full Assembly for a hearing - possibly as early as next week. The Senate passed its version back in June.

>> Click for news article.

MN Community Paramedicine Study Tour Participants share "Lessons Learned" with others

PAAW Administrator — Fri, 18 Sep 2015 14:00:00 GMT

The Professional Ambulance Association of Wisconsin, along with North Memorial Medical Center, sponsored last week a two-day Community Paramedicine Study Tour to Minneapolis.

A post review discussion of items learned during the recent Tour took place September 18. The conversation lasted 60 minutes, and brought out important items from all perspectives with creating a community paramedicine program.

To listen to the on-demand playback, click this link: http://tobtr.com/7928901

Green Bay Packers' Pepper Burruss to provide Stars of Life "Welcome Message" at Lambeau Field event

PAAW Administrator — Thu, 17 Sep 2015 13:00:00 GMT

Green Bay Packers Vice President of Marketing and Fan Engagement, Gabrielle Dow, announced on September 16, team Director of Sports Medicine Administration, Pepper Burruss, will deliver the welcome reception message at next week's Wisconsin Stars of Life event. Dow is also participating in the event by providing opening remarks.

Twenty-six Wisconsin Stars of Life honorees, each nominated by their respective ambulance service, will be recognized in a series of events in Green Bay on September 23 and 24. The first is a kickoff Welcome Reception at Lambeau Field, home of the Green Bay Packers, on Wednesday from 4:00 to 6:00 p.m. The second event on Thursday is a formal awards and dinner banquet during the Paramedic Systems of Wisconsin Conference at Tundra Lodge and Conference Center.

About Pepper Burruss
One of the more visible people in the organization, Pepper Burruss embarks upon his 23rd season with the Packers and his 39th in the NFL overall. Burruss, a certified athletic trainer and physical therapist, enters his first season as director of sports medicine administration after 22 years as the head athletic trainer. He joined the Green Bay Packers in 1993 following 16 seasons with the New York Jets as an assistant athletic trainer.

Burruss has won several awards during his NFL tenure. Most recently, he earned the NFL Physicians Society’s Outstanding NFL Athletic Trainer award for the 2012 season at the annual NFL Scouting Combine.

Critical Care Paramedic Training Course Dates Announced

PAAW Administrator — Wed, 16 Sep 2015 15:23:34 GMT

The Critical Care Emergency Medical Transport Program (CCEMTP) course will meet every Thursday and Friday, 8 am – 5pm, beginning April 7, 2016 through May 27, 2016.

A nationally recognized training program Critical Care Emergency Medical Transport Program (CCEMTP®) offers experienced paramedics and nurses a foundation that will prepare you to become a critical care transport specialist. This intense 100-plus hour course, presented at Gundersen Health System in La Crosse, WI was developed by the Department of Emergency Health Services at the University of Maryland, Baltimore County (UMBC); The curriculum has such an excellent reputation that it is accepted as the base course for many other state and national level certification training.

>> Click for course brochure containing further information and registration form.

For more information contact, Rick Barton in the EMS Education Department at Gundersen Health System, rkbarton@gundersenhealth.org. or by phone at (608) 775-6315.

This continuing education activity is approved by UMBC, an organization accredited by the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS).

PAAW hosts conference call with Wisconsin Dept. of Revenue on use of TRIP for ambulance billing

PAAW Administrator — Wed, 16 Sep 2015 14:21:44 GMT

Based on member interest, the Professional Ambulance Association of Wisconsin completed a conference call on September 15 with Wisconsin Department of Revenue TRIP Administrator Joseph Mugenga. TRIP, which stands for Tax Refund Interception Program, is administered by the Wisconsin Department of Revenue (DOR). >> Click here for the DOR TRIP website.

>> To listen to the conference call playback on-demand, click this link: http://tobtr.com/7892733

Interest in the TRIP conference call developed when Governor Scott Walker signed into law Act 59 on August 6, 2015, allowing all Wisconsin ambulance services to use TRIP as a means to collect on patient care and transportation bills that go uncollected and past due.

The call lasted 50 minutes with several important points highlighted and questions answered.

>> Click to read Act 59 (2015 Senate Bill 40 - TRIP) signed into law by Governor Scott Walker

>> To listen to the conference call playback on-demand, click this link: http://tobtr.com/7892733

>> Click here for the Wisconsin Dept. of Revenue TRIP website.

Wisconsin Paramedic gets five months in jail for stealing narcotics

PAAW Administrator — Thu, 10 Sep 2015 22:11:18 GMT

A former paramedic convicted of endangering patients by stealing pain meds and swapping them out with other substances will spend five months in jail and four years on probation.

During a sentencing hearing Wednesday, September 9, in Sauk County Circuit Court, 40-year-old Jason M. Ramker, formerly of Portage, was convicted of misconduct in office and possession of narcotic drugs.

Eleven other felony and misdemeanor charges against Ramker were dismissed as part of a plea agreement with the Sauk County District Attorney’s Office.

>> Click to read more.

PAAW to host conference call with Wisconsin Dept. of Revenue on use of TRIP for ambulance billing

PAAW Administrator — Thu, 10 Sep 2015 12:09:55 GMT

Based on member interest, the Professional Ambulance Association of Wisconsin has arranged a conference call with two representatives from the Wisconsin Department of Revenue (DOR) who are in charge of administering TRIP. The conference call is open to those interested and is dedicated to discussing TRIP and answering questions.

The DOR/TRIP conference call is scheduled for Tuesday, September 15, starting at 2:00 p.m. Listen or participate by either phoning in at 646-929-1081 (Blog Talk Radio) or via any internet connected device at this link: http://tobtr.com/7892733

Interest in the TRIP call developed when Governor Scott Walker signed a law this past August allowing all Wisconsin ambulance services to use TRIP as a means to collect on patient care and transportation bills that go uncollected and past due. TRIP, which stands for Tax Refund Interception Program, is administered by the Wisconsin Department of Revenue.

TRIP is another means to collect on past due accounts; however, the process can't be used for Medicare or Medicaid (i.e., BadgerCare) claims.

>> Click to read Act 59 (2015 Senate Bill 40 - TRIP) signed into law by Governor Scott Walker

Two-day Community Paramedicine Study Tour wraps up today in Minneapolis

PAAW Administrator — Thu, 10 Sep 2015 11:49:50 GMT

Thirty-three Wisconsin participants from EMS and fire departments, hospitals, and hospice organizations made their way to Minneapolis, Minnesota, for the Community Paramedicine Study Tour, presented by staff members at North Memorial Medical Center and sponsored by PAAW.

According to PAAW Executive Director Joe Covelli, "The opportunity brought together healthcare providers looking for ways to get started with CP and bring it to their local community. The staff at North Memorial Medical Center was very gracious with their time, information, and access, to include in-field clinical ride alongs for participants."

Besides clinical ride alongs, day one also included presentations from those in the Twin Cities metropolitan area with CP programs, to not only include North Memorial Medical Center, but also Hennepin County Medical Center and HealthEast Medical Transportation. In addition, there were presentations by North Memorial Medical Center staff members regarding care coordination, pharmacy, how to start a CP program, establishing dedicated CP clinic sites (i.e. mental health treatment), and scheduling coordination. All presentations and programs centered around one focal point - improving patient outcomes with a team approach. Data measures and outcomes presented support this point.

While the CP programs referenced are truly early in their development and still "feeling their way", one thing is evident, they are constantly gathering information and evaluating improvements to their approach - both for the individual patients and the overall delivery system Even though patient outcomes were improved in many examples referenced, and costs removed from lower Emergency Department utilization and through care coordination, the big nut to crack yet is stable funding. That is today's topic for day two.

Wisconsin EMS Live webcast hits on hot topics for today

PAAW Administrator — Tue, 08 Sep 2015 17:31:46 GMT

The latest broadcast of Wisconsin EMS Live was held Tuesday, September 8, and lasted 50 minutes.

Topics discussed included:

First Responder as legal ambulance crew member.
ICD-10 ambulance billing code changes, effective October 1, 2015, and what this means for your ambulance service. ICD-9 diagnostic code submissions won't be accepted as of the ICD-10 effective date by the Centers for Medicare and Medicaid Services. This can be a big deal depending on your payer mix and cash flow. The last thing you want is patient transport bills being denied by Medicare for improper diagnostic codes.
Medicare fraud with attorney Wendy Arends from Godfrey and Kahn, Madison.
Announcement of new webcast title from "Wisconsin EMS Live" to "EMS Live in Wisconsin" and reasons for the change.

>> Click to listen to this webcast!

CMS says they're ready for ICD-10 roll-out Oct. 1

PAAW Administrator — Fri, 28 Aug 2015 15:24:34 GMT

Ambulance providers and billers should be prepared too!

As ambulance providers around the country brace for the Oct. 1 conversion to ICD-10 diagnostic and procedural codes, the Centers for Medicare and Medicaid Services is reporting positive results from the final round of end-to-end testing of the Medicare claims processing system.

Overall, the CMS reported an 87% acceptance rate on 29,286 claims received.

What does this mean for your local ambulance service? According to PAAW Executive Director Joe Covelli, "The need for excellent patient care documentation by EMTs and Paramedics, so the correct billing code can be applied to a largely expanded list of complex codes. The other important item is ambulance billers must test and be ready to go with compliant ICD-10 software on October 1. The last thing anyone wants is a payment delay or rejection by CMS."

>> Click for information on ICD-10

>> Click for PAAW's webcast, completed in 2012, about the upcoming ICD-10 conversion that is still relevant today.

Source: American Ambulance Association

Remembering EMS Response to Hurricanes Katrina & Rita

PAAW Administrator — Thu, 27 Aug 2015 12:25:26 GMT

The American Ambulance Association honors the EMTs, Paramedics, dispatchers, and leaders of the dozens of ambulance services who answered America’s most desperate call for help.

Ten years ago, in August and September of 2005, the one-two punch of Hurricanes Katrina and Rita devastated over 93,000 square miles across 138 counties and parishes in Louisiana, Mississippi and Alabama. Together, the two storms caused $150+ billion dollars in damage and resulted in the deaths of more than 1800 people. Within this tragic narrative, the rapid and effective mobilization of EMS—particularly private EMS—stands out as an incredible accomplishment in disaster response and humanitarian relief.

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First Responder as "Legal Ambulance Crew Member" getting closer to reality in Wisconsin

PAAW Administrator — Mon, 24 Aug 2015 03:15:33 GMT

It seems apparent the Wisconsin legislature is well on its way to taking steps to allow First Responders to operate as one member of a two-person ambulance crew in the state.

The measure is designed to help communities, typically in the rural areas of Wisconsin, struggling to meet current minimum staffing requirements of two EMT-Basics, to get their local ambulance out-the-door and to the location of a 911 call. Neither Senate or Assembly bills attempt to place restrictions on a community’s ability to use a First Responder, because of population size or area in the state. Thus far, the only requirement in both bills is an EMT-Basic or higher credentialed crew member is to be in the patient compartment of the ambulance during transport.

On August 18, the Assembly’s Committee on Health held a public meeting at the State Capitol. Those who registered and spoke at the public meeting seemed to do so in favor of proposed legislation, Assembly Bill 213. No one opposed it. The Senate approved its version, Senate Bill 143, on June 9.

We’ll cover this topic in more detail during the live program of “Wisconsin EMS Live” webcast on Tuesday, September 8, 2015 starting at 9:00 a.m. Dial-in using 646-929-1081, or listen on any internet connected device at http://tobtr.com/7870921.

PAAW changing "Wisconsin EMS Live" webcast name at the request of WEMSA

PAAW Administrator — Mon, 24 Aug 2015 03:13:22 GMT

The Professional Ambulance Association of Wisconsin (PAAW) recently received a demand letter from the Wisconsin EMS Association’s (WEMSA) attorney, that it cease using the name, “Wisconsin EMS Live” for its monthly webcast due to a potential likelihood of confusion between “Wisconsin EMS Live” and WEMSA’s registered service mark “Wisconsin EMS Association.”

PAAW disagrees with WEMSA’s position and believes it would be able to mount a successful defense of the “Wisconsin EMS Live” name on the grounds WEMSA is attempting to assert its service mark by also claiming the broadly used industry reference “Wisconsin EMS”. Given these facts, information, and in consultation with its attorneys, PAAW has decided to change the name of its popular webcast rather than engage in what could be a long and expensive legal battle between the two organizations.

Since PAAW’s monthly webcast, Wisconsin EMS Live, debuted in March 2015, over 3,700 listeners have either listened live or downloaded an episode of the show. The webcast’s content, co-hosts, guests, and listeners make the program what it is and the early success it has experienced, not the program’s name.

Listen to PAAW’s next webcast on Tuesday, September 8, 2015 starting at 9:00 a.m. as they unveil the new name for their webcast. Dial-in using 646-929-1081, or listen on any internet connected device at http://tobtr.com/7870921.

First community paramedicine clinic opens in state

PAAW Administrator — Fri, 21 Aug 2015 16:54:03 GMT

On August 20, WKOW-TV in Madison, Wisconsin, posted an interview and news video highlighting the opening of Wisconsin's first community paramedicine clinic, with more still to come.

After seeing a previous news story this past April on community pararmedicine, Ryan Brothers Ambulance was contacted by apartment managers at a complex in Madison. They invited Ryan Brothers to open an on-site clinic to benefit their residents.

According to PAAW Executive Director Joe Covelli, "Isn't it great to see how the community responded by seeing an opportunity to use community paramedicine, a new and emerging concept, to benefit its residents with an on-site clinic. There are all kinds of healthcare needs that go unmet everyday in Wisconsin - community pararmedicine is about filling those gaps".

>> Click to watch video news story.

Finally! EMS performance measures

PAAW Administrator — Thu, 20 Aug 2015 16:21:36 GMT

>> Click to download this webcast.

What does performance measurement have to do with EMS? According to EMS Compass, a performance based initiative, it has everything to do with improving patient care and demonstrating value.

Unfortunately, data collection and performance measures haven’t been part of EMS’ vocabulary. It is true it’s been hard to measure performance and come up with the right tool that wasn’t labor intensive. Some ambulance services have a formal process to collect data, but many don’t. The Wisconsin Ambulance Run Data System, commonly known as WARDS, is an option, but clunky. Some have simply relied on what others gave them – like on-scene time reports from dispatch, or scene to balloon time for a stemi patient brought to the CATH Lab.

According to Dia Gainor with the National Association of State EMS Officials, “Measuring performance is the first step toward improving it.” I couldn’t agree with her more.

Currently, there is a national project underway to fund EMS Compass, an initiative to develop performance measures specific to EMS. They are making great strides with a team of 50 software developers – many of whom are volunteering their time. Nick Nudell is the project manager. Let’s find out what he has to say in this episode of EMS to the Point.

>> Click to download this webcast.

Governor's signature makes TRIP bill officially law

PAAW Administrator — Wed, 12 Aug 2015 15:28:34 GMT

PAAW led initiative allows all Wisconsin ambulance services to use TRIP.

By Patrick Ryan, President, Professional Ambulance Association of Wisconsin

The Professional Ambulance Association of Wisconsin (PAAW) is very pleased to announce that on August 6, 2015, Governor Scott Walker signed Act 59 into law. This law allows counties and municipalities to certify private debts owed to private ambulance services operating on behalf of a county or municipality to the Wisconsin Department of Revenue (DOR). PAAW has worked diligently on this piece of legislation since 2008.

The financial stability of Wisconsin’s Emergency Medical Services (EMS) is vital to the health and well-being of all citizens of our state. This expansion of the Tax Refund Interception Program (TRIP) will help support the entire EMS system and will significantly enhance services’ ability to collect reimbursement for services provided. PAAW wishes to thank Representative Paul Tittle (R-Manitowoc) and Senator Shelia Harsdorf (R-River Falls) for their assistance and support of this effort.

>> Click to read Act 59 (2015 Senate Bill 40 - TRIP) signed into law by Governor Scott Walker

PAAW announces 2015 Stars of Life honorees

PAAW Administrator — Tue, 11 Aug 2015 17:29:04 GMT

The Professional Ambulance Association of Wisconsin is pleased to announce the 2015 group of Wisconsin Stars of Life honorees, individuals who represent the best-of-the best in our industry as nominated by their respective department or organization.

Twenty-six honorees will be presented with awards and recognition at two events in Green Bay. The first is a welcome reception at Lambeau Field Atrium on September 23. The second is the dinner and awards program during the Paramedic Systems of Wisconsin Conference on September 24. Each nominee is also invited to the Wisconsin State Capitol this fall. One person from the group will advance to represent Wisconsin at the National Stars of Life ceremony in Washington, D.C. in April 2016.

2015 Wisconsin Stars of Life honorees include:

David Allen nominated by Amherst Fire District/Portage County EMS

Susan Armstrong-Schlegal nominated by Saukville Fire Department

Dr. Charles Cady nominated by the Professional Ambulance Association of Wisconsin

Tyler Christifulli nominated by Lifestar Emergency Medical Services

Julie Dehne nominated by Valders Ambulance

Dan Diestler nominated by County Rescue Services

Marlene Dirkes nominated by Gold Cross Ambulance / Mayo Clinic Medical Transport

Clayton Emons nominated by Gold Cross Ambulance Fox Valley

Deonne Eske nominated by Ashippun Fire Department

Kelsey Esser nominated by Tri-State Ambulance

Kevin King nominated by Shawano Ambulance Service

Matthew Koepp nominated by Baraboo District Ambulance

Thomas Konieczka nominated by Greenfield Fire Department

Larry Krueger nominated by the Town of Sheboygan First Responders.

Jon Masi nominated by Paratech Ambulance

Buck McAlpin nominated by the Professional Ambulance Association of Wisconsin

Beth Morando nominated by Ryan Brothers Ambulance

James Poltrock nominated by Kenosha Fire Department

David Robbins nominated by Ryan Brothers Ambulance

Nick Romenesko nominated by Gold Cross Ambulance Fox Valley

Amy Smith nominated by Tri-State Ambulance

Dr. Steven Stroman nominated by De Pere Fire Rescue

Rebecca Versey nominated by Orange Cross Ambulance

Christoph Walters nominated by Paratech Ambulance

Amy Zehr nominated by Tri-State Ambulance

Walt Zehr nominated by Tri-State Ambulance

Next live broadcast of Wisconsin EMS Live Tuesday, August 11 starting at 9:00 a.m.

PAAW Administrator — Thu, 06 Aug 2015 16:01:26 GMT

The next live broadcast of Wisconsin EMS Live is scheduled for Tuesday, August 11, starting at 9:00 a.m. central time and running 60 minutes.

You can listen by either dialing 646-929-1081, or listen on any internet connect device by clicking this link: http://tobtr.com/7772401

Our guest from 9:05 to 9:20 a.m. is new Wisconsin EMS/Trauma Medical Director Dr. Suzanne Martens.

From 9:20 to 10:00 a.m. we'll discuss the latest news and information taking place throughout EMS in Wisconsin, and also open the phone lines and email inbox for your questions. Some of our topics include:

Announcement of people being honored in September 2015 as Wisconsin Stars of Life

Allowing first responders to operate as an ambulance legal crew member

Community paramedicine, to include the recently announced study tour to Minneapolis, Wisconsin legislation and more...

Paramedic Systems of Wisconsin Conference agenda and schedule

Listener comments, questions and perspective!

Email questions to wisconsinemslive@paaw.us.

Join program co-hosts Chris Anderson, Joe Covelli, Patrick Ryan and Dan Williams.

Listen to previous programs in the archive. Some of the topics include avoiding drug diversion, community paramedicine, the evolution of paramedics with Randolph Mantooh (aka John Gage from EMERGENCY!) and others.

Don't miss a beat of the action - listen to Wisconsin EMS Live!

PAAW to host community paramedicine study tour Sept. 9 and 10 in Minneapolis

PAAW Administrator — Thu, 06 Aug 2015 13:15:45 GMT

Emphasis is:

How to approach the topic within your community
Who to discuss community paramedicine with and suggestions what to say
Using community paramedicine to "fill gaps" in health care delivery
How to start a community paramedicine program
Tour and see a fully working system from the inside out

The Professional Ambulance Association of Wisconsin, along with North Memorial Medical Center, is pleased to announce they will sponsor and host a two-day study tour field trip to Minneapolis, Minnesota to benefit those interested to consider or start a community paramedicine program.

The two-day on-site program is Wednesday and Thursday, September 9 and 10. It will be held at North Memorial Medical Center in Robbinsdale, a suburb of Minneapolis, Minnesota.

Minnesota is one of a few states truly leading the community paramedicine movement across the United States. Participants will see firsthand from both the ambulance provider and patient's perspective a fully working, successful program and system. Go on home visits with dedicated community paramedics. Best of all, receive valuable information, ask questions, and get real world answers.

Suggested participants include: ambulance service, hospital and home health administrators; patient care providers and advocates; medical directors; and government leaders and elected officials.

The two-day program is being presented by Buck McAlpin and Peter Carlson, both at North Memorial Medical Center's community paramedicine program. According to PAAW Executive Director Joe Covelli, "Both Buck and Pete are graciously offering their time, access, and expertise to this learn and exchange opportunity". Covelli added, "Group size is limited to 25 participants, and we've had 10 sign up already".

A modest fee is being charged: $100 for PAAW members and $150 for non-members (deduct $25 for each additional participant from the same organization). Travel, meals and hotel costs are additional. Again, group size is limited to 25 participants.

For additional information or to register, contact PAAW Executive Director Joe Covelli at 414-236-4192 or email admin@paaw.us.

Epi prefilled syringe 1:10,000 in short supply

PAAW Administrator — Thu, 30 Jul 2015 14:59:04 GMT

Manufacturers restricting quantities being released through September

According to Bound Tree Medical's Stacey Barksdale Price, Manager of EMS Pharmaceuticals and IV Therapy, "The epinephrine 1:10,000 shortage is of highest concern as both Hospira and IMS are restricting quantities that they are releasing. They are releasing product intermittently, but it is not at the levels that meet customer demand. Both companies project this allocation status to remain in effect on this and other prefilled syringes through September."

>> Click to review the latest weekly EMS pharmaceutical and IV backorder report.

Paramedic Systems of Wisconsin September 23 to 25

PAAW Administrator — Fri, 24 Jul 2015 20:40:19 GMT

Conference registration is now open at www.psow.org

The 28th annual Paramedic Systems of Wisconsin Conference is September 23 to 25 at the Tundra Lodge and Convention Center in Green Bay.

The original intent was to provide education for the new Paramedic systems throughout Wisconsin, specifically for Service Directors, Medical Directors and Training Centers. Organizers Dan Williams and Cal Lintz have held true to that mission. However, the PSOW Conference format is not limited to paramedic providers, but all license levels. PSOW is recognized as one of the top conferences for EMS and ambulance administrative personnel.

Some of the presentation topics include:

Fraud & Medicare Compliance (Thomas Shorter, Attorney, Godfrey & Kahn, Madison)

Community Paramedicine (Buck McAlpin, Vice President of Strategic Affairs, North Memorial Medical Center, Robbinsdale, MN, and Senior Lobbyist, Minnesota Ambulance Association)

Controlled Substances (Kathy Frederico, Wisconsin Drug Diversion Supervisor, Drug Enforcement Agency, Milwaukee)

Mission Life Line (Mic Gunderson)

Medical Directors Report (Dr. Suzanne Martens, Wisconsin EMS/Trauma Medical Director)

>> Click to be redirected to the PSOW website.

>> Click for the conference agenda.

Community paramedicine stakeholders hold forum

PAAW Administrator — Fri, 24 Jul 2015 20:16:02 GMT

By Joe Covelli, PAAW Executive Director

On July 20, the Wisconsin Office of Rural Health sponsored a Community Paramedicine Stakeholders Forum. The Eau Claire event was attended by over 130 participants, to include EMS agencies, medical directors, technical colleges, hospitals, home health agencies, and industry associations.

The program began with a discussion panel on Wisconsin community paramedicine activities. One of the panelists, Jennifer Ullsvik with the Wisconsin Office of Preparedness and Emergency Health Care, mentioned two community paramedic programs have been approved in the state, to include the cities of Green Bay and Madison, and a handful of other requests are pending approval by the EMS Section to commence community paramedicine operations. We also know this past year there have been about five community paramedic trial programs, mostly in the Milwaukee area, to identify frequent 911 users. Trials at West Allis and North Shore Fire Departments have set up in-home programs with high user individuals to be proactive and are by all accounts successfully addressing their care needs.

Mrs. Ullsvik attributed some of the delay in plan approvals in two areas. One, “Is community paramedicine in the current definitions of what an EMT can do?” and, two, “Does community paramedicine fall into the arena of home health?”. On the latter point, her office has asked for a legal opinion by the Department's attorney. She continued by stating her office is “on-board with this (referencing community paramedicine) and that proposed legislation will help”.

PAAW President Patrick Ryan, also a panelist, spoke to the work currently being done to draft legislation to include “Community Paramedic” and “Community EMT”. He hopes to have legislation introduced in the fall session.

Rounding out the panel included Terry Gonderzik with the Chippewa Valley Technical College and Jerry Biggart representing the Wisconsin EMS Advisory Board. Mr. Gonderzik indicated the Wisconsin Technical College System is looking to offer community paramedicine instruction as a “single” education entity, offering the same course and content instruction statewide. Taking this approach is currently before the Technical College board of directors for approval as a system. Mr. Biggart stated the EMS Advisory Board established a community paramedicine sub committee to work through the details and bring a recommendation to the full EMS Advisory Board, which will be presented to the Department of Health Services.

The afternoon program was spotlighted by three representatives leading the effort in Minnesota, to include: Dr. Michael Wilcox and Buck McAlpin, both from North Memorial Medical Center, and Kai Hjermstad with Hennepin Technical College, Minneapolis. The predominate message was community paramedicine is a “gap filling” initiative that provides access to health care.

If you would like to join the community paramedicine conversation, there are several opportunities highlighted below.

1. Sign up for the Rural Health CP list serve. The link is https://lists.wisc.edu/read/all_forums/subscribe?name=cp

2. PAAW created a webpage dedicated to serve as a central point of communication and information of historical significance for those interested in CP. The link is http://paaw.us/cp.

3. The Paramedic Systems of Wisconsin conference in Green Bay on Thursday, September 24 will include Minnesota's Buck McAlpin as a presenter speaking on community paramedicine. The conference website is http://psow.org/.

4. PAAW President Patrick Ryan hosts a regular community paramedicine conference call. Refer to item 2 above to find out when the next call is scheduled and the dial in number. The group is currently working on community paramedicine legislation.

Wisconsin EMS Live webcast discussed TRIP

PAAW Administrator — Thu, 16 Jul 2015 19:29:46 GMT

The July 14 webcast of Wisconsin EMS Live was dedicated to discussing TRIP (Tax Refund Intercept Program) and Stars of Life 2015.

>> Click to listen to this webcast.

Since 2007, a legislative emphasis for the Professional Ambulance Association of Wisconsin has been TRIP, which stands for Tax Refund Intercept Program. Since an ambulance service can't do a credit check when being dispatched to a person's 911 call, some patients unfortunately don't pay their ambulance bill even after the insurance company has sent the check directly to them for that purpose. This leaves the ambulance service in a bad situation unable to collect on services rendered, meet its own financial obligations, and reinvest those funds in its operation, equipment and staff. Some of Wisconsin's largest ambulance services are writing off each year $500,000 to one-million dollars in noncollectable debt.

TRIP recently passed the Wisconsin legislature and is simply awaiting Governor Scott Walker's signature. Gold Cross Ambulance - Fox Valley Executive Director Mark Fredrickson spoke with Governor Walker at his residence on Sunday, July 5 to confirm the Governor's support of TRIP (picture insert).

In the meantime, we need to prepare ambulance service management not familiar with TRIP, explain how it works, and is used as another option to collections when other attempts have failed. The Wisconsin Department of Revenue administers TRIP, which municipal owned ambulance services have had access to for years. With Governor Walker's signature, it opens the option of TRIP to all Wisconsin ambulance services under contract with a municipality to provide 911 service. TRIP cannot be used for inter-facility transfers or patients with Medicare or Medicaid insurance coverage.

Wisconsin EMS Live program guests who discussed TRIP and answered questions included: from The Stark Collection Agency in Madison, Pauline Kussart, and from Valders Ambulance, Director Jay Steuer. According to both Pauline and Jay, "11% of an ambulance service billings go through the TRIP process for payment".

The second half of the 60 minute program was dedicated to discussing Wisconsin Stars of Life 2015 with committee members Larry Knuth, a 2009 Star recipient himself, and Linda Wiedmann. The event is to recognize Wisconsin's best EMTs and Paramedics as nominated by their respective departments. An update was also offered by Dan Williams on the conference agenda for Paramedics Systems of Wisconsin this coming September 23 to 25.

Don't miss a beat of the action - listen to Wisconsin EMS Live!

>> Click to listen to this webcast.

Community paramedics catching on in Madison area

PAAW Administrator — Mon, 13 Jul 2015 15:25:28 GMT

On Sunday, July 12, the Wisconsin State Journal newspaper wrote a feature article on community paramedics and the new and emerging programs being developed in the Madison area. Several health care leaders and ambulance providers were quoted.

According to PAAW Executive Director Joe Covelli,"The article demonstrates the basis for community paramedicine, the great collaboration amongst health care providers to deliver care using this new and emerging model, gap filling to meet patient and community needs, and the need for state legislation to formally recognize community pararmedicine for funding purposes". Click the below link to read or share the article.

>> Community paramedics catching on in the Madison area

For those interested to join the CP conversation or get the latest information, the next Community Paramedicine conference call is Friday, July 17 starting at 9:00 a.m. central time. Join the conference call by either dialing in 646-929-1081 or listen on any internet connected device at this link >> click here.

Conference calls are recorded, so if you need to get caught up and listen to a past one, click here for the dedicated community paramedicine webpage established for historical purposes.

Certified Ambulance Coder and Compliance Officer Seminars

PAAW Administrator — Thu, 09 Jul 2015 21:21:14 GMT

We are pleased to share the Minnesota Ambulance Association is offering Certified Ambulance Coder and Certified Ambulance Compliance Officer training. These sessions will be held the week of August 24, 2015 at the Maple Grove Government Center, Maple Grove, Minnesota. Space is limited, so please register early.

For more information, click here.

Newest "Standby for Tones" blog posts

PAAW Administrator — Wed, 08 Jul 2015 13:27:22 GMT

Paramedic and nationally featured writer, Crystal Wallin, just added two new blog posts to "Standby for Tones" titled "scene safety" and "just doing my job".

>> Click to read the latest "Standby for Tones" blog posts.

Milwaukee firefighter grazed by bullet when attending to patient

PAAW Administrator — Tue, 07 Jul 2015 17:32:52 GMT

>> Watch news video.

A Milwaukee firefighter was shot overnight Sunday while he and other firefighters tended to a patient who was having trouble breathing.

The 46-year-old firefighter, whose name was not released, suffered a graze wound to the right side of his head and has since been treated and released from the hospital, according to a fire department news release issued Monday.

The firefighters were called just after midnight to the area of N. 40th St. and W. Lisbon Ave. to assist a patient.

They assessed and treated the patient and were in the process of transferring the patient to Curtis Ambulance when shots were fired from a nearby alley in the direction of the first responders, according to the news release. Several rounds also hit the ambulance.

But Police Chief Edward Flynn said it does not appear that the firefighter had been targeted.

Flynn said detectives had recovered shell casings near the scene that appear relevant to the investigation.

A similar incident happened this past May in Milwaukee when a Paratech ambulance was struck by a bullet inches from the driver when responding to a 911 call. This was the first incident of its kind in 43 years of business at Paratech Ambulance. >> Click for video story.

Source: WISN-TV Milwaukee

Governor signs exemption for out-of-state ambulances

PAAW Administrator — Thu, 02 Jul 2015 15:13:17 GMT

On July 1, 2015, Wisconsin Governor Scott Walker signed an exemption from licensing requirements for out-of-state ambulance services.

Act 26 signed by the Governor states, "An ambulance service provider licensed in another state that makes 10 or fewer patient transports per year that originate and terminate within this state is not required to hold an ambulance service provider license under this section. An emergency medical technician licensed in or holding a training permit in another state who is involved in 10 or fewer patient transports per year that originate and terminate within this state is not required to hold an emergency medical technician license or training permit under this section. A first responder certified in another state who provides emergency medical care to 10 or fewer patients per year within this state is not required to hold a first responder certificate under this section."

The issue drew attention when Wisconsin EMS Office staff made comments earlier in the year, which the Office later tried to clarify by issuing two memos on licensing requirements. The Office maintained the position Wisconsin licensure was required in order to provide ambulance or EMT service in Wisconsin as a statute requirement.

Residents of Gratiot and South Wayne, both located in Lafayette County, Wisconsin, which borders Illinois, became very concerned when their primary ambulance service, located just a few miles away in Warren, Illinois, was informed by the Wisconsin EMS Office they could no longer respond into Wisconsin without licensure approval. "Without a solution it might take up to 30 minutes for a Wisconsin ambulance to arrive to their homes (in that part of Lafayette County)", according to Assembly Rep. and bill sponsor Todd Novak.

In the opinion of many closely tied to EMS and fire department administration and industry associations in Wisconsin, the new Act 26 is not perfect by any means and leaves in question several items, to include operations mutual aid, documentation requirements, and self reporting of patient calls into Wisconsin.

Areas with frequent mutual aid requests, like those between Beloit, Wisconsin and South Beloit, Illinois, will easily reach and even exceed 10 patient transports within the first month, not giving them sufficient time to file operation plans and submit qualifying personnel rosters to the Wisconsin EMS Office for licensure approval. What complicates things further is Illinois does not follow National Registry EMT credentialing and administers their own state EMT test.

Since Act 26 was a "quick fix" it really missed the mark. A better, more long-term solution with clarifying legislative language is in the works with EMS and fire industry and association involvement. For now, ambulance service is restored for those in border state areas, unless they exceed ten runs per year and don't have licensure approval.

>> Click to review Act 26 giving rights to certain out-of-state ambulance service providers.

State's EMS Section makes personnel announcements

PAAW Administrator — Tue, 30 Jun 2015 13:35:00 GMT

On Monday, June 29, Jennifer Ullsvik, Director for the Office of Preparedness and Emergency Health Care at the State of Wisconsin Division of Public Health, shared two personnel announcements in hiring an EMS Section Chief and EMS/Trauma Medical Director. A third staffing change was also announced separately by a third party.

EMS Section Chief

Mr. James Newlun was named the new Wisconsin EMS Section Chief with a start date of July 13. The position has been vacant since April 2014 and was posted three separate times during the past twelve months.

Since 2002, Mr. Newlun has been an Emergency Medical Technician (EMT) with Camp Douglas Rescue. As EMT President, he was responsible for all operations, coordination of meetings, and employee/employer relations. Since 2008, Mr. Newlun has been employed as a full-time firefighter at the Volk Field Fire Department in Camp Douglas. While acting in the capacity of Captain he was responsible for completion of daily assignments, and responses to emergencies.

From 2000 – 2011, Mr. Newlun was a member of the Camp Douglas Fire Department and Chief of the Department from 2008 – 2011. He was responsible for managing and directing scenes as an Incident Commander, developing and maintaining the annual budget, and making all fire department purchases. In addition, he managed up to 25 fire department personnel.

From 2001 – 2010, Mr. Newlun was a Hazmat Technician and Safety Officer with the Juneau County Hazmat team, where he directed and coordinated functions of a comprehensive health and safety program.

In addition, Mr. Newlun has experience working with diverse community partners and grant writing. He has also served on the SCRTAC Executive Council for the past two years as the Rural Representative.

EMS/Trauma Medical Director

Ms. Ullsvik also named Dr. Suzanne Martens as the new Wisconsin EMS/Trauma Medical Director beginning July 1, 2015. She replaces Dr. Charles Cady who served as state EMS Medical Director since 2008. Dr. Cady's contract expires June 30, 2015.

Dr. Martens received her Doctor of Medicine degree from the Medical College of Wisconsin, where she also completed Residency. A Fellowship in Emergency Medical Services was completed at Carolinas Medical Center in North Carolina. Dr. Martens also has a Master of Public Health degree, and has been a licensed EMT for over 27 years.

Dr. Martens is currently the EMS and Trauma Program Medical Director at a Level III trauma facility. For 15 years, Dr. Martens has served as the medical director for several local agencies and has the opportunity to work with all levels of EMS providers, career and volunteer, fire-based and private agencies.

EMS education is important to Dr. Martens. She is actively involved in the education of current and new EMTs. She visits new classes at the local technical college, serves as an adjunct instructor, and regularly sponsors education evenings for the EMS personnel in her area.

Dr. Martens has been a member of the EMS Physician Advisory Committee (PAC) since 2001 and the committee’s chair since 2008. She has been involved in the trauma system since 2003, is an active member of the Southeast Regional Trauma Advisory Council (SERTAC), and served as its chair from 2008-2010.

Fred Hornby leaving State's EMS Section in July

In a separate, but somewhat related announcement, the Wisconsin EMS Association wrote on June 29, Mr. Fred Hornby, the state's Paramedic and EMS Education Coordinator, will be leaving his position next month. The announcement by WEMSA indicated Mr. Hornby will serve as their association's Sales and Conference Manager. His duties begin in mid-July and he will manage all aspects of the annual conference and sales operations, as well as the public relations and outreach program.According to PAAW Executive Director Joe Covelli, "Fred is one of the most passionate and dedicated EMS professionals we've had the opportunity to work with. His presence at the EMS office will be missed by us and many others as we could always count on him, his involvement, and professional guidance".

Community Paramedicine Forum July 20 in Eau Claire - register now to attend!

PAAW Administrator — Wed, 17 Jun 2015 19:26:07 GMT

Chippewa Valley Technical College in Eau Claire will host a Community Paramedicine Forum on Monday, July 20. The event is sponsored by the Wisconsin Office of Rural Health.

The day will include news and updates on community paramedicine in Wisconsin, a health care model designed to improve access to and quality of care in rural and urban communities.

Presentations include:

Status of community paramedicine legislation
Curriculum development
The role of physicians and hospitals in community paramedicine
Update on licensing

EMS, hospitals, providers, and local and state elected officials are among those who should find the Forum helpful.

The Forum will be in Room 103A of the Chippewa Valley Technical College Business Education Center, 620 W. Clairemont Ave, Eau Claire. The $25 registration fee includes continental breakfast and lunch.

>> Click for more information or to register.

State of Wisconsin EMS Section asks for your feedback on recent renewal licensing period experience

PAAW Administrator — Thu, 11 Jun 2015 18:02:13 GMT

If you renewed your license for the 2014-2016 time period, the Wisconsin EMS Section is inviting your feedback regarding your experience. This is an effort to improve the license renewal process for EMS providers and identify process improvements with the E-Licensing System.

The license renewal time period was from November 1, 2013, to June 30, 2014.

The survey is open through Friday, June 26, 2015. Participant responses are completely anonymous.

You can access the survey at http://4.selectsurvey.net/DHS/TakeSurvey.aspx?SurveyID=m8204565.

EMS Controlled Narcotics: Preventing drug diversion is only as good as your weakest link

PAAW Administrator — Thu, 11 Jun 2015 16:42:47 GMT

This webcast discusses chain of custody, drug diversion, and best practices

>> Click to listen now to this webcast interview

Where is your ambulance service most at risk with drug diversion (theft of a controlled narcotics)?

What is your procedure if drugs go missing or the inventory count is off?

Are you routinely checking to make sure box packaging and drug containers haven't been tampered with?

What is the most common weakest link in any drug control program? (hint: unwitnessed wasting)

What is best for inventory management and security - a snap lock or zip tie lock? (Hint: one lock failed and the other didn't in deterring drug diversion.)

Did you know a DEA registration number is required for each physical location where controlled narcotics are stored? A two station system requires two different DEA numbers.

While an ambulance service should trust its employees, sometimes the temptation for an employee to steal is too great! Employee theft is one thing, but diverting controlled narcotics is another that raises the severity of the crime. According to the DEA, theft of controlled narcotics most often happens when an employee suffers an injury and is taken off the prescribed pain medicine when under the care of a physician. Unfortunately, when it comes to drug diversion, it's not a matter of if something will happen, but when. Thinking about this is the kind of stuff that gives an ambulance director sleepless nights.

We answered all the questions that led into this post and many others too during our live broadcast of Wisconsin EMS Live regarding EMS controlled narcotics, system management and drug diversion on Tuesday, June 9. The program was recorded.

Our guests included Drug Enforcement Agency Wisconsin Supervisor Kathy Federico, Wisconsin Ambulance Inspector Paul Schilling, and Baraboo District Ambulance Chief Dana Sechler and Deputy Chief John Rago.

Listen as Dana and John share their recent event catching an employee diverting drugs, and what they did and learned from this experience.

Recommendations from the live show:

>> Click to review Wisconsin EMS Controlled Substance Management Procedure.

>> Click for a source recommended by Baraboo District Ambulance to purchase biometric safe locks.

Most importantly, test your controlled narcotics procedures and system. With all good intentions, and what maybe surprising results, throw inventory counts off, visibly tamper and reseal box packaging, open inventory tags - even ask employees to sign as a "witness" to an unwitnessed wasting of narcs. It's all for the better of your system and minimizing risk. Find ways to test your system and manage the weakest link - where are you most vulnerable?

In part two of the interview meet Eric Salzwedel with REACH-A-Child. He’s developed a storybook collection, called the REACH BAG, to help kids caught up in an emergency event or incident – and provide them with some comfort or a short distraction.

Show co-hosts included Joe Covelli, Patrick Ryan and Dan Williams. The full episode is 60 minutes. >> Click to listen now to this webcast interview.

Don’t miss a beat of the action – listen to Wisconsin EMS Live. Also, check the archive for all past show episodes.

Community Paramedic distance learning class to be offered in Wisconsin

PAAW Administrator — Thu, 11 Jun 2015 15:24:28 GMT

Ryan Brothers Ambulance in Madison announced it signed a distance learning agreement with Hennepin Technical College in Minneapolis. The effort shows great collaboration between the two organizations to bring Community Paramedicine to Wisconsin.

The online classes will be held Thursday evenings beginning August 13, 2015. The class will be distance learning, with one Skills Day to be held in Madison, Wisconsin in October. The class is open to those interested.

>> Click for Ryan Brothers class information and course fee.

>> Click for Hennepin Technical College CP brochure.

As we've previously reported, out of 1,000 community paramedics trained in the United States right now, Minnesota's Hennepin Technical College has trained 600 of them.

For more information, or to register, contact Patrick Ryan at Ryan Brothers Ambulance at 608-310-7922 or email pryan@ryanbros.net.

Medicare: Fighting fraud or hurting ambulance patients?

PAAW Administrator — Fri, 05 Jun 2015 19:39:33 GMT

At issue is nonemergency ambulance transportation, patients who need to be driven from their home or long-term care facility to regular appointments for treatment such as dialysis, wound care or chemotherapy and radiation.

The patients typically are confined to their beds and can't be moved in a wheelchair, so they need the service that ambulances and emergency medical technicians can offer.

The Centers for Medicare and Medicaid Services is now seven months into a pilot program designed to weed out fraud in ambulance service for nonemergencies.

The agency -- and some transportation companies -- say tougher compliance is doing the trick and saving taxpayers money. But other operators say it is going overboard and putting patients' lives at risk.

What's all the fuss about? States with the biggest increase in nonemergency ambulance trips, 2002-2011:

1. California: +554 percent

2. Georgia: +301 percent

3. South Carolina: +218 percent

4. Indiana: +183 percent

5. Pennsylvania: +159 percent

6. New Jersey: +144 percent

U.S.: +94 percent

>> Read more

Senate and Assembly committees discuss ambulance concerns in Lafayette County

PAAW Administrator — Wed, 03 Jun 2015 21:23:23 GMT

Rep. Novak explains, "The residents of Gratiot and South Wayne are obviously very concerned over the thought that it might take up to 30 minutes for a Wisconsin ambulance to arrive at their home."

At present, an Illinois ambulance can no longer cross the stateline, because its volunteer staff doesn't possess a certificate that Wisconsin requires.

In his testimony today, Novak explains the National Registry Certificate has nothing to do with the quality of service, it simply makes it easier for agencies to cross state lines. Illinois doesn't require it. Novak's bill looks to make an exemption for out-of-state ambulance services that make 10 or less transports per year in Wisconsin.

Novak says, "Warren, Illinois, will only be dispatched in emergency situations. And I believe between DHS and the sheriff, we'll be able to keep track of when Warren will be dispatched out."

>> Click for video news story.

Want in on the CP conversation? Here are 6 ways to get involved

PAAW Administrator — Wed, 03 Jun 2015 19:42:46 GMT

By Joe Covelli, PAAW Executive Director

Community paramedicine is all the buzz in Wisconsin EMS right now. We are learning a lot from our EMS friends in Minnesota, Texas, and elsewhere. On May 25, Nevada became the newest state to pass CP legislation.

Minnesota is years ahead of Wisconsin in developing community CP programs, legislation, curriculum, training, and licensing personnel. Minnesota has extended to Wisconsin their assistance, so we can shorten the learning curve, get caught up, and use best practices they've already vetted as successful. As we've previously reported, out of 1,000 community paramedics trained in the United States right now, Minnesota's Hennepin Technical College has trained 600 of them.

This past week we have fielded a lot of questions about CP and ways for those interested to get involved. Here's my top six suggestions:

1. Sign up for the Rural Health CP list serve. The link is https://lists.wisc.edu/read/all_forums/subscribe?name=cp. I believe there are over 150 signed up to get information on CP.

2. PAAW created a webpage dedicated to serve as a central point of communication and information for those interested in CP. The link is http://paaw.us/cp.

3. We've done several interviews on CP. The two most recent are at these locations by two people leading CP in Minnesota and nationally.
a. Buck McAlpin from Minnesota (click here for audio interview)
b. Gary Wingrove from Mayo Clinic (click here for audio interview)

4. The Paramedic Systems of Wisconsin conference in Green Bay on Thursday, Sept. 24 will include Minnesota's Buck McAlpin as a presenter speaking on CP. PAAW is sponsoring his presentation. The conference website is http://psow.org/. The conference schedule will be announced sometime in July or early August.

5. PAAW President Patrick Ryan hosts every other Friday a CP conference call. The next call is Friday, June 5 starting at 9:00 a.m. The call in number is 646-929-1081. The calls are also recorded and posted at the website noted above as item 2. There have been 35 to 40 participants on a regular basis the past few months. To be added to the call reminder list, contact Patrick at email president@paaw.us.

6. Wisconsin CP legislation in is draft form largely being discussed and driven by the group noted above as item 5.

Accept this posting as your invitation to join the CP conversation.

Wisconsin EMS Live show to discuss EMS controlled narcotics, diversion, best practices

PAAW Administrator — Tue, 02 Jun 2015 19:27:04 GMT

On Tuesday, June 9 we’ll be discussing from 9:00 until 9:40 EMS controlled narcotics, chain of custody, drug diversion, and best practices. The dial in number is 646-929-1081 or click here for the direct link.

Our guests include Drug Enforcement Agency Wisconsin Supervisor Kathy Federico, Wisconsin Ambulance Inspector Paul Schilling, and Baraboo District Ambulance Chief Dana Sechler and Deputy Chief John Rago.

And then from 9:40 to 10:00 a.m. meet Eric Salzwedel with REACH-A-CHILD. He’s developed a storybook collection with REACH BAG to help kids caught up in an emergency event or incidence – and provide them with some comfort or a short distraction.

Join co-hosts Chris Anderson, Joe Covelli, Patrick Ryan and Dan Williams for the conversation.

The episode is scheduled to run 60 minutes. As always your questions and emails will be taken during the live show. Should you miss it each show is recorded, so just look in the archive.

Join us Tuesday, June 9 starting at 9:00 a.m. Don’t miss a beat of the action – listen to Wisconsin EMS Live.

How To Get There: Defining Community Paramedicine for Today and Tomorrow

PAAW Administrator — Mon, 01 Jun 2015 22:51:58 GMT

There are about 1,000 paramedics in the United States now that have completed a Community Paramedic curriculum, roughly 600 of them trained by Hennepin Technical College in Minneapolis. Many of their distance learning CP classes are full with students from the US and abroad.

CP didn’t just show up. Like anything it continues to evolve, but what’s the vision for CP? Where is it going to lead those who perform and deliver pre and post hospital care, and home health medical care for patient treatment and monitoring? What is the big picture outlook for CP?

In this episode of EMSto the Point we called on Gary Wingrove to get the answers to our questions. He's been working to lay the CP foundation since 2007 and has national as well as international CP contacts. Gary is director for strategic affairs at Gold Gross Ambulance, which is affiliated with Mayo Clinic Medical Transport in Rochester, Minnesota.

>> Click to listen to the audio webcast with Gary Wingrove.

Wisconsin Stars of Life 2015 nomination period now open through August 1

PAAW Administrator — Thu, 28 May 2015 20:28:07 GMT

Each person nominated is presented with Wisconsin Stars of Life honors!

Take this opportunity to reward and celebrate an employee, volunteer, or community citizen who exemplifies the everyday spirit and commitment of a Star of Life.

You do not need to be a member of PAAW to submit a nomination application. All nominations are welcome.

One person from the group of 2015 honorees will be selected and advance to represent Wisconsin. This individual will be recognized at the National Stars of Life program in Washington, D.C., April 11 to 13, 2016. PAAW will provide a $750 travel voucher, and the American Ambulance Association Foundation will provide a grant for hotel and event registration fees for the Star, Star's guest, and host (employer).

The Professional Ambulance Association of Wisconsin's Stars of Life celebration is the most rewarding and exciting Wisconsin event in our field and is modeled after the American Ambulance Association's national Stars program.

The 2015 event will be the ninth time PAAW has proudly presented the Wisconsin Stars of Life program. This special event recognizes and honors the dedication of ambulance service professionals - people that stand out in every area of our field. You choose your "Star." These are the people who will be recognized in a series of celebratory events.

The schedule of events includes a welcome reception at Green Bay Packers Lambeau Field Atrium and dinner and awards program during the Paramedic Systems of Wisconsin (PSOW) conference. In addition, Stars gather at the State Capitol for a one-day event in Madison in October/November 2015 to be recognized before the senate and assembly, and to meet their local elected leaders for one-on-one meetings.

To nominate someone deserving of this high honor, just download the registration packet. Each person nominated is presented Wisconsin Stars of Life honors. The deadline to submit is August 1, 2015.

>> Click for Stars of Life 2015 webpage.

>> Click for schedule of events.

>> Click for Stars of Life 2015 nomination application.

Milwaukee ambulance struck by bullet inches from driver

PAAW Administrator — Thu, 28 May 2015 17:05:23 GMT

Both EMTs okay and no body was injured in the recent incident.

>> Click to watch WISN-TV Milwaukee news story.

Latest Wisconsin EMS Live show covers HIPAA, breach of HIPAA protected information, and use of social media by employees

PAAW Administrator — Wed, 27 May 2015 17:25:02 GMT

>> Click to listen to this episode or go to http://tobtr.com/7581379

What if a staff member loses a laptop or it's stolen from the ambulance and it has all kinds of patient information stored on it?
Do you have a HIPAA breach policy ready to go if needed?
What should the breach notification include and how long do I have to inform the patient their personal information may have been compromised?
What if an ambulance employee takes a picture on their personal smartphone of an accident scene or patient to share with the hospital ER staff?
Individual patient health records are worth a lot of money on the black market. How do you protect this information?

The May 12 Wisconsin EMS Live show discussed HIPAA laws, breach of HIPAA (patient) protected information, and use of social media by employees.

Our guest attorney Scott LeBlanc with Godfrey & Kahn in Milwaukee covers these HIPAA topics and more. >> Click to listen to this episode or go to http://tobtr.com/7581379

Also meet new nationally featured writer and critical care paramedic from La Crosse Crystal Wallin. Crystal's writings are also featured in her new blog, "Standby for Tones", on the PAAW website. Read them by clicking here.

Department of Health Services releases Legislative Audit Bureau report on non emergency medical transportation

PAAW Administrator — Wed, 20 May 2015 20:26:10 GMT

The Department of Health Services (DHS) administers the State’s Medical Assistance program, which includes non-emergency medical transportation (NEMT) services (to include ambulance providers) for individuals with low and moderate incomes. From August 2013 through June 2014, Medical Transportation Management (MTM), Inc., a transportation broker with which DHS has contracted, provided 2.3 million trips to approximately 69,300 Medical Assistance recipients. The Legislative Audit Bureau analyzed concerns with the transportation provided by MTM, including no-shows and late arrivals, and made recommendations to improve NEMT services and enhance oversight by DHS.

>> Non Emergency Medical Transportation (full report)

>> Briefing sheet

>> Report highlights

Ambulance concerns in Lafayette County

PAAW Administrator — Wed, 20 May 2015 19:50:35 GMT

If you were ever in an accident, you'd expect the closest first responders would be the ones to help you. But that's not the case in certain parts of southern Wisconsin. There's an area where the wait time for an ambulance has jumped from five minutes to nearly 30 and it's all because of a state regulation.

>> Click for more information and news video.

Note: The Professional Ambulance Association of Wisconsin Board of Directors, along with the Wisconsin State Fire Chiefs Association, Professional Fire Fighters of Wisconsin and Wisconsin EMS Association, is currently working with the National Association of State EMS Officials to have Wisconsin join a national effort to adopt legislation, called REPLICA, that would alleviate the problem with cross border ambulance personnel licensure. Illinois is the only non National Registry state. In addition, the state's fire and EMS stakeholder associations are coordinating efforts regarding cross border mutual aid legislation. >> Click for a webcast interview on REPLICA.

Lawsuit against hospitals sending patients home in ambulances could have nationwide impact

PAAW Administrator — Wed, 20 May 2015 18:35:17 GMT

A federal prosecutor in Jacksonville has developed a legal strategy that could have hospitals across the country on the hook for billions of dollars in unnecessary ambulance services.

U.S. Attorney A. Lee Bentley III said a group of Jacksonville hospitals has agreed to reimburse the federal government for ambulance companies’ inappropriate billing despite the hospitals not receiving direct financial gain.

The legal strategy allows the government to sue because the hospitals were the cause of the fraudulent billing by calling the ambulance services to take patients from the hospital to their residence and provided the necessary forms to bill federal health care programs, according to the U.S. Attorney’s Office.

The total amount of the settlement is about $7.5 million.

The hospitals agreed to reimburse the government $6.25 million for non-emergency ambulance rides. An ambulance service agreed to pay $1.25 million.

However, Baptist Medical Center officials believe the organization did nothing wrong and “fundamentally disagree” with the allegations.

“The government’s position essentially forces hospitals to become knowledgeable about complicated federal regulations applicable to ambulance companies,” said director of public relations Cindy Hamilton. “It puts the focus on reimbursement, not patient care.”

“The appropriate mode of transport should be determined by the attending physician, based on a professional assessment of the patient’s clinical needs,” she said.

Baptist settled the lawsuit to avoid the inconvenience and expense of lengthy litigation, Hamilton said.

The settlement does include language that the hospitals and ambulance companies do not admit fraudulently billing federal health care programs.

At least one of the operators of an ambulance service in the lawsuit is calling the government’s actions a “federal money grab” that’s bankrupting companies nationwide.

“We will continue to maintain to our dying breath that we are innocent,” said Michael Assaf, president of Liberty Ambulance. “It’s happening all over the nation. This is a federal money grab in our opinion.”

He said he’s refuted every claim the federal government has presented to him. He said the federal prosecutor who is working these cases even told him that ambulance billing for federal health care programs is one of the most difficult systems to navigate.

Recently, the U.S. attorney’s offices in South Carolina and New Jersey shut down about a dozen ambulance companies in those states with large settlement agreements.

Liberty Ambulance is the only company involved in the lawsuit that hasn’t settled with the U.S. Attorney’s Office.

The hospitals included in the lawsuit are: Baptist Medical Center Downtown, Baptist Medical Center South, Baptist Medical Center Beaches, Baptist Medical Center Nassau, Memorial Hospital Jacksonville, Orange Park Medical Center, Specialty Hospital Memorial Health, Lake City Medical Center and UF Health Jacksonville.

St. Vincent’s Medical Center and the Mayo Clinic did not have the same problems with ambulance transport as the other Northeast Florida hospitals, according to the U.S. Attorney’s Office.

The two largest, private ambulance companies in Jacksonville — Century Ambulance and Liberty Ambulance — also were sued. Century settled and agreed to pay $1.25 million over five years.

John Glover, chief executive officer at Century Ambulance, said his company fully cooperated with the government during the investigation. He said Century is looking at this as a constructive process and company officials meet weekly with hospital officials to discuss how to make sure they are in compliance with federal health care program billing practices.

“Health care fraud is a serious matter and it is not tolerated by Century, period,” he said. “We do business the right way.”

Jason Mehta, an assistant U.S. attorney, began the federal investigation into Medicare fraud by Jacksonville ambulance companies in 2011 after a whistle-blower lawsuit was filed by Shawn Pelletier, an EMT since 1998 who worked for Century from 2004 to 2006 and Liberty from 2007 to 2009.

Pelletier said he witnessed documents being falsified for the purpose of billing Medicare or Medicaid during his employment at both companies, according to the lawsuit.

Mehta said as he began pulling information from the ambulance companies, he noticed the majority of the non-emergency ambulance rides originated from the hospitals. Most of those rides ended at a nursing home. He said the other most common transport from a hospital in an ambulance ended at the patients’ residences.

The next most common destination was to another hospital, Mehta said.

He said there are also reasons for a hospital to use an ambulance service to transport a patient home, but when he cross-referenced those rides with available medical records, the U.S. Attorney’s Office deemed the vast majority were not needed.

Mehta said although the hospitals didn’t gain financially from billing Medicare, they did gain indirectly by removing patients who had already been treated, allowing for rooms to be filled quicker with new patients.

Baptist countered that it is often faster to transport a patient by family, friend or taxi.

The other hospitals also contend they did nothing wrong.

“It is important to note that UF Health Jacksonville did not receive any payments for transportation or ambulance services and did not charge federal payers for any services, which were central to the lawsuit,” the hospital said. “UF Health Jacksonville only makes requests for transportation services. As a condition of the settlement, UF Health Jacksonville has not admitted to any wrongdoing or violation of applicable laws but has agreed to provide additional guidance and education to employees involved in requesting ambulance services.”

HCA Healthcare owns four of the hospitals sued by the federal government — Memorial Hospital, Orange Park Medical Center, Specialty Hospital Memorial Health and Lake City Medical Center.

“Our goal is to do what is best for our patients — including post-discharge transport, whether by ambulance or not,” spokeswoman Ilyssa Drumm said. “There are complex Medicare rules that govern the appropriateness of when ambulance companies may bill for such transport if the patient is deemed well enough to travel in a cab or van. This settlement addresses that issue for certain former patients, and we are pleased the matter is resolved.”

Mehta said since the U.S. Attorney’s Office lawsuit became public, the expenses of ambulance transport has decreased by one-third in the Jacksonville area and many of the hospitals have began voucher programs for taxi services.

Mehta said ambulance companies filing fraudulent claims is a nationwide issue. He said while federal health care program expenses are increasing, the rate at which ambulance transport expenses are increasing is about twice the rate of other expenses.

In fact, this type of ambulance transport — a minimum of $150 per ride — cost the U.S. government $250 million during a six-month span in 2014, according to Mehta.

Bentley, the U.S. attorney for the Middle District of Florida, said the total hospital liability could be in the billions as the statute of limitations for this type of crime goes back six years.

Mehta described trying to fix the problem in arcade-style terms using Whack-a-Mole as an example.

“You hit one and three more popped up,” he said about past investigations. “This has unplugged the machine.”

Source: Jacksonville.com, May 2, 2015

Every Wisconsin Ambulance Service to Benefit from TRIP

PAAW Administrator — Mon, 18 May 2015 20:40:19 GMT

This PAAW driven initiative simply awaits Governor Walker's signature

A bill introduced by Rep. Paul Tittl and Sen. Sheila Harsdorf has passed both the Assembly and Senate, and is on its way to the Governor’s desk. Once signed by Governor Walker, the new law would let the Department of Revenue apply its tax refund intercept program (TRIP) to debts owed to all Wisconsin ambulance services who wish to access it.

Essentially, DOR could reduce a person’s tax refund by the amount needed to cover theunpaid costs of those services as long as they were performed pursuant to a contract with a municipality or county and are in response to a 911 call in that area. TRIP does not, however, apply to patients with Medicare or Medicaid.

Rep. Paul Tittl, R-Manitowoc, proposed the bill, and, according to his office, it arose from complaints that some ambulance companies carry bad debt because when insurance carriers mail a check directly to the patient for the cost of their services, the money is not always used for its intended purpose in paying the ambulance bill.

According to PAAW President Patrick Ryan, “Because of the efforts of PAAW, now all 911 ambulance providers can use TRIP as a means to collect on bad debt that continues to go unpaid by the patient for vital services rendered to them. This is another tool to help insure the strength and vitality of EMS in Wisconsin”.

The Professional Ambulance Association of Wisconsin has pursued TRIP legislation the past seven years, with the last two years showing the most promise in getting passed. PAAW is represented by Michael Brozek with Midwest Strategies, a government relations firm in Madison.

CBS News 58 in Milwaukee recently interviewed Bell Ambulance Operations Director Chris Anderson regarding TRIP. Click the player below to watch.

National EMS Week - May 17 to 23

PAAW Administrator — Mon, 18 May 2015 17:38:33 GMT

National EMS Week is May 17 to 23. It is a great time to create community and department events and opportunities around EMS, and spotlight the people who deliver patient care and operate within the system. National EMS Week is sponsored by the American College of Emergency Physicians and the National Association of EMTs.

To coordinate the occasion, Governor Scott Walker has proclaimed Wisconsin EMS Week, May 17-23. >> Click to download Governor Walker's Wisconsin EMS Week Proclamation

The Wisconsin EMS Office issued a statement, "We would like to thank you for your partnership in the Wisconsin EMS System. Your contributions to the Wisconsin EMS System ensure the highest level and quality of pre-hospital emergency medical care in your communities throughout Wisconsin. As always, the EMS office and the Department of Health Services appreciates your commitment to EMS in Wisconsin and our continued partnership to make the system the best it can be."

Live Show recording with Randolph Mantooth now on-line

PAAW Administrator — Wed, 06 May 2015 20:36:40 GMT

>> Click to listen now or go to http://tobtr.com/s/7522693

Meet real life Firefighter Paramedic John Gage from EMERGENCY! Learn why he believes the 1970s hit TV show was such a success - and why it's still referred to so often nearly 40 years after it first aired. The NBC program was watched by 30 million viewers per episode for seven straight years from 1972 to 1979.

The interview includes Pioneer of Paramedicine Dr. Eugene Nagel, Randolph Mantooth and Nancy McFarland. They are responsible for the rise of Paramedics in the 1960s and 70s. Find out what it means for us today and how this great EMS industry history has been archived!

The 60 minute program was dedicated to discussing the start of Paramedic systems, those responsible for its rise in the 1960's and 70's, the determination and vision it took, and based on their experiences how they see the industry evolving into Community Paramedicine!

(Picture insert: Dr. Nagel and Randolph Mantooth on May 7, 2010 standing by the original Squad 51 used in the 1970's hit TV show EMERGENCY! Nancy McFarland brought them together to record the early history of EMS)

Randolph Mantooth is widely known for his role as Paramedic John Gage in the TV series EMERGENCY! -- the show that transformed America's perception and approach to emergency medical care in the 1970s and introduced millions to the word "paramedic" for the first time. Mr. Mantooth is a popular speaker at Fire and EMS events, and an advocate for firefighter health and safety. His website is www.RandolphMantooth.com.

Upcoming Wisconsin EMS Live show webcasts:

>> May 12 HIPAA Compliance, Social Media and Employee Law. Guest attorney Scott LeBlanc and Paralegal Carrie Noonan from Godfrey & Kahn Law Firm (Milwaukee and Madison offices). Also, meet new nationally featured writer and Critical Care Paramedic from Gundersen Tri-State Ambulance Crystal Wallin, and discover more about her featured writings in her new blog, "Standby for Tones".

>> June 9 EMS Drugs: The Chain of Custody, Diversion and Best Practices. Guests: Drug Enforcement Agency (DEA) Wisconsin Supervisor Kathy Federico, Wisconsin Ambulance Inspector Paul Schilling, and Baraboo District Ambulance Chief Dana Sechler.

More information at www.PAAW.us/wisconsinemslive

EMS Advisory Board announces openings on sub-committees, invites applications

PAAW Administrator — Tue, 05 May 2015 14:38:01 GMT

The Wisconsin EMS Advisory Board announced it will have sub-committee elections. Interested persons are encouraged to apply for committee positions by May 26, 2015. Elections will take place at the June 3 EMS Advisory Board meeting at the Great Wolf Lodge in Wisconsin Dells. All applicants are invited to address the EMS Advisory Board at the June 3 meeting.

Subcommittees are formed to address specific issues and develop recommendations for EMS Advisory Board consideration. There are four subcommittees accepting applications:

System Quality and Data
EMS Education and Training
EMS System Development and Management
EMS Physician Advisory Committee

All persons interested in serving on a subcommittee should submit their application (Form F-00568) to dhsemssmail@wisconsin.gov by Tuesday, May 26, 2015. For more information about the WI EMS Board information, please visit https://www.dhs.wisconsin.gov/ems/boards/index.htm.

PAAW begins new featured blog: "Standby for Tones"

PAAW Administrator — Mon, 04 May 2015 14:20:35 GMT

Within the past few weeks, the Professional Ambulance Association of Wisconsin began featuring writings on its website by Gundersen Tri-State Ambulance employee and Critical Care Paramedic Crystal Wallin.

According to PAAW Executive Director Joe Covelli, "We never considered a writers blog until PAAW board member and Gundersen Tri-State Ambulance Executive Director Tom Tornstrom shared the idea." He added, "Tom shared a few of Crystal's writings with me. She has the ability to put you, as the reader, right in the human experience as an EMT and patient caregiver - and the range of emotions the job and work life deliver."

Covelli shared Wallin's featured writings with EMS World Editorial Director Nancy Perry, who quickly agreed it is very good. Perry offered Wallin space at EMSWorld.com for her writings and visibility to an audience of 50,000 online readers. EMS World is a leading national EMS magazine and online publisher of EMS news, information and content.

According to Wallin, "This is all so surreal".

>> Click to review Wallin's featured blog, "Standby for Tones".

(Picture insert: Crystal Wallin, featured writer and Critical Care Paramedic at Gundersen Tri-State Ambulance, La Crosse. Photo credit: Peter Thomson, La Crosse Tribune)

MedEx to roll out 10 ambulances with Google glass in Chicago

PAAW Administrator — Tue, 28 Apr 2015 22:03:05 GMT

MedEx, a Chicago-based provider of ambulance and telemedicine services announced it is rolling out 10 ambulances equipped with Google Glass, ChicagoInno reports. Utilizing Pristine’s EyeSight HIPAA compliant software, paramedics can now prepare emergency response for an incoming patient, document a call, or beam a remote specialist into the ambulance for a stroke consult in real time audio and video.

MedEx Ambulance is the first in the nation to implement Google Glass in EMS and has been approved by the Department of Public Health in Illinois to leverage hands-free, voice-activated telemedicine to coordinate care in both emergent and non-emergent cases. The company has spent $250k over the past two years developing Glass pilot program at The Advocate Illinois Masonic Medical Center. MedEx plans to expand it to more area hospitals throughout the year. Additionally, the company recently added 10 critical-care ambulances, priced at $250,000 each outfitted with Wi-Fi hotspots that facilitate video transmission to hospitals.

>> Click to watch video demonstration

Source: Chicago Business/Hendershot/1/29/15

Critical EMS drugs in short supply

PAAW Administrator — Tue, 28 Apr 2015 13:11:30 GMT

On April 27, Bound Tree Medical Product Manager Stacy Barksdale-Price reported short supply of critical EMS drugs, and that their company is on allocation status with two of the manufacturers.

According to Ms. Barksdale-Price, "Both Hospira and IMS have reported their emergency prefilled syringes (Atropine, Cal Chl, Epi, D50 and Bicarb) are now on allocation and the shortage status is expected to continue until September. The allocation status means that they are only fulfilling quantities that are consistent with each of their customer’s (e.g., Bound Tree) average monthly demand (based on the last 12 months). To prevent lengthy backorders, as these manufacturers are restricting our purchases to average monthly volumes, we encourage our customers to maintain their usual ordering patterns on these items at this time."

>> Click for April 27, 2015 Pharmaceutical backorder report

Proposed legislation would add Emergency Medical Responder as legal crew member

PAAW Administrator — Wed, 22 Apr 2015 16:31:20 GMT

On April 16 a letter was sent to fellow Wisconsin legislators about changing the minimum ambulance staffing requirements to allow one member of a two-person legal crew to be an Emergency Medical Responder (LRB 1636/1 and LRB 15-2224/1).

With input from local providers, state Representatives Jeff Mursau and Bob Kulp and Senator Terry Moulton intend to introduce legislation to change ambulance staffing requirements and help struggling volunteer ambulance services across Wisconsin. Their letter is seeking co-sponsors to the proposal with a reply date of April 24.

Currently, two Emergency Medical Technicians (EMTs), licensed registered nurse, registered physician assistant, physician, or a combination of these individuals are required when transporting an individual. This legislation would allow an Emergency Medical Responder (EMR) to act as one member of a legal ambulance crew. The bill also requires the EMT (or higher license level) to remain with the patient at all times during care and transport of the patient.

In their letter seeking co-sponsors they stated, “The proposal would immediately provide necessary relief for the staffing shortages caused by the difficulty of recruiting and retaining EMTs, especially in the volunteer services providing coverage in rural areas. Additionally, it would be a valuable tool to recruit new squad members as First Responders without the pressure to immediately commit to the additional education requirements of an EMT”. They also stated, “Many rural emergency ambulance volunteer services are in a state of crisis with few staff to cover a necessary 24/7 service to their communities”.

Regular Community Paramedicine Conference Calls

PAAW Administrator — Wed, 22 Apr 2015 13:16:18 GMT

Those interested in considering or currently developing Community Paramedicine concepts and programs in their local area are invited to join a conference call dedicated to the topic. The call is scheduled every other week and open to anyone interested. It is led by Patrick Ryan with Ryan Brothers Ambulance (Madison) and PAAW President.

The number of participants continues to grow. Currently, there are 15 to 20 who join on a regular basis, mostly in ambulance administration, from throughout the state. Current topics include CP curriculum, training, drafting CP legislation, community health "gap filling", and more.

If you have a question, wish to be added to the contact list, or receive the dial in phone number, email Patrick Ryan at president@paaw.us.

State reprimands Curtis Ambulance in fatal kickboxing bout

PAAW Administrator — Mon, 20 Apr 2015 13:14:56 GMT

Regulators have taken the rare step of issuing a letter of reprimand against Curtis Ambulance for failing to follow a state rule the night Dennis Munson Jr. died in his debut kickboxing bout in Milwaukee.

Curtis did not file a special event plan with the Wisconsin Department of Health Services for the March 2014 kickboxing event the company was hired to staff at the Eagles Club. State rules require an ambulance service to file such plans under certain circumstances to alert emergency response authorities of the event.

The state reprimand letter does not comment on the care the Curtis crew provided to Munson. But in response to a reporter's question, the department said it looked into all aspects of how Curtis handled the call and found the care was appropriate.

>> Read more

Upcoming Live Show: Paramedicine and those responsible for its rise in the 1960s and 70s - and what it means for us today!

PAAW Administrator — Fri, 17 Apr 2015 15:36:11 GMT

On Monday, May 4 starting at 12 noon central time, we have a special live broadcast planned for Wisconsin EMS Live. Our guests include Dr. Eugene Nagel, Randolph Mantooth and Nancy McFarland. If these names aren’t familiar to you, that’s okay. Just know they are some of the EMS industry’s strongest advocates.

The 60 minute program is dedicated to discussing the start of Paramedic systems, those responsible for its rise in the 1960's and 70's, the determination and vision it took, and based on their experiences how they see the industry evolving into Community Paramedicine! Listener questions will be invited during the live show.

Guests include:

Dr. Eugene Nagel – is still deeply involved in EMS – even at age 90. He continues to speak to groups and at community college paramedic classes in Florida. Dr. Nagel is a retired anesthesiologist. He was an innovative pioneer who served as medical director for the City of Miami Fire Department's rescue operation from 1964 to 1974. During those 10 years, Dr. Nagel developed the first paramedic program utilizing voice medical control and telemetry to send a patient’s heart rhythm from the field to the receiving hospital. The biophone or “orange box” was a familiar piece of equipment used by paramedics and on the TV show EMERENCY! The TV show’s unit now resides on display at the Smithsonian Institute in Washington, D.C.

Randolph Mantooth - actor, producer and speaker. Widely known for his role as Paramedic John Gage in the TV series EMERGENCY! -- the show that transformed America's perception and approach to emergency medical care in the 1970s and introduced millions to the word "paramedic" for the first time. Mr. Mantooth is a popular speaker at Fire and EMS events, and an advocate for firefighter health and safety. His website is www.RandolphMantooth.com.

Nancy McFarland – (Retired) LA County Fire Museum board director and Chair of the Pioneers of Paramedicine Committee. Ms. McFarland was instrumental in uniting the four doctors credited with starting the first (fire-based) paramedic programs in the United States in the late 1960s for taped interviews and a Lifetime Achievement Awards Gala in May of 2010.

Don't miss this inspiring conversation. Call in using 646-929-1081 or listen on any internet connected device. Listener questions can be called in during the live show or by emailing wisconsinemslive@paaw.us.

Don’t miss a beat of the action – listen to Wisconsin EMS Live.

A word from Randolph Mantooth

I’ve traveled the country speaking about the history of paramedics, and about the people whose visionary ideas changed the face of emergency medicine. I find that many men and women in the EMS profession and its related industries aren’t aware of their own history. They don’t know the names of the “Pioneers of Paramedicine.” Keeping that history alive, and telling the story of the journey of EMS in America has become a passion of mine -- a torch passed on to me by my good friend, Jim Page.

As with many ideas, this one started with a simple conversation during a road trip in Minnesota in 2009. We asked one another -- what if we were able to bring together the four doctors who started these paramedic programs, and have Eugene Nagel from Miami, Leonard Cobb from Seattle and Michael Criley and Walter Graf from Los Angeles record their personal stories on video. These four doctors weren’t just witnesses to the birth of modern EMS -- they conceived the idea, and delivered it.

Click below to hear the stories told by the people who lived them as visionaries of modern day EMS.

>> Click here for the Pioneers of Paramedicine video produced in 2010.

Rural Health Creates Community Paramedicine Forum

PAAW Administrator — Tue, 14 Apr 2015 21:37:11 GMT

By Kevin Jacobson, Wisconsin Office of Rural Health

The Wisconsin Office of Rural Health has been a strong supporter of Community Paramedic programs, or Mobile Integrated Healthcare, in the State.

We thought it would be beneficial to have a forum where those working on CP program development and implementation had a place to share their progress and ask questions of each other. We feel it’s also important for those new to the concept or just beginning to explore these programs, to have a place to find out more information. With that in mind, we have created the Community Paramedic Listserv. We hope this will fill a need in Wisconsin. Our Office will host the list, but its members will create the content.

You are welcome to subscribe by navigating to this website: https://lists.wisc.edu/read/all_forums/subscribe?name=cp where you’ll enter your name and email address. You’ll receive a confirmation email after you subscribe.

In addition, PAAW President Patrick Ryan hosts a conference call every other Friday for those interested in mapping out and discussing Community Paramedicine in more detail and to share information. Contact Patrick directly for more information at email president@paaw.us.

Today's Wisconsin EMS Live show recording now online!

PAAW Administrator — Tue, 14 Apr 2015 21:35:50 GMT

If you missed today's live show, no need to worry. The recording of the broadcast was just posted online.

>> Click to listen now!

Today's conversation was dedicated to Community Paramedicine and the Physician Advisory Committee recommendations with nitrous oxide and medication assisted advanced airway.

Our guests included Minnesota Ambulance Association’s Buck McAlpin, PAAW President Patrick Ryan, and city of Milwaukee Fire Department’s Michael Wright. All three are deeply involved in CP and building the infrastructure to deliver it the right way here in Wisconsin. Like anything new or evolving some education and learning is required to move forward, and there will be many questions to ask and answer.

Community Paramedicine programs have been evolving in Minnesota, Colorado and Texas. An architect in Minnesota’s CP development is Buck McAlpin, director of government affairs for the Minnesota Ambulance Association and North Memorial Medical Transportation in Robbinsdale, Minnesota. Given his experience in leading CP concepts in Minnesota, McAlpin’s knowledge and expertise is being sought nationally, to include by the Professional Ambulance Association of Wisconsin.

We were also joined by Dr. Suzanne Martens, Chair of the Physicians Advisory Committee. Her group recently recommended use of nitrous oxide as an option to control pain management at the Advanced EMT level and higher. Another recommendation is allowing one paramedic and one trained airway technician to perform a medication assisted advanced airway procedure that under current situations requires two paramedics.

Don't miss a beat of the action - listen to Wisconsin EMS Live!

Wisconsin EMS Service Directors Training Course dates announced by EMS Office

PAAW Administrator — Mon, 13 Apr 2015 16:14:49 GMT

The Wisconsin EMS Office recently announced multiple opportunities to participate in the Wisconsin EMS Service Directors Training Course. >> Click here for course dates and locations.

The purpose of the course is to educate service directors and interested individuals on how to operate a Wisconsin EMS service. Successful completion of the course provides eight hours of continuing education.

The first course is April 29 and 30 at Fox Valley Technical College. Registration is now open in the WiTrain (https://wi.train.org) learning management system.

Again, refer to the flyer or HOT TOPICS area of the Wisconsin EMS Office’s website at https://www.dhs.wisconsin.gov/ems/index.htm

Funding Assistance Program application period open until May 15

PAAW Administrator — Wed, 08 Apr 2015 14:38:33 GMT

The Wisconsin EMS Funding Assistance Program is now accepting applications through May 15. This funding can be used for “the purchase of ambulance vehicles, vehicle equipment and emergency medical service non-disposable supplies and equipment as well as emergency medical training for ambulance service personnel.”

More information and the application are on the >> EMS-FAP website.

Providers can't sue state Medicaid agencies over rates, Supreme Court rules

PAAW Administrator — Wed, 01 Apr 2015 13:18:16 GMT

Private healthcare providers cannot sue state Medicaid agencies over low reimbursement rates, the U.S. Supreme Court decided Tuesday, March 31 in a 5-4 decision (PDF), reversing a lower court's ruling.

Justice Antonin Scalia wrote in the majority opinion that the supremacy clause of the U.S. Constitution, which says federal laws reign supreme over state ones, does not allow providers to sue state Medicaid agencies over rates. Scalia also wrote that the Medicaid Act implicitly does not allow private parties to enforce a part of the law that requires state plans to “assure that payments are consistent with efficiency, economy, and quality of care” while “safeguard(ing) against unnecessary utilization of ... care and services.” Congress, he concluded, did not mean for the court to be able to get around that part of the law.

>> Read more

Source: Modern Healthcare, By Lisa Schencker

National EMS Week May 17 - 23

PAAW Administrator — Tue, 31 Mar 2015 18:59:02 GMT

If you haven't started already, now is the perfect time to begin plans for National EMS Week, May 17 to 23. The occasion is your opportunity to invite the public, community leaders and government officials to tour your operation and meet the people behind the siren, the newspaper headlines, and everyday heroes delivering patient care and serving as your community's emergency medical safety net.

National EMS Week is presented by the American College of Emergency Physicians and is in partnership with the National Association of EMTs.

If you need EMS Week ideas or a planning guide, one is available from ACEP at this link EMS Week website, or by emailing emsweek@acep.org.

Don't miss this opportunity to proudly share your EMS passion with the public and other healthcare professionals, as well as recognize and celebrate your ambulance service and emergency medical services.

Do you know someone at your ambulance service or EMS agency being recognized for their outstanding work or community service? Consider nominating them as a Wisconsin Star of Life. >> Click for more information.

Stars of Life 2015 celebration kicks off at Lambeau Field

PAAW Administrator — Tue, 31 Mar 2015 16:52:35 GMT

The Professional Ambulance Association of Wisconsin is pleased to announce it will host its Stars of Life 2015 "welcome reception" at historic Lambeau Field on Wednesday, September 23.

According to PAAW Executive Director Joe Covelli, "The gathering represents the start of a two-day event recognizing the best-of-the-best from EMS in Wisconsin. Lambeau Field is the perfect venue to kick the program off and celebrate the occasion with Star honorees and their families."

On day two, Thursday, September 24, Stars will attend the Paramedic Systems of Wisconsin conference and awards dinner program at Tundra Lodge and Conference Center, Green Bay.

Do you know someone at your ambulance service or EMS agency who deserves recognition for their outstanding work or community service? Consider nominating them as a Wisconsin Star of Life. One person from the group will advance to attend the National Stars of Life program in Washington, D.C. in April 2016.
Nomination applications will be available in mid-May and remain open until August 1, 2015. Each person nominated is presented with Stars honors.

>> Click for more information on Stars of Life 2015

Dept. of Health Leaves Door Open on Defining Community Paramedicine in the State

PAAW Administrator — Wed, 25 Mar 2015 19:28:54 GMT

Wisconsin EMS Live April 14 program dedicated to CP

>> Read Department of Health Response Letter

>> Read EMS Advisory Board Position Statement on CP/MIH

This past November the governor-appointed EMS Advisory Board sent a position statement to the state’s EMS Office about its unanimous support for the inception of Mobile Integrated Health Care and the associated programs and services provided from basic through advanced level of care.

In response to the above position statement, a letter was emailed to board members on March 23. In the letter, Wisconsin Office of Preparedness and Emergency Health Care Director Jennifer Ullsvick stated, “The emerging concept of Community Paramedic/Mobile Integrated Health Care is currently being piloted throughout the country and some areas have begun larger implementation”. She continued, “At this time, we believe that for the state to select and endorse a single model -- through rules or curriculum -- would be premature and would stifle innovation.”

In taking the above position, the Department of Health is encouraging interested parties (EMS services, hospitals, home health agencies, etc.) who identify gaps in their communities to work together in piloting approaches that meet those local gaps, and to work with EMS Office staff to evaluate proposals and see if waivers are needed.

While CP programs have started to pop up in Wisconsin, some as pilot projects like in the case at West Allis Fire Department, other states like Minnesota, Colorado and Texas are well on their way with CP and MIH. Wisconsin’s neighbor to the west, Minnesota, is far ahead of the badger state when it comes to developing models and implementation around CP and MIH concepts. Here’s why...

On April 6, 2011 Minnesota Governor Mark Dayton signed into law the Community Paramedics Bill (House File 262/Senate File 119), which created certification for emergency medical technicians—community paramedics (EMT-CP) and directed the Commissioner of the Department of Human Services to work with emergency medical service providers, physicians and public health nurses to further determine the services performed by Community Paramedics.

An architect in Minnesota’s CP and MIH development is Buck McAlpin, director of government affairs for the Minnesota Ambulance Association and North Memorial Medical Transportation in Robbinsdale, Minnesota. Given his experience in leading the CP/MIH effort in Minnesota, McAlpin’s knowledge and expertise is being sought nationally, to include by the Professional Ambulance Association of Wisconsin.

Minnesota smartly created their effort into law signed by the Governor. This did two things: one, created recognition of a provider level and, two, provided an income stream for ambulance services for Medicare eligibility and hospital reimbursement. They’ve graduated classes of community paramedics with state level certification, and following 24-hours of training by EMT-Basics in a pilot project, have reduced hospital patient re-admissions by 50% - not only creating community goodwill, but an income stream from the hospital to the ambulance service.

The Wisconsin EMS Live broadcast on Tuesday, April 14 is dedicated to CP and MIH. Our guests include Minnesota’s Buck McAlpin, PAAW President Patrick Ryan, and city of Milwaukee Fire Department’s Michael Wright. All three are deeply involved in CP and MIH and building the infrastructure to deliver it the right way here in Wisconsin. Other departments like West Allis Fire Department are too with their current CP pilot project. Like anything new or evolving some education and learning is required to move forward, and there will be many questions to ask and answer.

Begin by listening to the April 14th live show program starting at 9:00 a.m. and lasting 60 minutes, so come listen, ask questions or contribute. The call in number is 646-929-1081 for listen only or to ask a question, or hear it on any internet connected device. The broadcast is recorded, so if you miss it you can listen to the playback on-demand. For details, go to www.paaw.us/wisconsinemslive.

The Department of Health has left the door open to define the delivery model for your community with implementation of CP and MIH. As a patient care provider and EMS leader it is your responsibility to learn, be engaged in the process, and take action on this new and emerging opportunity if it benefits your community.

Have questions about getting started or involved with others going through the same process? PAAW is not only a participant in the process, but also leading the effort by holding regular conference calls for all interested ambulance directors from around the state. You do not need to be a PAAW member to participate in these bi-weekly calls. For more information, contact PAAW President Patrick Ryan by emailing president@paaw.us.

About Wisconsin EMS Live

Wisconsin EMS Live is an internet radio program that can be heard live on the internet or by calling in the second Tuesday each month starting at 9:00 a.m. central time, and when important news breaks.

The program is dedicated to discussing EMS in Wisconsin that offers information, perspective and clarity. Persons can listen to the live program on any internet connected device, or by calling into the show to listen only or ask a question of the co-hosts or guests. Each episode is recorded, so if you miss the live broadcast you can always listen to a previous episode on-demand.

REPLICA is the Way Forward for Interstate Licensing

PAAW Administrator — Tue, 24 Mar 2015 21:10:52 GMT

REPLICA, a new national licensing initiative, and one that should be of particular interest to border state ambulance services, ambulance services that transport into other states, and air ambulance programs. It is on the move nationally and could be enacted in Wisconsin if legislation is passed and signed by the Governor.

REPLICA stands for “Recognition of EMS Personnel Licensure Interstate CompAct”.

In our newest EMS to the Point webcast Executive Director Dia Gainor with the National Association of State EMS Officials (NASEMSO) provides answers to questions about REPLICA, how it benefits you as a patient care provider, your local ambulance service, and the state. REPLICA is a jointly sponsored effort by NAEMSO and the National Association of EMS Physicians.

Tri-State Ambulance in La Crosse is one ambulance service that sees tremendous benefits with REPLICA and are eager to see it enacted. According to their Executive Director Tom Tornstrom, "As a provider of ambulance services in three states, Wisconsin, Minnesota, and Iowa, REPLICA would be extremely helpful to our organizations. Due to the vast rural areas we serve, advanced life support ambulances, such as ours, are limited. REPLICA would allow us to provide rapid and streamlined ALS mutual aid services in times of need. For example, our La Crosse area paramedics are typically licensed in just Wisconsin and Minnesota. With REPLICA, we could quickly respond with four to five ALS ambulances from La Crosse to Northeast Iowa for a mass casualty incident. Likewise, we could send our Iowa paramedics over the border to Wisconsin to assist in a large incident event".

The Professional Ambulance Association of Wisconsin and Wisconsin State Fire Chiefs Association are laying the groundwork to further discuss REPLICA and the best way to approach a joint effort.

>> Click to listen to the REPLICA EMS to the Point audio webcast.

State EMS Director Job Re-posted for Third Time

PAAW Administrator — Mon, 23 Mar 2015 19:30:03 GMT

The Wisconsin Department of Health has re-posted the State EMS Director job again after not filling the position following the latest round of interviews.

The position was initially posted this past June and then again in December. The most recent job posting closes on April 2. Last year’s re-posting was due to the EMS office being moved from Unit to Section status. The position has been vacant since April 2014.

>> Click to review job posting

Wisconsin Stars of Life 2015 Nomination Period Opens Soon

PAAW Administrator — Wed, 11 Mar 2015 16:50:38 GMT

Wisconsin Stars of Life 2015 applications will be available starting in May. Who will you nominate? Each person nominated is presented with Wisconsin Stars of Life honors, with one person advancing to the National Stars of Life ceremony in Washington, D.C. in April 2016. Click here for more information.

Stars of Life has been produced by the Professional Ambulance Association of Wisconsin since 2006, and is modeled after the American Ambulance Association's National Stars of Life program.

Wisconsin EMS "Live" Format Offers Interaction and Information During Talk Radio Style Format

PAAW Administrator — Wed, 11 Mar 2015 15:37:42 GMT

>> Click here to listen to the March 10 live show recording.

The Professional Ambulance Association of Wisconsin unveiled its newest digital media program, Wisconsin EMS Live, on March 10. The 60 minute discussion was dedicated to news about the EMS Advisory Board, an update on hiring a new state EMS section director, the successful roll-out of community paramedicine at West Allis Fire Department, and EMS Leadership Academy classes coming to Wisconsin.

Guests who joined the program were EMS Advisory Board Chairman Jerry Biggart, West Allis Fire Department Captain Dave Bandomir, and EMS Leadership expert John Becknell. The program was co-hosted by Joe Covelli, Patrick Ryan, and Chris Anderson.

Each guest in the March 10 live show referenced handouts, so you can find them in the archive, to include: the EMS Advisory Board's position statement on community paramedicine, West Allis Fire Department's Mobile Integrated Healthcare work plan, and Wisconsin dates for the EMS Leadership Academy. >> Click here to review this information.

The live show is broadcast the second Tuesday each month starting at 9:00 a.m., with the next show being April 14. Each episode is also recorded, so don't worry if you miss the live show. >> Click here to listen to a previous episode in the archive.

PAC recommends pain management and medication assisted advanced airway technician options

PAAW Administrator — Mon, 09 Mar 2015 20:35:07 GMT

The Wisconsin Physicians Advisory Committee (PAC) met on March 4 to offer its recommendations regarding use of nitrous oxide for pain management, and replacing RSI with Medication Assisted Advanced Airway and expanding options for trained personnel, other than Paramedics, to perform the lifesaving procedure.

Use of nitrous oxide was recommended by PAC for ambulance services at the EMT-Intermediate Technician level and higher. Nitrous oxide is a medication inhaled by mask for patient pain management, and a skill already approved in the National Curriculum. PAC and the EMS office are currently working through a best practices document before any approvals are given to ambulance services. In its final form the document will detail education and training requirements as well as exposure, safety and diversion procedures. Dr. Charles Cady, Wisconsin’s EMS medical director, contacted several state medical directors about their experience using nitrous oxide for pain management.

Rapid Sequence Intubation, or RSI as it is commonly referred, is a medication induced airway management procedure that includes paralytics and currently requires two Paramedics at the patient's side. PAC recommends RSI be replaced with Medication Assisted Advanced Airway, and that the medically induced paralytic procedure be administered by two airway trained technicians, of which one must be a Paramedic. In addition, PAC recommended all new intubating ambulance services have wave form ETCO2 capabilities and all existing intubating services must have it by 2021.

Call to Action: Permanent Medicare Ambulance Relief

PAAW Administrator — Fri, 27 Feb 2015 20:25:52 GMT

The American Ambulance Association is requesting industry support with sending your members of Congress letters in support of cosponsoring H.R. 745 and S. 377 by accessing the AAA online letter writing tool. A sample letter is already preloaded and the tool will automatically determine your members of Congress and send them your letters. It is easy to use and will only take a few minutes.

The Medicare Ambulance Access, Fraud Prevention and Reform ActH.R. 745 and S. 377 would make the current temporary Medicare increases of 2% urban, 3% rural and the super rural bonus payment permanent. Participants should also ask their members of Congress to support an extension of the increases, which expire on March 31.

PAAW to debut "Wisconsin EMS Live" on March 10

PAAW Administrator — Wed, 25 Feb 2015 14:16:59 GMT

A Live Internet and Call In Radio Style Show

The Professional Ambulance Association of Wisconsin is pleased to announce it will debut its newest digital media program, Wisconsin EMS Live, on Tuesday March 10, starting at 9:00 a.m. central time.

According to PAAW Executive Director Joe Covelli, “The past four years we’ve produced a recorded webcast, called EMS to the Point. The program has done well with over 50 episodes and more than 30,000 downloads". He added, “One element was missing however – interaction with the listener. Wisconsin EMS Live changes that by involving hosts, guests and listeners with live call in or chat capabilities”.

Four co-hosts will provide the show’s dialog, to include: Chris Anderson, Operations Director, Bell Ambulance, Milwaukee; Joe Covelli, Executive Director, Professional Ambulance Association of Wisconsin; Patrick Ryan, President, Ryan Brothers Ambulance, Madison; and Dan Williams, Director, Emergency Services of Door County, Sturgeon Bay.

The March 10 debut is scheduled to run from 9:00 to 10:00 a.m. central time and is dedicated to discussing Community Paramedine. CP, or Mobile Integrated Healthcare as it is also referred, is a conversation building attention and momentum, especially with system models suddenly popping up and being tested in Wisconsin by some departments. In addition, the program will include conversations with EMS Advisory Board Chairman Jerry Biggart and EMS leadership expert John Becknell.

The dial in number to listen only or speak with the co-hosts is 646-929-1081. You can also listen or chat in questions via any internet connected device.

For more information, go to www.PAAW.us/wisconsinemslive.

Don’t miss a beat of Wisconsin EMS action!

Mobile Healthcare: West Allis Fire Dept. Home Visits Proving Successful

PAAW Administrator — Tue, 24 Feb 2015 14:21:22 GMT

Fire departments across Milwaukee have started making home visits to patients as part of what is turning out to be a successful community paramedicine program.

West Allis is one of the five departments in the county involved in the program designed to prevent patients from frequently calling 911 for problems that can be better handled with improved care, CBS 58 reports.

The department makes home visits to 29 patients. In 2013, those patients accounted for 857 911 calls, 596 ER visits and 571 ambulance unit hours. Since starting the home visit program in January 2015, none of the patients have called 911.

After 90 days, the department plans to review the results of the program.

Source: CBS 58 Milwaukee

Elimination Averted for Governor Appointed EMS Advisory Board

PAAW Administrator — Thu, 19 Feb 2015 17:49:09 GMT

By Jerry Biggart, Chairman, Wisconsin EMS Advisory Board

The members of the Governor appointed EMS Advisory Board were shocked to learn the Board was slated for elimination due to being inactive for the last year. The record reflected that we met and worked diligently at every meeting that was scheduled. On behalf of the Board I formally communicated with Department of Health Services, Department of Administration, and the Governor’s Office, in addition to the Professional Fire Fighters of Wisconsin, Professional Ambulance Association of Wisconsin, and Wisconsin EMS Association leadership sending a unified message that elimination of the EMS Board would be detrimental to the State, its citizens, and the EMS stakeholders.

I believe that the Governor and the citizens can be proud of the diversity, effectiveness, dedication, unimpeachable integrity, and expert consultation provided by the EMS Board volunteers that he has appointed. The EMS Board applauds the Governor for removing the recommendation to eliminate the Board prior to the initial budget being released. The Board will seek modifications with the Department of Health to ensure that this debate isn’t repeated moving forward.

This coordinated effort is an example, from a growing list of examples, where EMS advocates representing all EMS providers in Wisconsin, worked together with one unified voice. EMS stakeholder representation is stronger than it’s ever been, and with this renewed spirit of cooperation we will continue to achieve great things.

Bringing EMS to West Africa

PAAW Administrator — Wed, 18 Feb 2015 21:07:05 GMT

For a lot of EMS providers, it’s difficult to imagine an entire country not having a single ambulance. But until August 2014 that was a reality in the West African nation of Burkina Faso.

Now, after not having a single ambulance to serve its population of 17 million until a few months ago, Burkina Faso, a country about eh size of Colorado, will soon be receiving a second, thanks to a donation from Ryan Brothers Ambulance Service, based in Madison, WI, in December.

The windfall for Burkina Faso can be largely traced to two people: Hassimi Traore and Dawn Kiernan.

Traore, a chemistry professor at the university of Wisconsin-Whitewater, is a native of Burkina Faso. When he just 12 years old, he witnessed his best friend, his “brother,” get hit by a car hit by a car in his home village of Dédougou. There is no 9-1-1 system in Burkina Faso, so the only way to a clinic or hospital was to walk or, at the time, go by a cart pulled by livestock. Because Traore’s friend was unable to reach a clinic, he died.

Traore told himself that one day he would help his village so people wouldn’t have to die because there was no way to get to a hospital.

To fulfill this vow, in 2011 Traore purchased a 1990 Ford ambulance. It took him three years to pay it off with his own money. That was the ambulance that was delivered to Burkina Faso in August.

It was while he was raising funds to get the ambulance and medical supplies over to Africa that Traore was introduced to Kiernan, an EMT in Whitewater. Kiernan helped send out nearly 700 letters asking for assistance with the endeavor, one of which landed in the lap of Ryan Brothers co-owner Patrick Ryan.

Ryan notes company policy dictates once a vehicle hits 200,000 miles it can longer be used to transport patients. “Normally we’d remount it, but this time I remembered that letter I’d received,” Ryan says. “I thought, let’s just get a new one and donate this ambulance.”

In addition to the ambulance, Ryan Brothers donated a variety of back-up medical equipment and supplies to stock the rig. And when it starts its new life in Burkina Faso this spring, it will bring a little Wisconsin with it as a reminder of where it came from.

“All of the Ryan Brothers decals will remain on the ambulance,” says Kiernan. “The one we took over in August even still has its Wisconsin license plate.”

Sorely Needed

To say the new ambulance will be a benefit to the people of Burkina Faso is an understatement.

According to Kiernan, Burkina Faso’s only hospital is staffed by just six doctors—three general practitioners, one OB/GYN, one pediatrician and one surgeon. The first ambulance serves an area with a population of about 1.8 million people. Since August, it’s already transported about 500 patients, people who might never have made it to the hospital previously.

Kiernan was able to accompany the first ambulance on its trip to Burkina Faso with a group of volunteers, though the group hit a snag when the ambulance got waylaid in Ghana. “We’d hoped to do some training with the staff in Dédougou, but with our supplies unavailable we couldn’t do as much as we wanted.”

Still, Kiernan, who says she’s found a friend for life in Traore, plans to return to Burkina Faso with another group to continue the work she’s started. There, Kiernan and her colleagues will be able to provide more extensive EMS training and provide some much-needed assistance in an area where medical supplies and manpower are often scarce. “We’ll go back over once the threat of Ebola has truly subsided. Our goal is to bring other EMTs, stay in Dédougou and work in the hospital for a couple weeks.”

Source: Jason Busch is an associate editor for EMS World.

Newest Webcast: Raising the Bar: A Medical Director's Quality Improvement Initiatives

PAAW Administrator — Wed, 18 Feb 2015 13:57:46 GMT

Guest: Dr. Steve Stroman, Medical Director at Eagle III, Oshkosh Fire, DePere Fire and Rescue, and Oconto Falls Area Ambulance

Over the years, I’ve seen local ambulance service medical directors engaged in policy, procedures, trainings, and quality improvement projects. Unfortunately, we have medical directors at the other end of the spectrum who are never seen and their name not known by the people working under their MD license.

When Dr. Steve Stroman from the Green Bay area stood up at last September’s Paramedic Systems of Wisconsin Conference and rattled off over six or seven major initiatives they completed for the year, I listened in amazement. In this webcast Dr. Stroman offers some great ideas from the medical director’s perspective, and projects they’ve recently completed that you can easily pick up on and do the same.

Topics covered, include:

Identifying gaps in protocols, process and delivery
Intra nasal medications
Use of ketamine
Spinal protection procedures (not immobilization), cost savings
Airway video laryngoscopy
Cyanide toxicity kit
Physician oversight at scene calls
15 lead EKGs

There’s something to be learned in this webcast. It’s more than what’s being done, but also what you can do with some effort and collaboration. EMS departments often strive or boast to be the best. Proof is in your system’s performance and your next great initiative. The ideas shared in this webcast can be a good conversation starter.

>> Click here to listen now!

Newest Webcast: Wisconsin Healthcare Coalition Surges Forward

PAAW Administrator — Tue, 03 Feb 2015 14:06:50 GMT

The goal is to have seven healthcare coalition regions established in Wisconsin by July 1, 2015. The regions are determined by the Department of Health, and mirror the previous WHEPP regions, which had been established by patient referral patterns.

Wisconsin identified some gaps in widespread healthcare coordination, to include: coordinated plans for large scale disasters, lack of a formal regional medical coordination structure, established indicators for crisis standards when systems are overwhelmed, evacuation plans, and patient tracking capability.

Healthcare coalitions don’t replace day-to-day functions of individual responder agencies or organizations. Wisconsin is following a federal model that grew out of recent event experiences with the Joplin tornado and Hurricane Sandy. The goal is to coordinate how public health, healthcare institutions, and first responder agencies will manage their efforts to enact a uniform and unified response to an emergency, specifically the medical surge aspect of an event.

Get the latest information on Wisconsin’s Healthcare Coalition efforts in this webcast from co-medical advisor Dr. Michael Clark. Click here to listen now!

State's medical transportation broker holding town hall meetings

PAAW Administrator — Fri, 30 Jan 2015 22:51:33 GMT

MTM recently announced they will be holding three town hall meetings for their transportation partners. They are inviting comment on the Wisconsin non-emergency medical transportation (NEMT) program.

MTM, the state of Wisconsin’s non-emergency Medicaid and BadgerCare Plus transportation broker who schedules ambulance and other rides for medical appointments was recently criticized in a Journal Sentinel article for long wait times.

The town hall meetings will be held in the West Milwaukee area on March 31; the Black River Falls/Tomah area on August 4; and the Green Bay/Appleton area on November 3. The West Milwaukee meeting is scheduled for the Pewaukee Holiday Inn from 5 p.m. to 8 p.m. Locations for the Black River Falls/Tomah and Green Bay/Appleton meetings are TBD and will be announced as the dates approach.

To RSVP, click here

Union loses fight against doing community paramedic house calls

PAAW Administrator — Wed, 28 Jan 2015 22:53:25 GMT

The union for Green Bay firefighters has lost a nearly two-year fight against a city initiative requiring firefighters to make house calls on discharged hospital patients.

A state labor arbitrator has ruled the city was within its rights to initiate a program in which Bellin Hospital paid the city $50 for each house call.

But whether the so-called Hook and Ladder program will move forward in its original structure remains to be seen.

City officials suspended the program indefinitely while awaiting a decision on the grievance filed by the Green Bay Professional Fire Fighters Association.

The union argued that Hook and Ladder was an improper expansion of firefighters duties and that the city could not impose such new assignments unilaterally under the union's contract.

>> Read more

Source: Green Bay Press Gazette

PAAW Completes 2015-2017 Strategic Work Plan

PAAW Administrator — Wed, 28 Jan 2015 17:37:17 GMT

By Joe Covelli, PAAW Executive Director

At its January 8^th board of directors meeting, the Professional Ambulance Association of Wisconsin approved its 2015 – 2017 strategic work plan. The plan was developed on December 1, 2014 when association members, staff, consultants, and invited guests attended the all-day meeting.

The top priority calls for continuing to build momentum gained last year and introduce legislation in the current session to expand TRIP – Taxpayer Refund Intercept Program. Currently, only municipal ambulance services can access TRIP and file with the state to collect unpaid transport bills from the patient’s tax refund. PAAW is working with legislators to introduce legislation that allow ambulance services contracted by a municipality to provide 911 services the same TRIP collection benefits for unpaid patient transports. The reception by legislators to the idea has been favorable.

Additional items in the strategic work plan include community paramedicine, Medicaid reimbursement rates, ongoing communications, member growth, and advancing EMS leader networking opportunities. The Wisconsin Stars of Life Awards Program will change to an every other year event, with the next one being held in September 2015, and one honoree from the group advancing to the national Stars of Life in Washington D.C. in March 2016.

MedEvac Foundation funds sleep study for EMS clinicians

PAAW Administrator — Tue, 27 Jan 2015 17:42:46 GMT

The MedEvac Foundation International has approved grant funding for Dr. Daniel Patterson to investigate sleep-wake patterns and real-time fatigue reduction in emergency medical service (EMS) clinicians.

The medical transportation community requires that emergency care be available 24 hours per day. Shift work requires the prehospital emergency clinician to diverge from normal circadian sleep cycles and be alert when the pressure to sleep is greatest. While recent data suggests a link between sleep, fatigue and safety in the EMS setting, the data are limited to cross-sectional designs and subject to recall and measurement bias. The proposed study will provide detailed prospective observational data to address questions pertaining to the relationships between shift duration, sleep/wake cycles and behavioral alertness.

The overarching goal of the study is to address the Foundation’s research priority of “Educational techniques and technologies aimed at improving patient care, critical decision making, safety, or other areas pertinent to transport medicine.” Dr. Patterson, along with several colleagues, intends to accomplish this goal by performing a multi-site study of air-medical EMS clinicians. The Foundation Board has approved Phase 1 of the study, which will involve a prospective observational study of sleep/wake cycles, shift work duration, intershift recovery, fatigue and behavioral alertness (i.e., psychomotor vigilance).

The analysis of Phase 1 data will focus on differences between 12-hour versus 24-hour shifts.

>> Read more

Hold times. hang-up rates both cross limits for riders at MTM's Madison call center

PAAW Administrator — Tue, 27 Jan 2015 17:22:55 GMT

MTM schedules non-emergency ambulance requests for Medicaid and BadgerCare

Inadequate staffing at MTM Inc.'s call center in Madison appears to be the reason why more than 24% of people who called to schedule a medical ride in September hung up before getting through to a person. That's according to MTM's corrective action plan, obtained by the Public Investigator under a public information request.

MTM provides rides to Medicaid and BadgerCare Plus members who have no other way to get to their plan-covered services. Its contract with the State of Wisconsin caps the number of hang-ups at 5%. But in 2014, rates steadily climbed from 10.3% in March to 24.1% in September. Meanwhile, state officials sat by without any enforcement.

That's because MTM's contract says the 5% hang-up limit isn't enforced until the average hold time exceeds four minutes. The company came in under that every month through August.

However, according to newly released statistics, hold times exceeded the four-minute limit in MTM's contract in September. This triggered enforcement of both the hang-up limit and the hold time.

>> Read more

Source: JS Online

Orange Cross Ambulance names new executive director

PAAW Administrator — Thu, 22 Jan 2015 21:27:24 GMT

Brian Goelzer was selected as the new executive director at Orange Cross Ambulance in Sheboygan.

He recently wrote, “On October 1, 2014 Orange Cross Ambulance and Plymouth Ambulance services became one organization. It is my goal as the new leader to build a positive culture for all employees and their families’ while paving the way to exceed patients’ expectations and become leaders in EMS.”

New AHA CPR course focuses specifically on BLS pre-hospital care

PAAW Administrator — Thu, 22 Jan 2015 16:46:35 GMT

EMS professionals are a critical link in successful resuscitation from cardiac arrest. Approximately 400,000 Americans experience an out-of hospital cardiac arrest every year and only 10 percent survive. However there has never been a CPR course tailored to EMS professionals until now.

The American Heart Association released, for the first time, a new CPR course geared specifically toward BLS prehospital providers.

Basic Life Support for Prehospital Providers BLS PHP, released in October 2014, combines flexibility and customization to meet department and agency needs. The course is based on the 2010 American Heart Association guidelines for CPR and ECC and will be updated when the 2015 guidelines are released in November.

Why the new course?

The American Heart Association heard from EMS providers that the previous BLS Health Care Provider course was missing essential and realistic CPR training. The new BLS for Prehospital Providers course focuses on first responders and uses realistic EMS team approaches to respond to cardiac arrests in the field.

The new course format

The BLS for Prehospital Providers course consists of both online and classroom components, and the new format stresses the importance of transition of care from BLS to ALS EMS providers.

Online

The online portion is narrated and presents the cognitive information. Students must complete all the objectives in order to complete the online portion of the course, and cannot skip ahead.

The online course focuses on three core scenarios:

Cardiac arrest in a car
A child drowning in a family pool
Cardiac arrest in a home bathroom

Students must pass the online exam to move on to the classroom portion.

Classroom

Students then attend the in-classroom portion, led by an American Heart Association BLS Instructor. The classroom portion features instructor-led discussions, debriefing, coaching and support for hands-on skills. The classroom is blended with skills tests from the current health care provider course, along with discussions and a six-person team resuscitation.

The course focuses on a high-performance team approach, moving from two rescuers, to six suggested roles for responders, depending on personnel available. Teams with less than six may take on multiple roles.

Key roles include a compressor, a team member to handle compressions, a team member to handle the airway, another team member to defibrillate/AED, a team leader to delegate roles and make decisions and lastly a team member to administer an IV/IO/medication. The team approach is similar to an in-hospital resuscitation.

Course materials

All materials exist in an online format. EMS agencies can purchase multiple quantities of online keys to access materials for their personnel, and schedule the classroom sessions with their in-house American Heart Association BLS CPR Instructor.

The American Heart Association’s BLS for Prehospital Provider is fun and interactive, and incorporates EMTs, medics, firefighters and police with real life scenarios.

Source: EMS1 Danielle Cortes DeVito

Critical Care Paramedic Course Offered

PAAW Administrator — Mon, 22 Dec 2014 21:50:52 GMT

The Critical Care Emergency Medical Transport Program (CCEMTP) course will meet every Thursday and Friday, 8 am – 5pm, beginning April 2, 2015 through May 21, 2015.

A nationally recognized training program Critical Care Emergency Medical Transport Program (CCEMTP®) offers experienced paramedics and nurses a foundation that will prepare you to become a critical care transport specialist. This intense 100-plus hour course, presented at Gundersen Health System in La Crosse, WI was developed by the Department of Emergency Health Services at the University of Maryland, Baltimore County (UMBC); The curriculum has such an excellent reputation that it is accepted as the base course for many other state and national level certification training.

Course brochure containing further information and registration form can be obtained by contacting Rick Barton in the EMS Education Department at Gundersen Health System,rkbarton@gundersenhealth.org. or by phone at (608) 775-6315.

This continuing education activity is approved by UMBC, an organization accredited by the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS).

Course brochure containing further information and registration form can be obtained by contacting Rick Barton in the EMS Education Department at Gundersen Health System,rkbarton@gundersenhealth.org. or by phone at (608) 775-6315.

PAAW Plans on 2014 Momentum Continuing in New Year

PAAW Administrator — Mon, 22 Dec 2014 20:17:54 GMT

On December 1, the Professional Ambulance Association of Wisconsin’s Board of Directors, members, consultants, and invited guests met for a daylong meeting in Madison to review and discuss the Association’s current work plan.

During the six-hour meeting many items of success were highlighted, as well as areas to continue pressing forward and identification of new opportunities. The Association will announce its 2015 - 2016 work plan in the coming months.

The last time the Association met to formally write its strategic plan was July 2010. The previous plan served the Association well in strengthening its brand and message, member communications, adding and retaining the services of two lobbyists, pursuing a stronger EMS and legislative agenda, continuation of the Stars of Life awards program and more.

The last time the Association met to formally write its strategic plan was July 2010. The previous plan served the Association well in strengthening its brand and message, member communications, adding and retaining the services of two lobbyists, pursuing a stronger EMS legislative agenda, continuation of the Stars of Life awards program and more.

State EMS Director Job Re-posted

PAAW Administrator — Thu, 11 Dec 2014 14:10:58 GMT

The Wisconsin Department of Health has re-posted the State EMS Director position. The position was initially posted this past June, but since then and now the EMS Office has been upgraded from a unit to a section. This change became effective October 1. With that change also comes a pay grade increase, since the state EMS director position is also considered a section chief. The salary is negotiable based on qualifications, but the range listed is from $54,876 to $90,548.

For more information or to apply, click here. The job posting date closes December 16.

AED Ambulance Drone on the Way!

PAAW Administrator — Fri, 21 Nov 2014 17:52:19 GMT

A Dutch engineer has created a flying defibrillator for emergency situations. The drone, called the Ambulance Drone, could be stationed at various points in a city. In an emergency, people on the scene can call it in and it arrives a few seconds later. The built-in defibrillator unit can be used by anyone and it allows doctors to monitor the situation after the shocks are administered.

The drone includes a webcam and loudspeaker and allows remote doctors to walk people on the scene through the process of attaching the electrodes and preparing the defibrillator.

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The creator, Alec Momont of TU Delft’s Faculty of Industrial Design Engineering, said that 20% of people can operate a defibrillator without instruction and the number rises when they have prompts from trained personnel.

In the engineer’s home country some 800,000 people suffer a cardiac arrest in the EU every year, and only 8% survive,’ Momont explains. ‘The main reason for this is the relatively long response time of the emergency services (approx. 10 minutes), while brain death and fatalities occur within 4 to 6 minutes. The ambulance drone can get a defibrillator to a patient inside a 12 km zone within one minute. This response speed increases the chance of survival following a cardiac arrest from 8% to 80%.’

The system is still in prototype stage but there is a good chance it could be launched in five years for about $20,000 each. Drones are still not allowed to fly autonomously so they can’t wing their way around downtown Delft with their helpful payload… yet. It will be interesting to see these robots flying around one day, dropping first aid when needed.

Source: Techcrunch.com

Northwest Wisconsin Ambulance Services to Join Mayo Gold Cross

PAAW Administrator — Tue, 18 Nov 2014 15:23:07 GMT

Mayo Clinic Health System Northwest Wisconsin region’s Ambulance Services will become part of Gold Cross Ambulance on Thursday, Jan. 1. This change affects Ambulance Services based in Barron and Osseo.

The integration will be reflected by changes in reporting structure and rebranded vehicles and employee uniforms during the first quarter of 2015. Ambulance Services employees will continue to be based at the Barron and Osseo hospitals, and their job tasks and responsibilities throughout the hospitals will remain the same. Mayo Clinic Health System and Gold Cross employees will remain Mayo Clinic employees. No employee will lose his or her job as a result of the integration.

This transition is the result of ongoing integration over the past 10 years and is similar to other integration throughout Mayo Clinic Health System, such as Information Technology and the ambulance service in Mayo Clinic Health System in Albert Lea, Minnesota joining Gold Cross in 2013.

“The goal is to reduce the effort and liability we have invested in operating a stand-alone ambulance service at Mayo Clinic Health System in Barron and Osseo by relying on Mayo Clinic’s ambulance service to provide infrastructure and expertise,” says Rita Sullivan, Administration. “This is more than a change in uniform and ambulance branding. It’s an integration of our patient care and safety culture at a time when Mayo Clinic is positioning itself for health care reform.”

This integration allows for coordinated medical direction and protocols, fleet management, materials management and other quality and safety initiatives.

The Northwest Wisconsin Gold Cross team will be led by Kirk Gunderson, Gold Cross. He will work with closely with operational leadership in Barron and Osseo.

Barron and Osseo’s ambulance services began serving their communities in 1966 and 1971, respectively. Gold Cross, which began operations in 1962 and became part of Mayo Clinic in 1994, has served the Eau Claire region since 1995. Gold Cross is a service of Mayo Clinic Medical Transport, which also includes Mayo One, Mayo MedAir and the Mayo Emergency Communications Center. Together, the team offers 143 years of emergency medical service and experience.

Northwest Wisconsin Ambulance Services to Join Mayo Gold Cross

This integration allows for coordinated medical direction and protocols, fleet management, materials management and other quality and safety initiatives.

The Northwest Wisconsin Gold Cross team will be led by Kirk Gunderson, Gold Cross. He will work with closely with operational leadership in Barron and Osseo.

Gold Cross Ambulance in Menasha names new CEO

PAAW Administrator — Mon, 17 Nov 2014 15:19:47 GMT

Mark Fredrickson has been named the new executive director at Gold Cross Ambulance in Menasha (Appleton). Fredrickson will replace Jack Hill, who will retire Jan. 31 after 29 years at Gold Cross. Fredrickson will assume his new role Feb. 1.

“Three years ago we developed a strategic plan for succession and enlisted outside experts to help guide us,” Thomas Veeser, Gold Cross Ambulance Service board president and chief nursing officer at Affinity Health System, said in a statement. “The board agreed Mark is the right person to succeed Jack and continue to move Gold Cross forward as the leader in providing the best in EMS care in northeast Wisconsin.”

Fredrickson began with Gold Cross 25 years ago as a paramedic. He has been operations director since 2000. He serves on the Wisconsin EMS Board, where he was recently appointed by Gov. Scott Walker to a fourth three-year term. He also serves on the board of the North Central EMS Institute, and is a co-founder, past president and current board member of the Professional Ambulance Association of Wisconsin (PAAW).

A search is underway for Fredrickson’s successor as the operations leader.

Gold Cross provides paramedic-level care for 911 medical emergencies and non-emergency transport services to more than 260,000 people in portions of Outagamie, Winnebago, Calumet and Waupaca counties, responding to more than 17,000 calls each year. It is jointly owned by Affinity Health System and ThedaCare.

River Falls EMS to take over Prescott Ambulance's service area

PAAW Administrator — Fri, 14 Nov 2014 14:35:37 GMT

Starting Jan. 1, the Prescott Ambulance Service will be consolidated with the River Falls Emergency Medical Services.

"By combining the strengths of both organizations, we can offer a higher level of service to Prescott and surrounding communities," said Joe Rohl, Prescott Fire and EMS Association president. "While Prescott EMS has been an exceptional partner to our communities, we felt now was the time to expand on our services. Consolidating with River Falls (EMS) will allow us to provide additional services to the region."

The Wisconsin Emergency Medical Services Regulatory Board licenses Prescott as an Advanced EMT ambulance service.

Under its consolidation with River Falls, River Falls EMS will assume the ambulance license, upgrade the license to Critical Care Paramedic and perform all operational duties and be accountable to the Prescott Area Fire and EMS Association.

"We are honored and excited to be the EMS partner for the city of Prescott," said Jeff Rixmann, River Falls EMS Director. "In many ways, EMS providers are on the front line when it comes to public health.

“We are committed to providing the tools, talents, and technology to enhance the exceptional care your communities already receive."

"We look positively towards teaming with Prescott to jointly provide the best patient care to the residents going forward."

To ensure continuity of service, River Falls will hire the Prescott (EMS) employees who wish to work for River Falls EMS.

The Emergency Medical Services will continue to operate out of the existing Prescott Facility, with additional support coming from River Falls.

River Falls EMS provides Critical Care Paramedic level services for the residents in the city of River Falls and Prescott, and towns of Clifton, Oak Grove, and River Falls in Pierce County, and towns of Pleasant Valley, Kinnickinnic, Troy and Warren in St. Croix County.

River Falls EMS serves some 45,000 people and has a rural service coverage area of 220 square miles.

Source: River Falls Journal

Community Paramedicine Webinar

PAAW Administrator — Wed, 12 Nov 2014 14:38:40 GMT

The November Community Paramedicine Insights Forum will feature a CP program in Colorado which was one of the three first round CMS Innovation grant awardees, and which has found ways to utilize telemedicine services in its patient care.

The guest speaker is Becky Sproul, a community paramedic who coordinates the CP program and telemedicine services for the Pagosa Springs Medical Center, a critical access hospital. She will also offer some insight about the support and interest of the CMS staff with whom she has extensively interacted in the development of community paramedicine.

The webinar will be at 2 PM Central Time on Monday, November 17th.

If you wish to attend the webinar, please go to http://cpif.communityparamedic.org and register. You will receive webinar sign on information by Monday morning for the afternoon show.

The webinar is sponsored by the National Association of State EMS Officials.

Ventilator Recall

PAAW Administrator — Sun, 09 Nov 2014 14:40:00 GMT

On November 9, the Wisconsin EMS Office emailed the attached document for an important ventilator recall.

If your service(s) are currently using these ventilators for inter-facility transports, please follow the link to see if your ventilator is one that is designated under the recall.

If your ventilator is included, do not use it for patient care until the software issue can be remedied.

NASEMSO and NHTSA to Develop a Set of EMS Performance Measurements

PAAW Administrator — Mon, 03 Nov 2014 14:42:08 GMT

The National Association of State Emergency Medical Services Officials (NASEMSO) announced today a cooperative agreement with the National Highway Traffic Safety Administration (NHTSA) to develop a comprehensive set of EMS performance measures.

“We’re excited because measuring performance is the first step toward improving it,” said NASEMSO Executive Director Dia Gainor. “Developing a set of performance measures will give EMS agencies across the country the ability to ensure they are providing high-quality, patient-centered care. We see this as a huge opportunity to transform how we do EMS in this country.”

The two-year project, funded by NHTSA, will engage a wide range of EMS stakeholders to develop performance measures that are relevant to EMS agencies, regulators, and patients. The measures will be based on the latest National EMS Information System (NEMSIS) version data and will allow local and state EMS agencies to use their own data meaningfully. The project will facilitate an inclusive and open development process, with participation from dozens of EMS and healthcare experts and organizations and multiple opportunities for input and public comment.

“NHTSA is very pleased to be partnering with NASEMSO and with EMS providers across the United States on this project,” said Drew Dawson, director of the NHTSA Office of EMS. “This is the next step in helping EMS, from ambulance services and other emergency medical services, to government agencies, and ultimately the communities and patients they serve.”

Wisconsin EMS Office Upgraded to "Section" Status

PAAW Administrator — Sat, 25 Oct 2014 14:31:39 GMT

According to the State of Wisconsin EMS website, the EMS office underwent a status change, effective October 1, 2014. Formerly considered an “EMS Unit” these past few years, the office was upgraded and reinstated to its former classification as “Section”, and is referred to the “EMS Section” within state government.

While the move doesn’t bring back the glory years dating back to the late 1990’s and early 2000’s when the EMS office was considered a “Bureau”, the move to Section is nonetheless welcomed.

As flu season starts, Ebola fear may fill emergency rooms

PAAW Administrator — Thu, 16 Oct 2014 19:37:15 GMT

As Ebola ignites fear of a widespread outbreak, it's easy to overlook the fact that a common illness actually poses a far more serious threat to thousands of people in the U.S. Every year the flu kills between 3,000 and as many as 49,000 Americans, the Center for Disease Control and Prevention reports.

Flu season starts in October, and it remains to be seen how severe this year's flu season will turn out to be. But even in a mild year, the flu takes a deadly toll.

"The flu is easy to dismiss, especially among young healthy adults who think that they can just 'fight' the illness," Dr. Sudip Bose, an emergency medicine physician and former U.S. army doctor told CBS News. Even so, "Influenza A can wipe out the most vulnerable patients, including children, senior citizens and people with medical conditions."

Ninety percent of flu-related deaths are among people age 65 or older. Young children are also at risk; during the 2012-2013 flu season, 169 children died, according to the CDC.

Emergency room doctors normally see a 10 percent increase in the number of patients during cold and flu season. But this year they're expecting to see a much bigger influx of people worried that their flu-like symptoms could be something they've seen on the news.

"Due to the nature of what's going on in the community and also in the world, especially with Ebola and enterovirus," the uptick in patients would not be surprising, said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York.

Glatter says hospitals like his are taking steps to be prepared for whatever walks through the door. "We have all protocols in place to isolate people, whether it's concern for Ebola or flu, we're always prepared," he told CBS News' Marlie Hall.

Initial symptoms of the two illnesses can look similar: fever, aches and fatigue. In order to tell the difference, one of the key factors medical staff will be looking for is a patient's travel history -- whether a person had recently been in one of the West African countries where Ebola is more widespread.

"The kinds of illnesses they could have are directly influenced by where they've been," Glatter explained.

Ebola is transmitted only through contact with the bodily fluids of someone who's sick and exhibiting symptoms of the disease, which progress to gastrointestinal illness and sometimes hemorrhaging, experts say. It has a fatality rate ranging from 50 to 90 percent.

The flu, by contrast, is far less lethal but much more easily transmissible. The flu virus can go airborne and spread through coughing or sneezing, as well as by touching contaminated surfaces or even shaking hands.

Complications of the flu can include bacterial pneumonia, ear infections, sinus infections, and the worsening of more severe conditions like asthma, heart failure and diabetes.

To stay out of the ER or doctor's office with a case of the flu this season, now is the time to get vaccinated, health officials say. Flu shots or nasal sprays are readily available and usually effective.

"Many people don't get vaccinated because they think that the immunization gives them the flu," said Dr. Randy Wexler, associate professor of family medicine at The Ohio State University Wexner Medical Center. But that is a misconception, he said. "[Vaccinations] may cause achiness and fatigue, but they do not cause the flu."

Wexler added that elderly often forgo vaccinations, even though they're at risk for more serious complications. "Add it all up, and a lot of people, particularly those at risk, do not take the best precaution which is vaccination."

"At the end of the day, focus on the bigger responsibility," warns Bose. "Flu prevention is not just about you. [Getting vaccinated] can prevent grandma or babies from getting sick too."

The CDC lists several flu vaccine options for the 2014-2015 flu season. It notes that traditional flu vaccines, made to protect against three different flu viruses (called "trivalent" vaccines), and flu vaccines made to protect against four different flu viruses (called "quadrivalent" vaccines) are both available. Good hand-washing habits and using hand sanitizers can also cut down on the spread of the flu virus.

"The take-home message is that the flu is preventable," said Dr. Matthew Levy of John Hopkins Emergency Medicine unit. "Although the flu receives far less attention [than Ebola], it's a much bigger threat."

Source: CBS Interactive Inc.

Ebola Webcast for EMS/Police on Friday

PAAW Administrator — Thu, 16 Oct 2014 19:35:08 GMT

On Friday October 17, 2014 at 2:00pm, the Division of Public Health will host a webcast for healthcare agencies and Emergency Medical Services (EMS) to provide information on preparing for and responding to Ebola, which will include a brief situation update as well as time for questions and answers.

Here is the webcast link: http://dhsmedia.wi.gov/main/Play/b990f09390c1495fab0ebad6cfdc067b1d

The session will be recorded and archived. Once the webcast concludes please use the above link to view the recorded session.

The Department of Health Services continues to work with local public health agencies, the Centers for Disease Control and Prevention (CDC), hospitals, EMS, emergency management, medical examiners and coroners, and other partners to prepare for potential Ebola cases.

Orange Cross, Plymouth Ambulance Announce Merger

PAAW Administrator — Wed, 15 Oct 2014 14:20:19 GMT

Orange Cross Ambulance Service and Plymouth Ambulance Service have merged into one company that will serve the City of Sheboygan, surrounding communities and the western part of Sheboygan County.

The merger, announced Thursday, was effective Wednesday, Oct. 1.

Andy Bagnall, president and CEO of St. Nicholas Hospital and the president of Orange Cross, said the merger came about after months of talks between the two organizations.

“We have the same role in our distinct communities,” Bagnall said. “We realized quickly we can be pretty strong together through shared services, shared structures.”

Terry Abler, president of Plymouth Ambulance Service, was not available for comment. But in a press release, Abler said the merger will help both ambulance services stay strong into the future.

“By coming together, we will enhance the quality of service we provide to the City of Plymouth and western portion of Sheboygan County,” he said. “We can ensure longterm sustainability by streamlining operations, taking advantage of shared services and providing long-term financial strength for our communities.”

Orange Cross Ambulance Service began in 1979, operates as a 50/50 joint venture of Aurora Health Care and St. Nicholas Hospital and provides paramedic-level, critical care ambulance service. Plymouth Ambulance Service has been in service for more than 20 years.

Orange Cross will retain its locations in Sheboygan and Plymouth, and it will continue to be a non-profit entity.

During the transition period, which will take several months, Plymouth Ambulance Service will retain its logo on ambulances.

Eventually, the logo and the name will be phased out and the Plymouth Ambulance Service corporation will be dissolved, Bagnall said.

As part of the transition, an advisory committee made up of members of the defunct Plymouth Ambulance Service board of directors will monitor how well the new service is being received and advise Orange Cross on improvement, Bagnall said.

Orange Cross averages 3,600 runs per year and has 31 employees. Plymouth Ambulance averages 1,700 runs per year and has 36 employees.

Currently, Bagnall said, there are no plans to cut the number of employees from either organization.

“As of right now, we’re not looking at that,” he said. “We’re really focused on merging, trying to figure out how to have the two cultures combine. We have a lot more similarities than differences.”

Source: Sheboygen Press

Sports cars to speed up paramedics' response times to emergencies in Dubai

PAAW Administrator — Wed, 15 Oct 2014 14:19:39 GMT

Paramedics in Dubai will soon be able to speed to the scene of traffic accidents and other emergencies in a high-powered sports car that can hit 260kph (or 161 mph), dramatically reducing response times.

The two-seater was unveiled at the Gitex Technology Week at the Dubai World Trade Centre on Sunday. The car is equipped with most of the same emergency and first-aid equipment that is carried in a regular ambulance.

“We can handle all kinds of emergencies,” said Zaid Al Mamari, a paramedic with the Dubai Corporation for Ambulance Services. “It is fitted with a responder bag, suction unit, foam splints for fractures, cardiac defibrillators and oxygen bags.”

The vehicle also carries a mobile data terminal to key in patient data and vital stats that can be transmitted to hospitals ahead of a regular ambulance arriving at the scene.

Two more Ford Mustangs will be added to the fleet of First Responder vehicles. Currently, the response time for a regular ambulance is eight minutes, but officials said the target time for all ambulances, including the sports car, was under four.

Source: The National

CDC releases EMS checklist for detecting, managing Ebola

PAAW Administrator — Mon, 13 Oct 2014 14:29:12 GMT

The guidelines highlight key areas to enhance overall preparation and response to potential or diagnosed Ebola patients

The Centers for Disease Control and Prevention recently released a checklist aimed at preparing EMS agencies to recognize and treat patients with Ebola.

Highlights include:

Train all EMS personnel on how to identify signs and symptoms of Ebola infections and to avoid risk of exposure
Consider travelers with fever, fatigue, vomiting and/or diarrhea and returning from affected West African countries as potential cases, and obtain additional history.
Post screening criteria in conspicuous locations in EMS units, at EMS stations, and in other locations frequented by EMS personnel (see suggested screening criteria).
Designate points of contact within their EMS organization/system responsible for communicating with state and local public health officials. Remember: Ebola must be reported to local, state, and federal public health authorities.
Conduct a detailed inventory of available supplies of PPE suitable for standard, contact, and droplet precautions. Ensure an adequate supply, for EMS personnel, of:
- Fluid resistant or impermeable gowns
- Gloves
- Shoe covers, boots, and booties
Maintain an appropriate combination of the following:
- Eye protection (face shield or goggles)
- Facemasks (goggles or face shield must be worn with facemasks)
- N95 respirators (for use during aerosol-generating procedures)
- Other infection control supplies (e.g. hand hygiene supplies).
Ensure procedures are in place to require that all EMS personnel accompanying a patient in a transport unit are wearing (at minimum): gloves, gown (fluid resistant or impermeable), eye protection (goggles or face shield), and a facemask
Review, develop, and implement plans for: adequate respiratory support, safe administration of medication, and sharps procedures; and reinforce proper biohazard containment and disposal precautions
Plan for regular situational briefs for decision-makers, including:
- PUI for Ebola who have been identified and reported to public health authorities
- Isolation, quarantine and exposure reports
- Supplies and logistical challenges
- Personnel status
- Policy decisions on contingency plans and staffing

Read the full checklist

FY15 Rural Health Care Services Outreach Grant Program

PAAW Administrator — Tue, 07 Oct 2014 17:31:06 GMT

The Federal Office of Rural Health Policy (ORHP) is pleased to announce that the FY15 Rural Health Care Services Outreach Grant Program funding opportunity announcement (announcement number: HRSA-15-039) is now available. To access the application package and learn more about the funding opportunity announcement, please click on: http://www.grants.gov/view-opportunity.html?oppId=264030 (look under ‘application package’ tab)

BRIEF SUMMARY (Refer to HRSA-15-039 funding opportunity announcement for more details and information)

A. Eligibility criteria

The lead applicant must be a rural non-profit or rural public entity that represents a consortium of at least 3 health care providers.

B. Purpose and Goals of FY15 Outreach grant program:

The purpose of this grant is to improve outreach and service delivery in local and regional rural communities. The goals for the Outreach Program are the following:

o Expand the delivery of health care services to include new and enhanced services exclusively in rural communities

o Deliver health care services through a strong consortium, in which every consortium member organization is actively involved and engaged in the planning and delivery of services

o Utilize and/or adapt an evidence-based or promising practice model(s) in the delivery of health care services

o Improve population health, demonstrate health outcomes and sustainability

C. Award amount:

o Applicants can request up to $200,000/year for three years.

D. Deadline to apply:

o The deadline to submit an application in www.grants.gov is November 14, 2014. ORHP strongly recommends that applicants submit their applications prior to the due date to avoid any technological problems. All applications have to be submitted electronically in www.grants.gov and waiver requests to submit a paper copy application will not be accepted.

E. Technical assistance webinar:

There will be a technical assistance webinar on Wednesday, September 24, 2014 from 1:00-2:30pm EDT to assist applicants in preparing their applications. The technical assistance webinar is open to the general public. The purpose of the webinar is to go over the funding opportunity announcement, and to provide any additional or clarifying information that may be necessary regarding the application process. There will be a Q&A session at the end of the webinar to answer any questions. While the webinar is not required, it is highly recommended that anyone who is interested in applying for the FY15 Outreach Program plan to listen to the webinar. It is most useful to the applicants when the funding opportunity announcement is easily accessible during the call and if questions are written down ahead of time for easy reference.

Call-in number (for audio): 888-282-9630 // passcode: 1632772

URL (for web): https://hrsa.connectsolutions.com/fy15_outreach_foata/

Prior to joining, please test your web connection: https://hrsa.connectsolutions.com/common/help/en/support/meeting_test.htm.

Note: You must dial into the conference line to hear the audio portion of the webinar. No registration is required. To access the webinar recording, visit http://www.hrsa.gov/ruralhealth/about/community/careservicesoutreach.html.

FY15 Rural Health Care Services Outreach FOA program contact:

Linda Kwon, MPH

Rural Health Care Services Outreach Program Coordinator

Office of Rural Health Policy

Telephone: (301) 594-4205

E-mail: lkwon@hrsa.gov

Wisconsin's STEMI Coordinators Request EMS Input

PAAW Administrator — Mon, 06 Oct 2014 16:59:12 GMT

The Wisconsin STEMI coordinators group met on October 3 in Janesville. The group met to discuss statewide STEMI efforts, statewide benchmarks and recent convers ations at the State Capitol. In addition, the group sought input from EMS representatives.

PAAW President Patrick Ryan was invited to speak at the meeting. He offered this comment afterwards, "We appreciate the STEMI coordinators' invitation. It is great to see them include EMS in their statewide planning, since ambulance services are an important and essential part to developing any successful statewide program."

Medicare Ambulance Access, Fraud Prevention and Reform Act of 2014 Introduced in U.S. House of Representatives

PAAW Administrator — Tue, 30 Sep 2014 17:28:29 GMT

The Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2014 (H.R. 5460) was recently introduced in the U.S. House of Representatives. The bill would make several key reforms to the Medicare ambulance fee schedule including as of April 1, 2015 the permanent extension of the current temporary Medicare 2% urban, 3% rural and super rural add-on payments.

“In developing H.R. 5460, Congressmen Greg Walden (R-OR), Peter Welch (D-VT), Devin Nunes (R-CA) and Richard Neal (D-MA) developed a sensible and bipartisan approach to addressing below cost Medicare reimbursement of ambulance service providers and implementing important reforms,” said Jimmy Johnson, AAA President. “This is the most significant legislation on Medicare reimbursement and policy since the Balanced Budget Act of 1997 and the creation of the Medicare ambulance fee schedule.”

In addition to making the current relief permanent, H.R. 5460 would:

Implement prior authorization for Basic Life Support (BLS) non-emergency ambulance transports to and from dialysis centers,
Change the status of ambulance service suppliers to provider.
Direct the Centers for Medicare and Medicaid Services (CMS) to collect ambulance cost data using a survey methodology.

“Ambulance service providers and our paramedics and EMTs are often the health care professionals to first come into contact with a patient and we are providing state-of-the-art medical care to ensure better patient outcome,” said Johnson. “H.R. 5460 will not only address several of the current issues facing our profession but also put us on a path for Congress to make data-driven decisions on the future role ambulance service providers will play in our changing health care system.”

Source: American Ambulance Association

Ex-Sullivan EMS officials free on signature bond

PAAW Administrator — Tue, 30 Sep 2014 14:16:30 GMT

Two former Sullivan Emergency Medical Service members charged with theft and misconduct in public office were released on $10,000 signature bonds on Tuesday, September 16.

Kimberly Heine and Richard Heine, of Helenville, the former deputy chief and chief of Sullivan EMS, respectively, are accused of fraudulent actions relating to funds and property associated with the former emergency medical service.

The couple appeared before Jefferson County Circuit Court Judge Jennifer Weston to face the charges, including one count each of theft-false representation over $10,000 and misconduct in office-fraudulent records/statement. In addition, Kimberly Heine is charged with one count of identity theft for financial gain.

If convicted, Kimberly Heine faces a combined maximum sentence of 19 1/2 years in prison and fines of more than $45,000, while Richard Heine could be sentenced to a maximum of 13 1/2 years in prison and fines totaling more than $35,000. A pre-trial conference at the District Attorney’s Office was scheduled for Wednesday, Oct. 15.

The Heines are not to work for any ambulance or EMS service, but were granted permission to continue operating their medical transportation business called Sullivan Prestige Ambulance Inc. or Prestige Transports, as long as they only are paid directly by the users of that service and not handling the clients’ accounts. As ordered, they are not to engage in any business in which they are entrusted with someone else’s money.

According to the criminal complaint, the theft and misconduct in office offenses allegedly committed by the pair occurred between January 2011 and June 30, 2012. The single count of identity theft for financial gain charged against Kimberly Heine relates to her alleged use of the Sullivan EMS phone number from July 3, 2012, to August 20, 2012.

The Jefferson County Sheriff’s Office was contacted by the Sullivan EMS Secretary/Treasurer Nancy Emons about the service’s telephone number being disconnected and ported to a personal U.S. Cellular account in the name of Kimberly Heine in August 2012.

The couple had been suspended from their duties within Sullivan EMS on June 23, 2012, pending the outcome of an internal investigation and audit. The suspension had been the result of allegations that the pair had mismanaged funds and assets at Sullivan EMS as chief (Richard) and deputy chief (Kimberly) and administrative assistant.

Kimberly Heine did all the recordkeeping as part of her duties as administrative assistant, including payroll.

The Sullivan EMS Board of Directors voted to terminate the couple’s employment on July 3, 2012, and on July 9, Emons reportedly contacted the telephone company asking it to remove the pair as authorized persons on the account, the complaint said.

The board believed Heine was attempting to start her own emergency transport company using the Sullivan EMS telephone number.

Kimberly Heine admitted to authorities of taking possession of the phone number “due to the fact that Sullivan EMS had abandoned the number.”

According to the complaint, she said members of Sullivan EMS had asked her to find a way to cut the phone bill and that they were aware that the phone number in question would be cancelled to reduce the bill.

Emons reportedly countered that a conversation about reducing the phone bill was held; however, “cancelling the main phone line was never an option.”

Kimberly also allegedly admitted in an interview with detectives that her new transport company, Sullivan Prestige Ambulance, was providing inter-facility transportation, which Sullivan EMS no longer provided, and that people contacting her at the stolen Sullivan EMS number for this service could get it through her company, the complaint said.

Under Federal Communications Commission requirements, a tax identification number was required for control of the phone number.

Kimberly stated that a U.S. Cellular employee provided the tax identification number, but she admitted that she and her husband had access to the Sullivan EMS tax identification number because it was stored in their home, according to the complaint.

The mentioned U.S. Cellular employee denied providing the tax identification number, stating in the complaint that he only had access to the last four digits of the number.

Even after the number had been returned to Sullivan EMS, investigators attempted to contact Kimberly using a phone number she provided and in reaching her voicemail found she was still representing herself as being affiliated with Sullivan EMS.

Further investigation related to the Heines’ alleged illegal runs by Sullivan EMS that were not reported to LifeQuest, the processor for Sullivan EMS.

Kami Warren, former Sullivan EMS chief, provided documentation which details a total of 533.25 runs Kimberly submitted to Sullivan EMS payroll, but not to LifeQuest. By statute, all runs by Sullivan EMS had to be reported to LifeQuest.

According to the complaint, Warren’s documentation also showed 499 runs reported by Richard Heine to Sullivan EMS, but not to LifeQuest.

Reports show that Sullivan EMS overpaid Kimberly Heine $13,647.50 for runs and Richard by $13,514.75.

It was further noted that “at no time was Kimberly approved to receive $1,250 per month as a regular monthly stipend.”

Kimberly was appointed as both deputy chief of inter-facility and administrative assistant beginning Sept. 1, 2011, with a total monthly stipend of $700.

Payroll summaries in the complaint show that Kimberly received a stipend in excess of $17,503 from January 2011 to June 2012.

When confronted with the allegations, the Heines defended the unaccounted-for runs, citing that LifeQuest would deny runs because they were not medically necessary or that runs were not billed because they were submitted through the Sentimental Journeys program.

The couple also said runs would go unreported if they lasted more than two hours, the complaint said.

Source: Ryan Whisner, Daily Union regional editor

Jack Hill Named Wisconsin Honorary Star of Life

PAAW Administrator — Thu, 18 Sep 2014 17:24:50 GMT

On September 17, Jack Hill, executive director at Gold Cross Ambulance Service, headquartered in Menasha, was named 2014 Wisconsin Honorary Star of Life and Lifetime Member of the Professional Ambulance Association of Wisconsin.

The award was presented by the Professional Ambulance Association of Wisconsin where Hill is treasurer and serves on the board of directors. Governor Scott Walker acknowledged the moment by providing Hill with a certificate of appreciation for his many years of service to citizens of Wisconsin. The award presentation and recognition dinner was held at Tundra Lodge in Green Bay during the annual Paramedic Systems of Wisconsin Conference. Several Gold Cross Ambulance employees, pictured with Hill, attended the program to celebrate the occasion.

During his 21 years of leadership, Gold Cross has grown from 60 employees to more than 160, and from 8 ambulances to 17. The company has incorporated new technologies and clinical care protocols while he’s been at the helm, and has expanded to become a regional service covering 1,200 square miles of Outagamie, Winnebago, Calumet and Waupaca counties, serving more than 260,000 people.

As a part-time police officer in mid-1976 in his home town of Hoyt Lakes, MN, Hill got a taste of the career that would eventually become his passion. He was hired at Gold Cross in 1985 as a paramedic, when he decided to turn his volunteer EMS work into a career. Today, looking back over 29 years with Gold Cross, he remains committed to the quality, efficiency, dedication, compassion and professionalism that characterize the company and his life.

In early 2015, Jack and Noi Hill will live part-time in Thailand, spending time with family, enjoying a life of retirement and new adventures.

(Picture insert, left to right, Professional Ambulance Association of Wisconsin President Patrick Ryan, Jack Hill, Noi Hill)

Ambulance Company Manager Pleads Guilty in $5.5 Million Medicare Fraud Conspiracy

PAAW Administrator — Tue, 16 Sep 2014 17:45:21 GMT

WASHINGTONundefinedThe general manager of a Southern California ambulance company pleaded guilty yesterday in Los Angeles to conspiracy to commit Medicare fraud, conspiracy to obstruct a Medicare audit, and making materially false statements to law enforcement officers.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, Acting U.S. Attorney Stephanie Yonekura of the Central District of California, Special Agent in Charge Glenn R. Ferry of the Los Angeles Region of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and Assistant Director in Charge Bill Lewis of the FBI’s Los Angeles Field Office made the announcement.

Wesley Harlan Kingsbury, 34, of Bloomington, California, pleaded guilty to the charges before U.S. District Judge Dale S. Fischer. Sentencing is scheduled for Feb. 9, 2015.

According to court documents, Kingsbury was the general manager of Alpha Ambulance Inc., which specialized in the provision of non-emergency ambulance transportation services to Medicare beneficiaries, primarily to and from dialysis treatments. Between April 2010 and July 2012, Kingsbury conspired with Alex Kapri and Aleksey (Russ) Muratov, the owners of Alpha Ambulance, as well as the training supervisor Danielle Medina, to bill Medicare for ambulance transportation services for individuals that Kingsbury knew did not need to be transported by ambulance. In addition, as general manager, Kingsbury instructed emergency medical technicians (EMTs) that worked at Alpha Ambulance to conceal the true medical condition of patients they were transporting by altering requisite paperwork and creating false reasons to justify the transportation services.

In early 2012, Medicare notified Alpha Ambulance that the company would be subject to a Medicare audit. In response, Kingsbury and his co-conspirators altered patient documentation to create false justifications for the ambulance transportation services. Kingsbury and others used light tracing tables to trace over original documents and create falsified patient documentation for the purpose of sending those falsified documents to Medicare, and then they used a paper shredder to destroy the original patient documents.

Kingsbury and his co-conspirators submitted $5,522,079 in fraudulent claims to Medicare, and Medicare paid $1,338,413 on those fraudulent claims.

Further according to court documents, in April 2012, Kingsbury was approached by law enforcement officers and was asked to assist with the investigation into Alpha Ambulance. Kingsbury disclosed to the owners of Alpha Ambulance the names of the law enforcement officers who were conducting the investigation and the questions they had asked Kingsbury about the company. On May 1, 2012, Kingsbury falsely denied to the law enforcement agents that he had previously disclosed that information to the owners of Alpha.

Kapri, Muratov and Medina pleaded guilty to conspiracy to commit health care fraud on October 28, 2013. They were sentenced to terms of imprisonment of 75 months, 108 months, and 30 months, respectively.

The case was investigated by the FBI and the Los Angeles Region of HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. The case was prosecuted by Trial Attorneys Blanca Quintero and Alexander F. Porter and Assistant Chief Ben Curtis of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

2015 Ambulance Inflation Factor Announced

PAAW Administrator — Mon, 15 Sep 2014 15:08:50 GMT

Medicare reimbursement rates will increase by 1.4% for ambulance services in 2015, but that's not the whole story. CMS is also proposing to change designations of certain zip codes from rural to urban and vice-versa in 2015, and this would affect reimbursement amounts to ambulance providers picking up in those zip codes. Moreover, unless Congress passes legislation, the urban, rural and super-rural ambulance bonus payments will expire on March 31, 2015. There are a lot of big things set to impact ambulance reimbursement in the coming year.

Source: Page, Wolfberg and Wirth EMS Attorneys

Beneficiary Signature Requirement - Positive Change

PAAW Administrator — Wed, 23 Jul 2014 12:02:05 GMT

By David M. Werfel, Attorney, American Ambulance Association

When the patient is unable to sign the form requesting payment and authorizing the release of records due to a physical or mental condition, the request may be executed on their behalf by a legal guardian, relative, representative payee or representative of an institution providing care.

Until now, the person signing on behalf of the patient was required to also list their name, address, relationship to the patient and reason the patient could not sign.

Over two years ago, I asked CMS to remove the requirement of the address, when one of the Medicare Administrative Contractors (WPS) notified ambulance suppliers the address was required. The requirement of the address of the person signing on behalf of the patient was impractical as there was no space on the 1500 form for it, no field for it on electronic claims, it was not required in the CMS Regulation (42 C.F.R. 424.36) and the industry would usually not be able to obtain it.

After many follow-ups, CMS has removed the requirement in Transmittal 2984.

Link to transmittal:
https://www.cms.gov/ Regulations-and-Guidance/ Guidance/Transmittals/ Downloads/R2984CP.pdf

In sum, the address of the person signing on behalf of the patient is no longer needed.

PAAW Appoints ACA Attorney as Consultant

PAAW Administrator — Wed, 25 Jun 2014 02:17:00 GMT

The Professional Ambulance Association of Wisconsin Board of Directors is pleased to announce they have recently appointed attorney Thomas Shorter as their consultant on health care matters, to include the Affordable Care Act. Mr. Shorter is with the firm Godfrey & Kahn in Madison.

According to PAAW President Patrick Ryan, “Mr. Shorter is highly regarded for his health care knowledge and awareness to ACA. We look forward to his expertise as we anticipate many questions about ACA and navigating it both as healthcare providers and as EMS employers. Having this relationship in place will help the Association, its members and other ambulance services that need a resource to consult.”

Mr. Shorter added, “We greatly value our new relationship with PAAW. Under the Affordable Care Act (ACA) the United States is rapidly moving towards more alignment of all health care providers, both clinically and economically. Ambulance service providers are a critical element of the system, and often the entry-point into the system. Our expertise in health care and corporate law allows us to partner with PAAW and its members to address the legal issues in the evolving healthcare landscape. We look forward to a long and relationship with PAAW.”

Mr. Shorter was also recently appointed to the Board of Directors for the American Health Lawyers Association, which is the largest national health law association in the US.

State EMS Director Job Search Posted

PAAW Administrator — Tue, 24 Jun 2014 00:25:28 GMT

The Wisconsin Department of Health Services has posted the job search announcement for the state EMS Director position.

The Emergency Medical Services (EMS) Director is responsible for managing and directing the EMS Unit staff and its programs. The EMS Director assigns, directs, and supervises projects specific or related to emergency medical services.

Responsibilities of this position include leadership, management, and coordination of a complex EMS system across the state, involving federal, state, and local governments, local service providers, hospitals, other public safety organizations, and elements from the private sector, for quality emergency medical care for all Wisconsin citizens and visitors. The EMS Director leads the enforcement activities of all EMS providers regulated by the EMS program and recommends licensure/certification for EMS providers to assure the provision of quality emergency medical services in Wisconsin. This position manages the Unit’s EMS data collection and processing operations, as well as internal quality assurance programs.

Salary is negotiable based on qualifications and will be between $22.470 and $37.076 per hour (approx $46,917 and $77,414 per year). The application deadline is July 7, 2014.

For more information or to apply, click here.

EMT and First Responder License Renewal Deadline June 30

PAAW Administrator — Tue, 24 Jun 2014 00:15:47 GMT

All current Wisconsin EMS provider licenses and certifications expire on June 30, 2014, unless you have recently renewed or been issued.

The mission of the Wisconsin Emergency Medical Services (EMS) program is to ensure that the highest quality and standards of pre-hospital emergency medical care are available to all Wisconsin citizens and visitors. Certification or licensing provides a level of protection to Wisconsin citizens and visitors, and assures that an individual holding a certificate or license has met certain minimum competencies and is authorized to practice, as defined by law. All current Wisconsin EMS provider licenses and certifications expire on June 30, 2014.

Besides holding a current Wisconsin certification and license to practice as an Emergency Medical Services provider in Wisconsin, you must also be locally credentialed with the service for which you are practicing. Licenses and certifications must be renewed prior to the expiration date of June 30, 2014, in order to continue practicing under your license. To practice as an EMT or First Responder in Wisconsin, you must have a current license/certificate and be credentialed with a service.

The 2014-2016, Provider License Renewal application is available online through E-Licensing account for the July 1, 2014, through June 30, 2016, licensing biennium. You must complete the 2014-2016, Provider Renewal application by June 30, 2014, in order to obtain a current certification or license that is valid until June 30, 2016.

All Wisconsin EMS provider applications are completed in the E-Licensing system. The important renewal dates to remember for 2014-2016, are:

November 1, 2013 through June 30, 2014 is the standard renewal period.

July 1, 2014 through December 31, 2014 is the late renewals period and incurs a $50 late renewal administrative fee (per DHS 110.16 (1) (a)).

For more information or to review the long version of this information, click here.

Questions Surround Future of State's EMS Office

PAAW Administrator — Wed, 04 Jun 2014 04:30:00 GMT

PAAW leadership to meet with DHS officials

In the next few weeks, the Professional Ambulance Association of Wisconsin will be meeting with officials at the Wisconsin Department of Health Services.

According to PAAW President Patrick Ryan, “Questions and concerns have been raised in light of recent changes at the State’s EMS Office and its future direction. We felt now was an appropriate time to contact DHS and have this important conversation, which they scheduled a time with us shortly after the letter was sent.” He added, “We’ve had productive conversations in the past with officials at DHS and feel we will again.”

The letter sent to DHS identified three areas PAAW would like to discuss, to include:

What are the short and long term plans for the Office and how will the industry’s needs be met?
What is the status of the most recent NHTSA review? Discussion on the study has seemingly been non-existent.
Concerns with the reduction in Funding Assistance Program (FAP) funds available to state providers.

As an EMS stakeholder, PAAW is committed to insuring the strength and vitality of EMS in Wisconsin through representation of its members and EMS at-large.

Field EMS Innovation Act Introduced in the U.S. Senate

PAAW Administrator — Wed, 28 May 2014 01:47:45 GMT

By Melissa M. Trumbull, Industry Relations Manager, NAEMT

On Thursday, May 22, the U.S. Senate, led by Sen. Michael Bennet (D-Colo.), Sen. Mike Crapo (R-Idaho) and Sen. Tim Johnson (D-S.D) honored our nation’s EMS practitioners during EMS Week by introducing the S.2400 Field EMS Innovation Act (Field EMS Bill) in the Senate. This bill is the companion to the Field EMS Bill introduced in the U.S. House of Representatives on February 26, 2013, as H.R. 809 by Congressman Larry Bucshon (R-Ind.).

The Field EMS Bill addresses many of the challenges EMS systems face while trying to fulfill public expectations that all who need EMS can depend upon the highest quality of care and transport to the most appropriate clinical setting. This is the first bill to seriously look at EMS issues since the 1960s, the act would improve access to essential and life-saving EMS services and better integrate EMS within the larger health care system. Regardless of the model of EMS care delivery – whether governmental, nonprofit, private or volunteer – all EMS providers fulfill an essential public function for all patients in need. This function is carried out to the best of their ability and in spite of limited resources. The Field EMS Bill puts patients first by promoting high quality and evidence-based care for all patients in need of emergency medical care.

To view the full press release, visit the NAEMT web site at www.naemt.org. To view the latest information about the Field EMS Bill, visit here.

As NAEMT President Don Lundy states “advocacy is a marathon not a sprint”, and we are surely moving closer and closer to the finish line because of your help.

The Professional Ambulance Association of Wisconsin signed on early to support the Field EMS Bill.

State of Wisconsin EMS Medical Director Position Open for Proposals

PAAW Administrator — Tue, 20 May 2014 11:39:11 GMT

The State of Wisconsin EMS Office is accepting proposals for the EMS Medical Director position until May 30th. Proposals should be sent to the Wisconsin EMS Office.

The State's current medical director, Dr. Charles Cady, has expressed interest to continue with these responsibilities and plans to submit a proposal.

The current medial director contract expires June 30, 2014.

PAAW Announces Change, Places National Emphasis on Wisconsin’s Stars of Life Program

PAAW Administrator — Wed, 14 May 2014 02:09:04 GMT

At its May meeting, the Professional Ambulance Association of Wisconsin’s Board of Directors approved a modest change to the Wisconsin Stars of Life program, as well as advancing every other year an honoree to the American Ambulance Association’s national Stars of Life event held in Washington, D.C.

Beginning in September 2015, PAAW will host the Wisconsin Stars of Life awards program every other year, allowing it to coordinate its bi-annual visit of honorees to the State Capitol. Every person nominated is presented with Wisconsin Stars of Life recognition. From the group of Wisconsin honorees, one individual will be advanced in the subsequent year as Wisconsin’s representative and presented national Stars honors, the first opportunity being March 2016 under the new timeline.

According to PAAW President Patrick Ryan, “We’ve been extremely pleased to produce the Stars event that recognizes Wisconsin’s best Emergency Medical Technicians as nominated by their local ambulance service. Stars of Life provides awareness to our profession and the dedicated service being provided by so many. We’ve wanted to be part of the national Stars program for some time; now Wisconsin will be.”

The American Ambulance Association, through generous financial support from its Foundation, will cover airfare and a majority of other costs for the Washington, D.C. event in March 2016 for the Star, Star’s guest and host (employer). This beneficial arrangement will continue to be offered every other year with PAAW’s recommendation.

Maria Bianchi, Executive Vice President for the American Ambulance Association stated, “We are extremely proud to work with PAAW and the fine job they are doing in recognizing the dedication of so many EMTs. This is such a terrific program. We are so honored to have Wisconsin included in the national Stars of Life event and awards ceremony.”

The Wisconsin Stars dinner and awards program will continue to coordinate with the opening night of the Paramedic Systems of Wisconsin conference in Green Bay. So timing lines up, there will not be a Wisconsin Stars program held in September 2014.

PAAW has produced the Wisconsin Stars of Life program since 2006, and is modeled after the American Ambulance Association national Stars program. Persons nominated by their employers all receive Wisconsin Stars of life honors and exhibit these suggested EMS workplace criteria:

Employee of the year
On-duty or off-duty service above the call of duty
Setting significant records
Significant community contributions outside of EMS

Rural Health Grant Opportunity

PAAW Administrator — Tue, 06 May 2014 01:16:29 GMT

The WI Office of Rural Health will once again offer funding in 2014-15 for community health projects through the Rural Community Grant Program. Guidelines are available at their website (http://www.worh.org/grants/wi-orh ). Any rural healthcare coalition that includes a rural hospital with fewer than 50 staffed beds is eligible to apply.

Funding is offered for both planning and implementation projects. Beginning this year, projects must address an issue identified as a priority in the partner hospital(s)’ Community Health Needs Assessment.

Proposals are due no later than July 14; late proposals will not be accepted.

The WI Office of Rural Health will host a webinar/conference call on May 14 at 10:00 to review the guidelines and answer any questions.

For more information, contact Kevin Jacobson at kmjacobson2@wisc.edu.

FDA provides update on saline drug shortage

PAAW Administrator — Tue, 29 Apr 2014 01:03:02 GMT

In response to the ongoing shortage of 0.9% sodium chloride injection (normal saline), Baxter Healthcare Corp. of Deerfield, Ill., will temporarily distribute normal saline in the United States from its Spain manufacturing facility. FDA is temporarily exercising its discretion regarding the distribution of Baxter’s saline product from Spain and Fresenius Kabi’s saline product from Norway as needed to address this critical shortage, which poses a serious threat to patients.

FDA inspected Baxter’s Spain facility where its normal saline product is made to ensure the facility meets FDA standards. FDA asks that health care professionals contact Baxter directly to obtain the product.

In addition to these sources of normal saline, U.S.-based manufacturers – Baxter Healthcare Corp., B.Braun Medical Inc., and Hospira Inc., – are currently producing and releasing normal saline. Baxter’s saline product from Spain will be distributed temporarily in addition to Baxter’s FDA-approved version that is currently manufactured and distributed in the United States.

While the shipments described above will help reduce current disruptions, they will not resolve the current shortage of 0.9% sodium chloride injection.

Preventing drug shortages is a top priority for the FDA, and we are doing everything within our authority to improve access and alleviate this shortage.

The Professional Ambulance Association continues to report and share information as it becomes available. To review Bound Tree Medical's weekly pharmaceutical backorder report, click here.

Brian Litza resigns as State EMS Chief, no longer with unit

PAAW Administrator — Sat, 26 Apr 2014 03:20:00 GMT

The following was emailed on the afternoon of April 25 by the State of Wisconsin EMS Office to EMS Stakeholders:

Brian Litza is no longer with the Wisconsin EMS Office. He has resigned effective 2014-04-24.

Jennifer Ullsvik will be taking his responsibilities on an interim basis. All communication that would normally go to Brian should be directed to Jenny. She will work with the EMS Office staff to continue to move EMS in Wisconsin forward. Her contact information is:

Jennifer Ullsvik, MS JD, Section Chief

Emergency Health Care and Preparedness

Division of Public Health

1 W. Wilson Street, Room 1150

Madison, WI 53701

Phone: 608.267.7178

jennifer.ullsvik@wi.gov

The day to day operations of the EMS Office will not change. We remain committed to the positive customer service and professionalism that the office has encouraged.

On a personal and professional level, the Professional Ambulance Association of Wisconsin wishes to extend its appreciation to Brian Litza for his leadership as State EMS Chief and Coordinator these past years. Both are demanding positions.

Since 2002, we have seen Jon Morgan, Nan Turner, Dan Williams and Brian Litza lead and later resign the State EMS Chief position. During this same time we have also seen the EMS Office be downgraded from a Bureau, to a Section, then to its current status as a Unit.

The Wisconsin EMS system includes over 17,000 licensed individuals operating as Paramedics, EMTs and Emergency Medical First Responders. In addition, there is over 750 licensed ambulance services and first responder groups, and 1,200 licensed ambulances.

New Rule Increases Air Ambulance Safety Regulations

PAAW Administrator — Sat, 12 Apr 2014 14:05:12 GMT

New rules from the Federal Aviation Administration (FAA) will have a significant impact on helicopter air ambulance services. These regulations implement new operational procedures and require additional equipment for helicopter air ambulances in response to an increase in fatal helicopter air ambulance accidents. The new rules identify four common factors in those accidents- inadvertent flight into Instrument Meteorological Conditions, loss of control, controlled flight into terrain, and night conditions.

The rule becomes effective April 22, 2014 and includes the following provisions:

Requires all helicopter air ambulance operations with medical personnel on board to be conducted under Part 135 operating rules, not just the flights involving actual transport of the patient.
Introduces new weather minimums and visibility requirements.
Mandates flight planning of terrain and obstacles.
Requires a pre-flight risk analysis focusing on characteristics of the planned flight path, flight crewmember availability to safely conduct the operation, weather, and if the flight has been rejected by another operator.
Requires that all medical personnel be given a safety briefing with information specific to helicopter air ambulance flights prior to each flight or receive eight hours of helicopter safety training every two years.
Mandates that operators with 10 or more helicopter air ambulances establish operations control centers staffed with operations control specialists.
Requires all helicopter air ambulances be equipped with both helicopter terrain awareness and warning systems by April 22, 2017 and flight data monitoring systems by April 22, 2018.
Mandates that all helicopter air ambulance pilots hold instrument ratings and demonstrate the ability to recover from inadvertent flight into instrument meteorological conditions.

The rule does not apply to public aircraft unless it operating for a commercial purpose. This means public agencies who are not paid for their services are not bound by the new rule.

Click HERE for a more detailed summary of the Final Rule.

Source: Page, Wolfberg and Wirth EMS Attorney Law Firm

Gov. Walker signs bills aimed at fighting Wisconsin heroin problems

PAAW Administrator — Thu, 10 Apr 2014 01:22:31 GMT

Gov. Scott Walker signed seven bills Monday aimed at fighting the state's growing heroin problem during stops around the state.

The new laws include ones that will allow drug users to call 911 about overdoses without fear of prosecution, expand treatment alternatives and create quicker punishments for offenders who violate the terms of their probation.

Walker signed the bills at events in Marinette, Stevens Point, Eau Claire and Milwaukee. The Marinette County Courthouse was chosen as one venue because it is in the district ofstate Rep. John Nygren (R-Marinette), who has taken a lead in drafting the measures. Nygren's daughter Cassie has struggled with heroin addiction.

Bell Ambulance in Milwaukee also served as one of Gov. Walker's stops highlighting the new law (picture insert).

"Wisconsin, like many states across the country, is experiencing a dangerous trend undefined an escalating number of cases of heroin use, addiction and overdose," Walker said in a statement. "Heroin addiction does not discriminate, and we have to take action to protect our friends, family members and neighbors who need help."

Supporters have dubbed the bills Heroin Opiate Prevention and Education, or HOPE.

"I know that our HOPE agenda isn't the 'silver bullet' to overcoming our state's heroin epidemic," Nygren said in a statement. "Rather, these seven bills are an important first step in the right direction."

The new laws will:

■ Give people immunity from criminal prosecution for drug possession if they bring a fellow drug user to an emergency room or call911 because they believe the person is suffering from an overdose.

The measure does not provide immunity for drug dealing or other serious crimes.

■ Allow any first responders to administer naloxone if they are trained. Known by its brand name of Narcan, naloxone counteracts overdoses from heroin and other opiates. Currently, only certain emergency medical technicians are allowed to administer the drug, and the bill would make it more widely available.

■ Allow communities to create programs to dispose of prescription and illegal drugs to curb abuse of substances that can lead to heroin addiction.

■ Require people to show identification to pick up prescriptions that are considered to have a high potential for abuse.

■ Create two or three state programs to help treat heroin addicts in high-need, rural areas at an estimated cost of $2 million a year.

■ Add $1.5 million in funding annually for treatment alternatives and diversion programs that focus on substance abuse treatment for those who commit crimes.

■ Implement "swift and certain" punishments for those who violate the terms of their probation or parole. Advocates say making certain punishments happen quickly helps deter those on probation from reoffending.

Source: Milwaukee Journal-Sentinel

Newest Audio Webcast Posted: Preparing Your Ambulance Service for the Affordable Care Act

PAAW Administrator — Wed, 09 Apr 2014 02:03:51 GMT

Preparing Your Ambulance Service for the Affordable Care Act

April 8, 2014 - Run Time 13:56

Guest:
Attorney Thomas Shorter
Godfrey and Kahn Law Firm
Madison, WI

The Affordable Care Act, commonly referred to as ACA or Obamacare, will influence and change EMS in ways we don’t quite know yet. Health exchanges, insurance plans and packages, health coverage mandates and so on.

Ambulance services and their respective billing companies need to draw up plans and probably make some assumptions. A few things seem to be certain. Your payer mix may change, health exchanges and insurers for your region might be different, and self-pay patient transports will likely increase as ACA deductible amounts for some plans are in the thousands of dollars.

Now is a good time to start asking questions and getting answers from your billing company and healthcare facilities and communicating your findings with your ambulance service's Board of Directors or city and town officials.

In this webcast we start asking those important ACA questions of Madison attorney Thomas Shorter. Mr. Shorter is with the law firm Godfrey and Kahn. We found him to be extremely knowledgeable in ACA. In this webcast he offers some initial guidance to ambulance services. We also start to hear some new terminology, like Accountable Care Organizations or ACOs.

Supporting Information:

A good source for exchange enrollment information: click here

About our Guest

Thomas Shorter is a shareholder in the firm's Madison office and Chair of the Health Care Team. Tom represents hospitals, physicians' groups, research institutions and health care related organizations, as well as other businesses, providing counsel on health care, corporate, labor and employment and regulatory matters.

For clients in the health care industry, Tom handles matters regarding Medicare compliance, Health Insurance Portability and Accountability Act (HIPAA), Emergency Medical Treatment and Labor Act (EMTALA), Physician Self-Referral (Stark), and Anti-Kickback.

Additionally, Tom is also called upon by other organizations to handle management-side legal corporate and employment issues, including the Family and Medical Leave Act (FMLA), Fair Labor Standards Act (FLSA) compliance, Individuals with Disabilities Education Act (IDEA), Section 504, and Americans with Disabilities Act (ADA).

This audio webcast is sponsored by:

Madsion, WI Ambulance crew helps police catch suspects after road rage stabbing

PAAW Administrator — Mon, 07 Apr 2014 14:56:34 GMT

With so many cars, driving styles and distractions these days, the Madison Police Department sees plenty of road rage cases. However, they can't remember a time where the situation ended with a stabbing.

The incident happened just before 8:00 p.m. Sunday near the corner of East Washington Avenue and Blount Street in Madison.

"The victim fully expected that he was going to be in a fight. He thought that's how this was going to resolve itself after he had been spat in the face. He was very surprised when he found out he was stabbed," Madison Police spokesman Joel DeSpain says.

Police say the spit came from 25-year-old passenger Shyloh Nelson who was riding with 26-year-old John Howard. They were arguing with the victim over a traffic issue when both drivers decided to get out of their vehicles. Both men started fighting and at one point Howard stabbed the 30-year-old victim in the torso with a knife.

"Directly behind the two vehicles that are involved in the road rage is an ambulance crew from Ryan Brothers," DeSpain says.

Not only did the crew catch the entire confrontation on their ambulance's video camera, but afterwards they rushed the victim to UW Hospital where he was treated for non-life threatening injuries. The ambulance driver and Ryan Brothers Ambulance Service don't want to comment on the situation on camera until the investigation is a little further along, but they did release this written statement Monday afternoon.

"We are proud that their quick thinking and training allowed them to assist both the victim and MPD. We thank MPD for their quick response, assistance and professionalism."

Police say the crew also helped them track down the suspects by calling police and reading the suspect's license plate information. The department is considering putting the crew members names in for a special accommodation.

Howard was arrested for first degree reckless endangerment, disorderly conduct and a warrant for heroin possession. His passenger Shyloh Nelson was arrested for disorderly conduct after spitting on the victim.

Source: WKOW TV, Madison, WI

Ambulance Medicare Relief Extended One-Year and ICD-10 Codes Delayed

PAAW Administrator — Wed, 02 Apr 2014 02:02:46 GMT

The EMS attorney firm Page, Wolfberg and Wirth shared on the afternoon of April 1, the White House reported the President just signed a bill extending the Medicare ground ambulance bonus payments until March 31, 2015 and delaying the implementation of ICD-10 codes until at least October 1, 2015.

This means that the 2% urban, 3% rural and 22.6% super-rural bonuses that were set to expire on March 31, 2014 will remain in place for another year. Ambulance services should not see any interruption in these bonus payments. In addition, the ambulance industry now has until at least October 1, 2015 to prepare for the transition from ICD-9 to ICD-10 code sets.

H.R. 4302 provides temporary relief to certain providers while Congress considers a more permanent fix to combat rising Medicare costs. In the meantime, ambulance services are already exploring new delivery models and considering non-traditional revenue sources in order to be successful in the healthcare reform era.

This delay does not mean sit and wait another year. ICD-10 codes are coming and now is the time to get prepared for ICD-10 compliance and to use this delay to get ready - like training your crews to be more focused on "specificity" in patient care documentation - which will take time to do.

Source: Page, Wolfberg and Wirth EMS Attorney Firm

ICD-10: What is it?

The Professional Ambulance of Wisconsin completed an interview in 2012 that is relevant today yet regarding a forthcoming change from ICD-9 to ICD-10, and what this change means for those who write patient care reports and do the billing. ICD-10 increases the EMS billing codes by several thousand and places significant emphasis, or "specificity", on patient care reports. Click here to listen to the interview PAAW previously completed on this topic.

CMS Announces Delay: May Impact Processing of Ambulance Claims for Payment

PAAW Administrator — Tue, 01 Apr 2014 02:02:03 GMT

On March 28, the Centers for Medicare and Medicaid Services (CMS) announced that it had instructed its Medicare Administrative Contractors to hold claims paid under the Medicare Physician Fee Schedule for the first 10 business days of April (i.e., through April 14, 2014).

CMS indicated that this delay was necessary to prevent implementation of a negative update (i.e., a cut) to the physician fee schedule that was scheduled to take effect January 1, 2014. However, the passage of the Pathway for SGR Reform Act of 2013 delayed the implementation of that payment reduction through March 31, 2014. CMS indicated the most recent delay was intended to give Congress time to pass additional legislation that would further delay these cuts.

While the announcement did not specifically mention a delay in the processing of Medicare ambulance claims, the temporary adjustments for ground ambulance (urban (2%), rural (3%), and the super-rural bonus) are also currently scheduled to expire on March 31, 2014. Therefore, ambulance services should be aware that this delay may also impact the processing of ambulance claims.

Source: American Ambulance Association

IV Fluids Backorder Situation Worsens with Baxter Action

PAAW Administrator — Thu, 27 Mar 2014 02:01:15 GMT

Large Volume IV Fluids Supply Update

IV bags continue to be on a nationwide shortage. To make matters worse, this week Baxter cancelled all existing backorders and reduced their allocation quantities. "These two action steps by Baxter will have a notable negative impact on what is already an extremely strained supply chain", according to Stacey Barksdale Price, Product Manager of IV Therapy and Pharmaceuticals at Bound Tree Medical, the nation's largest EMS product dirstributor.

The American Society of Health-System Pharmacists (ASHSP) recently shared the Intravenous solution conservation strategies document attached. Barksdale Price noted, "Be encouraged by the May / June relief timeline that is mentioned in this document. We are seeking to understand the remedial efforts taking place at the manufacturing level that supports that resolution timeline. As more information is available, we will be sure to keep you updated."

To view the latest backorder report, click here.

To listen to an EMS to the Point audio interview with Stacey Barksdale Price regarding the ongoing IV fluids and EMS pharmaceutical backorder problem, click here.

Ambulance Medicaid State Rate Survey Results Announced

PAAW Administrator — Wed, 19 Mar 2014 01:59:41 GMT

The American Ambulance Association released on March 10 its 2014 State Medicaid Rate Survey results. During the past few weeks, members of AAA’s Medicare Regulatory Committee researched the Medicaid rates paid to ambulance service providers in every state, and consolidated that information into a single reference guide.

With this year’s Rate Survey, the Committee also added a chart showing the status of crossover payments for dual-eligible patients (i.e., beneficiaries with both Medicare and Medicaid).

Federal Medicaid monies are distributed to each State, and each State is responsible for establishing a Medicaid rate paid for modes of transportation to cover its insured beneficiaries, to include ambulance transportation.

Below is a chart showing Wisconsin’s Medicaid ambulance rate and that of surrounding states from AAA's Medicaid Rate Survey.

STATE	BLS	ALS	ALS-2	PER MILE	OXYGEN	SUPPLIES
Wisconsin	$94.90	$113.88	$260.97	$5.56	$14.73	$14.73
Illinois (Lake County)	$127.34	$198.49	$198.49	$5.00	$15.05
Iowa	$69.98	$113.29		$2.16	$10.79	$4.32
Michigan	$105.32	$191.88	$191.88	$3.27
Minnesota	$206.33	$250.06	$573.13	$6.97

Prior to having knowledge of the AAA Medicaid Rate Survey, the Professional Ambulance Association of Wisconsin’s Board of Directors on January 9, 2014 identified Wisconsin’s Medicaid rates as an area of concern. Wisconsin ambulance providers have not received a Medicaid fee increase in many years. PAAW established a committee to further discuss Medicaid rates, with one potential idea being reimbursement that matches the Federal Medicare fee schedule.

PAAW also completed a webcast interview in advance of the AAA State Medicaid Rate Survey being announced. To listen to the interview with Tristan North, Senior Vice President of Government Affairs for the AAA in Washington DC, click here.

AAA members may log-in to view the 2014 State Medicaid Rate Survey by clicking here.

Source: American Ambulance Association

Ambulance Chassis Shortage Predicted Throughout 2014

PAAW Administrator — Thu, 06 Mar 2014 02:58:20 GMT

Both Ford and GM, the primary producers of chassis for our industry, will be producing fewer chassis for ambulance production in calendar year 2014.

The slowdown has already started at Ford, where a V-10 engine commodity problem has curtailed the availability of Econoline 6.8L vans and cutaways so far this year. Many ambulance manufacturers are reporting they are virtually out of both models, and that new chassis will be scarce for the foreseeable future.

The shortage will escalate in June, when Ford cutaway (Type III) production is shut down for 6 weeks due to a plant modification. In addition, the venerable Econoline van, long the workhorse of our industry, will be completely discontinued at that same time. It will be replaced by the new Ford Transit as part of Ford’s global plan.

Industry sources state that the Transit startup in a new Ford plant will be slower than planned, and that the gas powered Transit vans with the required ambulance package are not expected to be available until early calendar 2015. Diesel powered Transit vans may be available slightly earlier.

GM is also making some moves that will affect the supply of their ambulance chassis in 2014. A start up of production for a new mid-size pickup in the same GM plant that produces the G series vans and cutaways will reduce the production of those models by approximately 50% in the second half of calendar 2014. GM does not have any significant changes in their ambulance chassis models scheduled in the short term.

Supplies of Ford F cab chassis, Sprinter, International, Freightliner and Ram ambulance chassis appear to be normal, and no shortage is anticipated in those models at this time.

Source: American Ambulance Association

State of Wisconsin EMS Office Announces 2014-2016 Biennium License Renewal Process and Timeline. Deadline to complete your renewal application is June 30, 2014

PAAW Administrator — Sun, 23 Feb 2014 02:55:38 GMT

To read the long version of this memo officially released by the Wisconsin EMS Office, click here.

The mission of the Wisconsin Emergency Medical Services (EMS) program is to ensure that the highest quality and standards of pre-hospital emergency medical care are available to all Wisconsin citizens and visitors. To operate as an EMT or Emergency Medical First Responder, one must be licensed with the State of Wisconsin and credentialed with an ambulance service.

The 2014-2016 Provider License Renewal application is now available online through individual E-Licensing accounts. The Renewal application must be completed by June 30, 2014, in order to obtain a current certification or license that is valid until June 30, 2016. All current Wisconsin EMS provider licenses and certifications expire on June 30, 2014.

Important renewal dates to remember for 2014-2016:

November 1, 2013 through June 30, 2014 is the standard renewal period.

July 1, 2014 through December 31, 2014 is the late renewal period.

January 1, 2015 through June 30, 2016 is the reinstatement period.

A license or certification that has been expired for two years or more may only be reinstated by successful completion of the initial education, training and examination requirements.

As an EMS provider applicant, you will need the following information to complete the 2014-2016, EMS Provider Renewal Application on the E-Licensing system:

Your initial or continuing EMS education refresher training completed between July 1, 2012 and June 30, 2014;
Your current CPR card; and
Whether you were convicted of a felony or misdemeanor, or deferred prosecution, since your last application, or have pending charges at this time, or received a traffic violation that led to the suspension, revocation or withdrawal of your driver's license, and all required court documentation. (You will have the opportunity to upload the documents if you have them electronically.) If you cannot upload your documents into the application, you should email them to the Wisconsin EMS program at dhsemssmail@wisconsin.gov or fax them to 608-266-6391.

2014-2016, renewal instructions by provider level
2014-2016, First Responder Renewal Instructions
2014-2016, EMT Basic Renewal Instructions
2014-2016, EMT Intermediate Technician /AEMT Renewal Instructions
2014-2016, EMT Intermediate Renewal Instructions
2014-2016, EMT Paramedic Renewal Instructions
2014-2016, EMT Paramedic with Critical Care Endorsement Renewal Instructions

AAA Update: Medicare, Medicaid, Affordable Care Act and more for EMS

PAAW Administrator — Fri, 21 Feb 2014 02:54:58 GMT

Besides delivering EMS care to a community, two of the most important business responsibilities an ambulance manager has is obviously billing for services provided and daily sales outstanding (the number of days from the patient being transported to the ambulance service actually being paid). Topping the list for many is the fee structure paid by Medicare (Federal), Medicaid (BadgerCare at the State of Wisconsin), and now the Affordable Care Act through health insurance exchanges.

These three important areas are discussed in this newest webcast with Tristan North, Senior Vice President for Government Affairs at the American Ambulance Association in Washington, D.C.

Two items covered in the webcast are worth noting:

A current study is being completed to compile a ranking of state Medicaid rates paid to ambulance services. We know Wisconsin ranks low in rates paid for BLS and ALS patient transportation; however, the final results will be telling.
The Affordable Care Act appears to offer insurance plans that cover many hospital charges, but not ambulance transportation. The greater concern is some of these plan options have much higher deductibles in the thousands of dollars, possibly changing the payer mix to more self-pay patient transports. This may put an ambulance service more at risk for not getting paid for 911 and other call out requests in serving the public's emergency or medical needs.

To listen to the webcast, click here.

EMS Leadership Academy- Registration Now Open

PAAW Administrator — Tue, 11 Feb 2014 02:52:58 GMT

The EMS Leadership Academy is a dynamic, four-level, 60-hour educational program designed to prepare persons to lead and manage today’s EMS organization. It is designed to give participants the basic tools and information needed to quickly and successfully assume or be in the role of an EMS leader. The program series is underwritten and sponsored by the Wisconsin Office of Rural Health.

Since 2009, more than 900 leaders across the nation have participated in the Academy, many from Wisconsin during the past couple of years.

Each level is a 15-hour, two-day program presented on consecutive days in comfortable settings that invite participation and openness. Class size is limited and the sessions are engaging, lively and participatory.

Each course is two-days and costs only $40 - inclusive of both days. Meals and refreshments are included. Please note that the levels need to be taken in order. The previous level is a prerequisite for the next.

Click here for the program brochure and outline.

Register on-line at: https://charge.wisc.edu/ruralhealth/workshops.asp

Level One
March 15-16, 2014
Marshfield Fire and Rescue Dept., Marshfield, WI

Level One
April 24-25, 2014
Green County EMS, Monroe, WI

Level Two
April 26-27, 2014
Green County EMS, Monroe, WI

Level Three
July 26-27, 2014
Lemonweir Valley Phone Company, Camp Douglas, WI

Level Four
August 16-17, 2014
Three Bears Lodge, Warrens, WI

For additional information or if you have a question, contact: Kathryn Miller, Program Manager, Rural Hospitals & Clinics Program, Wisconsin Office of Rural Health, Phone: 608-261-1891.