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The rule becomes effective April 22, 2014 and includes the following provisions:
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.
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
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
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 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.
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.
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.
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.
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
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
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.
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
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