News

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!

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. 
  

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

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!

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!

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

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.

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. 

• NGS (National Government Services). our Medicare Administrative Contractor
  
• MLN – Medicare Learning Network PDF covering the transition
  
• New MBI Poster
  
• Resources for patients who did not receive their cards.
  

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.

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!