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Patrick Ryan, PAAW President
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Current News and Information from PAAW

October 1, 2015

Community Paramedicine "draft legislation" making the rounds at State Capitol

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.

September 29, 2015

New concept for the Milwaukee Fire Dept.:  Paramedics treating patients before they call 911

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

September 26, 2015

Wisconsin Stars of Life shine in Green Bay during two recognition events

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

September 26, 2015

First Responder legislation now includes population criteria 

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.

September 18, 2015

First Responder Bill Passes Health Committee and heads to full Assembly for Hearing

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.

September 18, 2015

MN Community Paramedicine Study Tour Participants share "Lessons Learned" with others
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
September 16, 2015

Critical Care Paramedic Training Course Dates Announced

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).
September 16, 2015

PAAW hosts conference call with Wisconsin Dept. of Revenue on use of TRIP for ambulance billing

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.

September 10, 2015

Wisconsin Paramedic gets five months in jail for stealing narcotics

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.

September 10, 2015

Two-day Community Paramedicine Study Tour wraps up today in Minneapolis

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.

September 8, 2015

Wisconsin EMS Live webcast hits on hot topics

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 for services provided by an ambulance service 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 situation.  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!

August 28, 2015

CMS says they're ready for ICD-10 roll-out Oct. 1

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

Upcoming Events

Current PAAW Priorities

Tax Refund Intercept Program (TRIP) (Completed 8/6/2015, Signed into law by Governor Scott Walker)
Community Paramedicine / Mobile Integrated Healthcare (legislation being introduced fall 2015)
Recognition of EMS Personnel Licensure Interstate CompAct (REPLICA)
Stars of Life 2015 Awards and Recognition Event (completed Sept. 23 and 24, 2015)
Collaboration with Dept of Health Services/EMS Office (ongoing)

Next Live Show

Tuesday, October 13

starting at 9:00 a.m. central time


Review and Conference Highlights of Paramedic Systems of WI Hot Topics

Procedure to give CHF patients relief (presented by Tyler Christifulli, Lifestar EMS, West Bend, WI)

New CPAP Technology!

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


Or listen on any internet connected device - even email in a question.

Treating CHF patients with better results (Tyler Christifulli, Training Coordinator, Lifestar EMS, West Bend, WI)
Emergency calls or patient contacts to PAAW members last year

Over 285,000

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

Finally!  EMS data performance measures

Posted 8-20-2015
Run Time 21 min:19 sec


Nick Nudell
EMS Compass Initiative Project Manager, National Association of State EMS Officials

>> Click for the newest audio webcast or review the library of previous ones.

Weekly IV Fluids and EMS Pharmaceutical Backorder Report

PAAW continues to monitor the ongoing EMS pharmaceutical drug and IV fluids backorder situation by posting weekly updates, courtesy of Bound Tree Medical.

Through a special arrangement with EMS World magazine, PAAW members and their employees or volunteers receive a free 12-month subscription, a $40 value. 

Stay on top of national EMS news, tips, a variety of topics and special reports - delivered right to your home or work address or e-mail account the beginning of every month!  >> Click to receive this benefit.

Monitor Police, Fire and EMS Radio Traffic Around the U.S.!

Browse over 2,000 police, fire and EMS scanner monitoring stations around the U.S. with a simple click of your computer mouse.  It's sure to make any scanner junkie go wild!

>> Click here to find out more about selecting your own monitoring station or click the scanner below to open the audio player for Milwaukee County Fire radio traffic.

Milwaukee County Fire
(click scanner below to activate feed)

Winamp Aplha Display

Crystal Wallin

Wisconsin Critical Care Paramedic and Nationally Featured Writer

Recent blog posts by Crystal: Standby for Tones

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