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PAAW is dedicated to healthy, sustainable ambulance and emergency medical service delivery in Wisconsin


Patrick Ryan, PAAW President
>> Read welcome letter

Listen to Wisconsin EMS Livestream >> Tuesday, April 14 at 9:00 a.m. central time.

Current PAAW Priorities

Tax Refund Intercept Program (TRIP)
Community Paramedicine / Mobile Integrated Healthcare
Liability Legislation
Collaboration with Dept of Health Services/EMS Office
WI Medicaid Patient Transportation Rates

Current News and Information from PAAW

March 25, 2015

Dept. of Health Leaves Door Open on Defining Community Paramedicine in the State

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.

March 24, 2015

REPLICA is the Way Forward for Interstate Licensing


REPLICA, a new national licensing initiative, and one that should be of particular interest to ambulance services that border other states, complete calls or patient transfers 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 is 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.

March 23, 2015

State EMS Director Job Re-posted for Third Time

The Wisconsin Department of Health has re-posted the State EMS Director position 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


March 11, 2015

Wisconsin EMS "Live" Format Offers Interaction and Information During Talk Radio Style Format

>> 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.

March 11, 2015

Wisconsin Stars of Life 2015 Nomination Period Opens Soon

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.

March 9, 2015

PAC recommends pain management and medication assisted advanced airway technician options

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.


PAC is an advisory committee.  Click here to see who’s a member of PAC.

Upcoming Events

Emergency calls or patient contacts to PAAW members last year

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REPLICA is the Way Forward for Interstate Licensing

(Posted 3/24/15 - Run Time 20 min:10 sec)


 Guest:



Dia Gainor
Executive Director
National Association of State EMS Officials (NASEMSO)











WEEKLY IV FLUIDS & 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.













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