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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.

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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.”

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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.

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.

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

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.

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

State Capitol