Legislation

The long-awaited Community Paramedicine / Mobile Integrated Healthcare Bill was read for the first time before the Wisconsin Assembly at the State Capitol on March 17, and then referred to the Committee on Health.  The bill is sponsored by Rep. Amy Loudenbeck.  Wisconsin's fire and EMS stakeholder groups, to include PAAW, have worked diligently the past three or more years on drafting the bill.  >> Click for the Community Paramedicine Bill (AB151).

According to PAAW President Patrick Ryan, "PAAW, along with State stakeholders have worked long and hard to get this important legislation to this point. We are optimistic about support throughout the state for the establishment of a framework for the development of Community Paramedic programs across the state".

The Community Paramedicine Bill, known in the Assembly as AB151, now moves to the Committee on Health for review and public comment.  The first public hearing is scheduled for Wednesday, March 22, starting at 10:00 AM in room 225 Northwest.  >> Click for the Committee on Health's public hearing agenda.
Upcoming Podcast on Community Paramedicine - Tuesday, March 28 at 9:00 a.m.

The next EMS Live in Wisconsin podcast on Tuesday, March 28, is dedicated to Community Paramedicine.  Guests include Minnesota Ambulance Association Legislative Lobbyist Buck McAlpin and PAAW President Patrick Ryan.  Listen live by calling 646-929-1081, or on the internet at this link >> http://tobtr.com/9900319.  The program is broadcast live from 9:00 to 9:30 a.m.

Minnesota is a leading state in Community Paramedicine, with its bill signed into law in 2011.  McAlpin was instrumental in the bill passing in Minnesota, and has consulted with PAAW and other ambulance services in Wisconsin intending to deliver Community Paramedicine in the badger state.  McAlpin's employer, North Memorial Medical Center, Brooklyn Park, Minnesota, offered a two-day class in September 2015 for Wisconsin's ambulance services and other healthcare providers to review their operation and stats, to meet those delivering out-of-hospital Community Paramedicine care, and help these organizations begin to lay the groundwork for Community Paramedicine in their own community.

EMS Live in Wisconsin Podcast

>> Click to listen now!

March is Kidney Awareness Month. Our guest on the March 14th EMS Live in Wisconsin podcast was Dr. Ashraf El-Meanawy, Director of Dialysis at Medical College of Wisconsin, Milwaukee.

Even though only .5% of the population is diagnosed with kidney disease, these patients account for 4% of the federal Medicare budget.

We discussed:

• What makes a dialysis patient different from a regular pre-hospital EMS patient?
• Are dialysis patients at higher risk for cardiac arrest and why?
• What are pit-falls EMS personnel can fall into when responding to a call for a dialysis patient?
  

• Wisconsin EMS Advisory Board update from Chairman Jerry Biggart and committee member Dana Sechler.  Patrick Ryan discussed Community Pararmedicine legislation being introduced soon at the State Capitol.  >> Click to listen now!

• Making Medicare "Add-on Payments" Permanent with American Ambulance Association Senior VP of Government Affairs Tristan North, Washington, D.C.  Medicare payments account for a minimum of 50% of an ambulance service's payer mix.  >> Click to listen now!

• State EMS Office Updates about new regional coordinators, changes to FAP funding with State EMS Director James Newlun.  >> Click to listen now!

Standby for Tones Blog
Hello, my name is...

He’s seen a few presidents, and he’s known a few good decades. Right now, he’s hanging out with me, because his head laceration is impressive. Fire did a great job of bandaging the wound up, but no one’s addressed the puddle of blood just yet. His speech is slurred, refined but slurred. I’m making his acquaintance as I put on my three lead, take my first blood pressure, scope out the oxygen saturation level. Everything checks out within normal parameters, so I press on. No odor of alcohol, blood sugar also within what I’d like to see. He cocks his head, then, looks at me.

“I sound funny.”

“Funny ha, ha?” I ask lightly, carefully watching him. 

“My words – like I’ve been drinking. I haven’t been.”

There it is, then. Altered from his baseline – and he knows it. Assessment continues, he denies loss of consciousness, denies any neck pain, CMS is intact, on down the line. Cervical collar in place, we assist him to a standing position and with the cot positioned behind, guide him to be seated. Securing him with straps, wheeling him to the truck, loading him within. Once inside, transport begins as secondary assessment shows no new findings. Eyes equal, round and reactive to light – I go on down the familiar road of assessment. I keep up a light banter about the weather, the circumstances surrounding the purpose of my arrival at his home today. I circle back around some details so he ends up re-answering questions he’s already answered. His answers remain on point, consistent.

>> Click to read more of the story...

In the end, seven pieces of draft bill legislation were considered by the Joint Legislative Council, with six bill drafts approved for introduction to the full legislature by the Joint Legislative Council.  The only bill draft to not be approved involved creation of a fire service district authorizing the district to levy a property tax and impose special charges.   >> Click to review draft bill legislation voted on by the Joint Legislative Council. 

According to PAAW Executive Director Joe Covelli, "It is apparent anything with a fiscal note or tax wasn't being considered or moved forward, so that really handcuffed the Study Committee.  The legislative bill drafts to address the EMT volunteer shortage are largely centered around three main themes:  license renewal, income tax and length of service credits, and adding first responders to the Funding Assistance Program.  These measures may help if they become law, but is it enough to increase firefighter and EMT recruitment and retention?  Time will tell."  Covelli added, "I think we still need to look at how EMS is delivered and better resource management.  That's on us as an industry to work together and figure out".

EMS Product Savings

Deadline to submit recent three-month purchase rebate is March 31, 2017

Attorney General Brad Schimel announced February 1, he has renewed the State’s agreement with Amphastar Pharmaceuticals, which established a rebate program for the heroin and prescription painkiller antidote naloxone. Naloxone, often branded as Narcan, can be administered as a nasal spray or injection and works within minutes to reverse the effects of an opioid overdose.
 
“When an individual has overdosed on prescription painkillers or heroin, we only have a few minutes to intervene and save that person’s life,” said Attorney General Schimel. “I appreciate Amphastar’s willingness to partner with the State and provide those on the frontlines of this battle with financial relief.”
 
Amphastar Pharmaceuticals has agreed to continue providing a $6 rebate for each Amphastar naloxone syringe purchased by public entities in Wisconsin from now until February 1, 2018.

“Since 2013, we have been working to expand access to lifesaving opioid antagonists like naloxone,” said Rep. John Nygren. “While these medications can be expensive, our state has worked with Amphastar on an agreement that ensures the affordability of these important medications. Measures like this save lives, and I’m looking forward to working with my legislative colleagues, the medical community, law enforcement and the Attorney General, and recovery advocates statewide on more efforts that will help combat Wisconsin’s opioid epidemic.”
 
State, county, and local government agencies, as well as law enforcement and other public and government entities that distribute naloxone are eligible for the Amphastar naloxone rebate.

The Professional Ambulance Association of Wisconsin (PAAW) was instrumental in bringing the Narcan rebate program to Wisconsin in 2016, and working closely with Attorney General Brad Schimel's office.
 
More information can be obtained from the DOJ website at https://www.doj.state.wi.us/news-releases/ag-schimel-renews-rebate-agreement-manufacturer-lifesaving-opiate-antidote

Purchases made between November 1, 2016, and January 31, 2017, qualify for the rebate under the previous contract; however, to receive a rebate check a DOJ approved form must be submitted no later than March 31, 2017.   To claim the rebate or learn more about it, refer to the links below.

>> Amphastar Pharmaceuticals, Inc. Contract
>> Naloxone Rebate - Press Release
>> Naloxone Rebate Instructions
>> Naloxone Rebate Account Form
>> Naloxone Purchase Summary Rebate Form (Quarter 4 - Nov, Dec, Jan)

Wisconsin Attorney General Brad Schimel announced the first rebate program on March 23, 2016, during a press conference at Ryan Brothers Ambulance, Madison.

>> Click for more information about the DOJ announcement and rebate program.

State EMS Section Updates

>>  Click to listen now on-demand.

On January 24, State of Wisconsin EMS Director James Newlun, photo insert, joined PAAW Executive Director Joe Covelli for an EMS to the Point podcast.  The podcast is just over 25 minutes.

The interview offers an update on several important topics.  They discussed: 

• Changes to the Funding Assistance Program (FAP),
  
• Adding two new regional coordinators to staff and changing staff responsibilities to operate in regions versus past practice by level of license,
• Recent work by the Legislative Study Committee and pending introduction of EMS legislation by the Legislative Council,
  
• EMT and First Responder renewals, and
• Upcoming deadlines in transitioning to WARDS Elite.

>>  Click to listen now on-demand.

State Licensing 

The Wisconsin Department of Health Services (DHS) EMS Office will open the 2018-2020 Provider Renewal process on August 1, 2017, through June 30, 2018.  Individual providers must complete all educational requirements prior to completing and submitting the 2018-2020 Provider Renewal application. 

The deadline to complete the 2018-2020 Provider Renewal application is June 30, 2018, to obtain a current certification or license that is valid until June 30, 2020.

All Wisconsin EMS provider applications are completed in the E-Licensing system. The important renewal dates to remember for 2018-2020, are:

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.

All continuing education is a personal responsibility.  >> Click to review Memo 1701 that provides information and re-certification requirements.  

EMS Product Savings
Deadline to submit recent three-month purchase rebate is March 31, 2017

A statewide program to reimburse ambulance services and other qualifying agencies $6.00 per vial of Narcan is soon approaching, according to the one-year agreement between Wisconsin's Department of Justice (DOJ) and Narcan manufacturer Amphastar Pharmaceutical.  The Professional Ambulance Association of Wisconsin (PAAW) was instrumental in bringing the rebate to Wisconsin, which is valued at approximately $6.00 per syringe, or a 25% savings.

Purchases made between November 1, 2016, and January 31, 2017, qualify for the rebate, but to receive a rebate check a DOJ approved form must be submitted no later than March 31, 2017.   To claim the rebate or learn more about it, refer to the links below. 
>> Amphastar Pharmaceuticals, Inc. Contract
>> Naloxone Rebate - Press Release
>> Naloxone Rebate Instructions
>> Naloxone Rebate Account Form
>> Naloxone Purchase Summary Rebate Form (Quarter 4 - Nov, Dec, Jan)

Wisconsin Attorney General Brad Schimel announced the rebate program on March 23, 2016, during a press conference at Ryan Brothers Ambulance, Madison.

>> Click for more information about the DOJ announcement and rebate program.

Mark Mandler came to the EMS Section as a limited term employee in 2016. He has assisted with operational plan and protocol reviews.  In the released announcement, Mr. Newlun wrote, "Mark has proven his ability to assist services, EMS directors and medical directors. He has been directly involved in the review of community paramedic programs".

Prior to coming to the EMS Section, Mark volunteered as both a firefighter and an EMT.  Mark holds a paramedic license, various fire service certifications, and is currently completing his law degree at the University of Wisconsin-Madison Law School. Mark will be the EMS regional coordinator for Regions 6, and 7.

Rick Stenson has served as an EMS professional for the past 13 years in both the municipal and private sectors, working in both urban and rural settings. Rick has worked as a licensed EMT since 2004, a Critical Care Paramedic since 2008, and has served as a BLS, ACLS, or PALS Instructor for most of his career. Rick will be the EMS regional coordinator for Regions 4, and 5.

With this change, current EMS staff member Ray Lemke moved from First Responder/BLS/Education Coordinator into the Coordinator spot for Regions 1, 2, and 3. 

According to the announcement, Mark, Rick and Ray's responsibilities will be within the seven Healthcare Coalition Regions.  >> Click for Healthcare Coalitions Regions map.  This is a departure from past practice whereby coordinators were assigned by level of licensed provider, i.e., paramedic, intermediate, advanced EMT, basic, first responder, etc.

Coordinators will work with all EMS professionals, Training Centers, Technical Colleges, and agencies within their regions.  The Wisconsin EMS statewide system is comprised of over 600 ambulance services, emergency first responders, and training centers, and 16,500 individual licensed providers.