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.

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 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.  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!

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

The American Ambulance Association honors the EMTs, Paramedics, dispatchers, and leaders of the dozens of ambulance services who answered America’s most desperate call for help.

Ten years ago, in August and September of 2005, the one-two punch of Hurricanes Katrina and Rita devastated over 93,000 square miles across 138 counties and parishes in Louisiana, Mississippi and Alabama. Together, the two storms caused $150+ billion dollars in damage and resulted in the deaths of more than 1800 people. Within this tragic narrative, the rapid and effective mobilization of EMS—particularly private EMS—stands out as an incredible accomplishment in disaster response and humanitarian relief.

It seems apparent the Wisconsin legislature is well on its way to taking steps to allow First Responders to operate as one member of a two-person ambulance crew in the state. 

The measure is designed to help communities, typically in the rural areas of Wisconsin, struggling to meet current minimum staffing requirements of two EMT-Basics, to get their local ambulance out-the-door and to the location of a 911 call.  Neither Senate or Assembly bills attempt to place restrictions on a community’s ability to use a First Responder, because of population size or area in the state.  Thus far, the only requirement in both bills is an EMT-Basic or higher credentialed crew member is to be in the patient compartment of the ambulance during transport.

On August 18, the Assembly’s Committee on Health held a public meeting at the State Capitol.  Those who registered and spoke at the public meeting seemed to do so in favor of proposed legislation, Assembly Bill 213.  No one opposed it.  The Senate approved its version, Senate Bill 143, on June 9.

We’ll cover this topic in more detail during the live program of “Wisconsin EMS Live” webcast on Tuesday, September 8, 2015 starting at 9:00 a.m.  Dial-in using 646-929-1081, or listen on any internet connected device at http://tobtr.com/7870921.

The Professional Ambulance Association of Wisconsin (PAAW) recently received a demand letter from the Wisconsin EMS Association’s (WEMSA) attorney, that it cease using the name, “Wisconsin EMS Live” for its monthly webcast due to a potential likelihood of confusion between “Wisconsin EMS Live” and WEMSA’s registered service mark “Wisconsin EMS Association.”  

PAAW disagrees with WEMSA’s position and believes it would be able to mount a successful defense of the “Wisconsin EMS Live” name on the grounds WEMSA is attempting to assert its service mark by also claiming the broadly used industry reference “Wisconsin EMS”.  Given these facts, information, and in consultation with its attorneys, PAAW has decided to change the name of its popular webcast rather than engage in what could be a long and expensive legal battle between the two organizations.

Since PAAW’s monthly webcast, Wisconsin EMS Live, debuted in March 2015, over 3,700 listeners have either listened live or downloaded an episode of the show. The webcast’s content, co-hosts, guests, and listeners make the program what it is and the early success it has experienced, not the program’s name.

Listen to PAAW’s next webcast on Tuesday, September 8, 2015 starting at 9:00 a.m. as they unveil the new name for their webcast.  Dial-in using 646-929-1081, or listen on any internet connected device at http://tobtr.com/7870921.

On August 20, WKOW-TV in Madison, Wisconsin, posted an interview and news video highlighting the opening of Wisconsin's first community paramedicine clinic, with more still to come.

After seeing a previous news story this past April on community pararmedicine, Ryan Brothers Ambulance was contacted by apartment managers at a complex in Madison.  They invited Ryan Brothers to open an on-site clinic to benefit their residents.

According to PAAW Executive Director Joe Covelli, "Isn't it great to see how the community responded by seeing an opportunity to use community paramedicine, a new and emerging concept, to benefit its residents with an on-site clinic.  There are all kinds of healthcare needs that go unmet everyday in Wisconsin - community pararmedicine is about filling those gaps".

>> Click to watch video news story.

>> Click to download this webcast.

What does performance measurement have to do with EMS?  According to EMS Compass, a performance based initiative, it has everything to do with improving patient care and demonstrating value.

Unfortunately, data collection and performance measures haven’t been part of EMS’ vocabulary.  It is true it’s been hard to measure performance and come up with the right tool that wasn’t labor intensive.  Some ambulance services have a formal process to collect data, but many don’t.  The Wisconsin Ambulance Run Data System, commonly known as WARDS, is an option, but clunky.  Some have simply relied on what others gave them – like on-scene time reports from dispatch, or scene to balloon time for a stemi patient brought to the CATH Lab. 

According to Dia Gainor with the National Association of State EMS Officials, “Measuring performance is the first step toward improving it.”  I couldn’t agree with her more. 

Currently, there is a national project underway to fund EMS Compass, an initiative to develop performance measures specific to EMS.  They are making great strides with a team of 50 software developers – many of whom are volunteering their time.   Nick Nudell is the project manager.  Let’s find out what he has to say in this episode of EMS to the Point.

>> Click to download this webcast.

PAAW led initiative allows all Wisconsin ambulance services to use TRIP.

By Patrick Ryan, President, Professional Ambulance Association of Wisconsin

The Professional Ambulance Association of Wisconsin (PAAW) is very pleased to announce that on August 6, 2015, Governor Scott Walker signed Act 59 into law. This law allows counties and municipalities to certify private debts owed to private ambulance services operating on behalf of a county or municipality to the Wisconsin Department of Revenue (DOR). PAAW has worked diligently on this piece of legislation since 2008.

The financial stability of Wisconsin’s Emergency Medical Services (EMS) is vital to the health and well-being of all citizens of our state. This expansion of the Tax Refund Interception Program (TRIP) will help support the entire EMS system and will significantly enhance services’ ability to collect reimbursement for services provided. PAAW wishes to thank Representative Paul Tittle (R-Manitowoc) and Senator Shelia Harsdorf (R-River Falls) for their assistance and support of this effort. 

>> Click to read Act 59 (2015 Senate Bill 40 - TRIP) signed into law by Governor Scott Walker

The Professional Ambulance Association of Wisconsin is pleased to announce the 2015 group of Wisconsin Stars of Life honorees, individuals who represent the best-of-the best in our industry as nominated by their respective department or organization.  

Twenty-six honorees will be presented with awards and recognition at two events in Green Bay.  The first is a welcome reception at Lambeau Field Atrium on September 23.  The second is the dinner and awards program during the Paramedic Systems of Wisconsin Conference on September 24.  Each nominee is also invited to the Wisconsin State Capitol this fall.  One person from the group will advance to represent Wisconsin at the National Stars of Life ceremony in Washington, D.C. in April 2016.

2015 Wisconsin Stars of Life honorees include:

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