Manufacturers restricting quantities being released through September

According to Bound Tree Medical's Stacey Barksdale Price, Manager of EMS Pharmaceuticals and IV Therapy, "The epinephrine 1:10,000 shortage is of highest concern as both Hospira and IMS are restricting quantities that they are releasing. They are releasing product intermittently, but it is not at the levels that meet customer demand. Both companies project this allocation status to remain in effect on this and other prefilled syringes through September."

>> Click to review the latest weekly EMS pharmaceutical and IV backorder report.

Conference registration is now open at www.psow.org

The 28th annual Paramedic Systems of Wisconsin Conference is September 23 to 25 at the Tundra Lodge and Convention Center in Green Bay.

The original intent was to provide education for the new Paramedic systems throughout Wisconsin, specifically for Service Directors, Medical Directors and Training Centers.  Organizers Dan Williams and Cal Lintz have held true to that mission.  However, the PSOW Conference format is not limited to paramedic providers, but all license levels.   PSOW is recognized as one of the top conferences for EMS and ambulance administrative personnel.

Some of the presentation topics include:

By Joe Covelli, PAAW Executive Director

On July 20, the Wisconsin Office of Rural Health sponsored a Community Paramedicine Stakeholders Forum.  The Eau Claire event was attended by over 130 participants, to include EMS agencies, medical directors, technical colleges, hospitals, home health agencies, and industry associations.

The program began with a discussion panel on Wisconsin community paramedicine activities.  One of the panelists, Jennifer Ullsvik with the Wisconsin Office of Preparedness and Emergency Health Care, mentioned two community paramedic programs have been approved in the state, to include the cities of Green Bay and Madison, and a handful of other requests are pending approval by the EMS Section to commence community paramedicine operations.  We also know this past year there have been about five community paramedic trial programs, mostly in the Milwaukee area, to identify frequent 911 users.  Trials at West Allis and North Shore Fire Departments have set up in-home programs with high user individuals to be proactive and are by all accounts successfully addressing their care needs.

Mrs. Ullsvik attributed some of the delay in plan approvals in two areas.  One, “Is community paramedicine in the current definitions of what an EMT can do?” and, two, “Does community paramedicine fall into the arena of home health?”.  On the latter point, her office has asked for a legal opinion by the Department's attorney.   She continued by stating her office is “on-board with this (referencing community paramedicine) and that proposed legislation will help”.

PAAW President Patrick Ryan, also a panelist, spoke to the work currently being done to draft legislation to include “Community Paramedic” and “Community EMT”.  He hopes to have legislation introduced in the fall session.

Rounding out the panel included Terry Gonderzik with the Chippewa Valley Technical College and Jerry Biggart representing the Wisconsin EMS Advisory Board.  Mr. Gonderzik indicated the Wisconsin Technical College System is looking to offer community paramedicine instruction as a “single” education entity, offering the same course and content instruction statewide.  Taking this approach is currently before the Technical College board of directors for approval as a system.  Mr. Biggart stated the EMS Advisory Board established a community paramedicine sub committee to work through the details and bring a recommendation to the full EMS Advisory Board, which will be presented to the Department of Health Services.

The afternoon program was spotlighted by three representatives leading the effort in Minnesota, to include:  Dr. Michael Wilcox and Buck McAlpin, both from North Memorial Medical Center, and Kai Hjermstad with Hennepin Technical College, Minneapolis. The predominate message was community paramedicine is a “gap filling” initiative that provides access to health care.

If you would like to join the community paramedicine conversation, there are several opportunities highlighted below.

1. Sign up for the Rural Health CP list serve.  The link is https://lists.wisc.edu/read/all_forums/subscribe?name=cp

2. PAAW created a webpage dedicated to serve as a central point of communication and information of historical significance for those interested in CP.  The link is http://paaw.us/cp.

3.  The Paramedic Systems of Wisconsin conference in Green Bay on Thursday, September 24 will include Minnesota's Buck McAlpin as a presenter speaking on community paramedicine.  The conference website is http://psow.org/.

4. PAAW President Patrick Ryan hosts a regular community paramedicine conference call.  Refer to item 2 above to find out when the next call is scheduled and the dial in number.  The group is currently working on community paramedicine legislation.

The July 14 webcast of Wisconsin EMS Live was dedicated to discussing TRIP (Tax Refund Intercept Program) and Stars of Life 2015. 

>> Click to listen to this webcast.

Since 2007, a legislative emphasis for the Professional Ambulance Association of Wisconsin has been TRIP, which stands for Tax Refund Intercept Program. Since an ambulance service can't do a credit check when being dispatched to a person's 911 call, some patients unfortunately don't pay their ambulance bill even after the insurance company has sent the check directly to them for that purpose.  This leaves the ambulance service in a bad situation unable to collect on services rendered, meet its own financial obligations, and reinvest those funds in its operation, equipment and staff.  Some of Wisconsin's largest ambulance services are writing off each year $500,000 to one-million dollars in noncollectable debt.

TRIP recently passed the Wisconsin legislature and is simply awaiting Governor Scott Walker's signature.  Gold Cross Ambulance - Fox Valley Executive Director Mark Fredrickson spoke with Governor Walker at his residence on Sunday, July 5 to confirm the Governor's support of TRIP (picture insert).

In the meantime, we need to prepare ambulance service management not familiar with TRIP, explain how it works, and is used as another option to collections when other attempts have failed.  The Wisconsin Department of Revenue administers TRIP, which municipal owned ambulance services have had access to for years.  With Governor Walker's signature, it opens the option of TRIP to all Wisconsin ambulance services under contract with a municipality to provide 911 service.  TRIP cannot be used for inter-facility transfers or patients with Medicare or Medicaid insurance coverage.

Wisconsin EMS Live program guests who discussed TRIP and answered questions included:  from The Stark Collection Agency in Madison, Pauline Kussart, and from Valders Ambulance, Director Jay Steuer.  According to both Pauline and Jay, "11% of an ambulance service billings go through the TRIP process for payment".

The second half of the 60 minute program was dedicated to discussing Wisconsin Stars of Life 2015 with committee members Larry Knuth, a 2009 Star recipient himself, and Linda Wiedmann.  The event is to recognize Wisconsin's best EMTs and Paramedics as nominated by their respective departments.  An update was also offered by Dan Williams on the conference agenda for Paramedics Systems of Wisconsin this coming September 23 to 25.

Don't miss a beat of the action - listen to Wisconsin EMS Live!

On Sunday, July 12, the Wisconsin State Journal newspaper wrote a feature article on community paramedics and the new and emerging programs being developed in the Madison area.  Several health care leaders and ambulance providers were quoted.

According to PAAW Executive Director Joe Covelli,"The article demonstrates the basis for community paramedicine, the great collaboration amongst health care providers to deliver care using this new and emerging model, gap filling to meet patient and community needs, and the need for state legislation to formally recognize community pararmedicine for funding purposes".  Click the below link to read or share the article.

>> Community paramedics catching on in the Madison area

For those interested to join the CP conversation or get the latest information, the next Community Paramedicine conference call is Friday, July 17 starting at 9:00 a.m. central time.  Join the conference call by either dialing in 646-929-1081 or listen on any internet connected device at this link >> click here.

Conference calls are recorded, so if you need to get caught up and listen to a past one, click here for the dedicated community paramedicine webpage established for historical purposes. 

For more information, click here.

Paramedic and nationally featured writer, Crystal Wallin, just added two new blog posts to "Standby for Tones" titled "scene safety" and "just doing my job".

>> Click to read the latest "Standby for Tones" blog posts.

>> Watch news video.

A Milwaukee firefighter was shot overnight Sunday while he and other firefighters tended to a patient who was having trouble breathing.

The 46-year-old firefighter, whose name was not released, suffered a graze wound to the right side of his head and has since been treated and released from the hospital, according to a fire department news release issued Monday.

The firefighters were called just after midnight to the area of N. 40th St. and W. Lisbon Ave. to assist a patient.

They assessed and treated the patient and were in the process of transferring the patient to Curtis Ambulance when shots were fired from a nearby alley in the direction of the first responders, according to the news release. Several rounds also hit the ambulance.

But Police Chief Edward Flynn said it does not appear that the firefighter had been targeted.

Flynn said detectives had recovered shell casings near the scene that appear relevant to the investigation.

A similar incident happened this past May in Milwaukee when a Paratech ambulance was struck by a bullet inches from the driver when responding to a 911 call.  This was the first incident of its kind in 43 years of business at Paratech Ambulance.  >> Click for video story.

On July 1, 2015, Wisconsin Governor Scott Walker signed an exemption from licensing requirements for out-of-state ambulance services.

Act 26 signed by the Governor states, "An ambulance service provider licensed in another state that makes 10 or fewer patient transports per year that originate and terminate within this state is not required to hold an ambulance service provider license under this section. An emergency medical technician licensed in or holding a training permit in another state who is involved in 10 or fewer patient transports per year that originate and terminate within this state is not required to hold an emergency medical technician license or training permit under this section. A first responder certified in another state who provides emergency medical care to 10 or fewer patients per year within this state is not required to hold a first responder certificate under this section."

The issue drew attention when Wisconsin EMS Office staff made comments earlier in the year, which the Office later tried to clarify by issuing two memos on licensing requirements.  The Office maintained the position Wisconsin licensure was required in order to provide ambulance or EMT service in Wisconsin as a statute requirement. 

Residents of Gratiot and South Wayne, both located in Lafayette County, Wisconsin, which borders Illinois, became very concerned when their primary ambulance service, located just a few miles away in Warren, Illinois, was informed by the Wisconsin EMS Office they could no longer respond into Wisconsin without licensure approval.  "Without a solution it might take up to 30 minutes for a Wisconsin ambulance to arrive to their homes (in that part of Lafayette County)", according to Assembly Rep. and bill sponsor Todd Novak.

In the opinion of many closely tied to EMS and fire department administration and industry associations in Wisconsin, the new Act 26 is not perfect by any means and leaves in question several items, to include operations mutual aid, documentation requirements, and self reporting of patient calls into Wisconsin. 

Areas with frequent mutual aid requests, like those between Beloit, Wisconsin and South Beloit, Illinois, will easily reach and even exceed 10 patient transports within the first month, not giving them sufficient time to file operation plans and submit qualifying personnel rosters to the Wisconsin EMS Office for licensure approval.  What complicates things further is Illinois does not follow National Registry EMT credentialing and administers their own state EMT test. 

Since Act 26 was a "quick fix" it really missed the mark.  A better, more long-term solution with clarifying legislative language is in the works with EMS and fire industry and association involvement.  For now, ambulance service is restored for those in border state areas, unless they exceed ten runs per year and don't have licensure approval.

>> Click to review Act 26 giving rights to certain out-of-state ambulance service providers.

EMS Section Chief

Mr. James Newlun was named the new Wisconsin EMS Section Chief with a start date of July 13.  The position has been vacant since April 2014 and was posted three separate times during the past twelve months.

Since 2002, Mr. Newlun has been an Emergency Medical Technician (EMT) with Camp Douglas Rescue. As EMT President, he was responsible for all operations, coordination of meetings, and employee/employer relations.  Since 2008, Mr. Newlun has been employed as a full-time firefighter at the Volk Field Fire Department in Camp Douglas. While acting in the capacity of Captain he was responsible for completion of daily assignments, and responses to emergencies.

From 2000 – 2011, Mr. Newlun was a member of the Camp Douglas Fire Department and Chief of the Department from 2008 – 2011.  He was responsible for managing and directing scenes as an Incident Commander, developing and maintaining the annual budget, and making all fire department purchases.  In addition, he managed up to 25 fire department personnel. 

From 2001 – 2010, Mr. Newlun was a Hazmat Technician and Safety Officer with the Juneau County Hazmat team, where he directed and coordinated functions of a comprehensive health and safety program.

In addition, Mr. Newlun has experience working with diverse community partners and grant writing. He has also served on the SCRTAC Executive Council for the past two years as the Rural Representative.

EMS/Trauma Medical Director

Ms. Ullsvik also named Dr. Suzanne Martens as the new Wisconsin EMS/Trauma Medical Director beginning July 1, 2015.  She replaces Dr. Charles Cady who served as state EMS Medical Director since 2008.  Dr. Cady's contract expires June 30, 2015.

Dr. Martens received her Doctor of Medicine degree from the Medical College of Wisconsin, where she also completed Residency.  A Fellowship in Emergency Medical Services was completed at Carolinas Medical Center in North Carolina.  Dr. Martens also has a Master of Public Health degree, and has been a licensed EMT for over 27 years.

Dr. Martens is currently the EMS and Trauma Program Medical Director at a Level III trauma facility.  For 15 years, Dr. Martens has served as the medical director for several local agencies and has the opportunity to work with all levels of EMS providers, career and volunteer, fire-based and private agencies. 

EMS education is important to Dr. Martens.  She is actively involved in the education of current and new EMTs. She visits new classes at the local technical college, serves as an adjunct instructor, and regularly sponsors education evenings for the EMS personnel in her area.

Dr. Martens has been a member of the EMS Physician Advisory Committee (PAC) since 2001 and the committee’s chair since 2008.  She has been involved in the trauma system since 2003, is an active member of the Southeast Regional Trauma Advisory Council (SERTAC), and served as its chair from 2008-2010.  

Fred Hornby leaving State's EMS Section in July