PAAW is deeply saddened to learn of this morning's tragic helicopter crash. Our hearts are with the families, friends, and colleagues of those who passed away in the line of duty. Our deepest condolences to the Ascension Spirit team.

By Samantha Hilker

Patrick Ryan, co-owner of Ryan Brothers Ambulance and current PAAW board member, worked furiously to correct a problem some services may not have known they even had. 

A few weeks ago, Patrick noticed something strange.  The MTM transfers were being reimbursed at $1.75/mile instead of $5.56/mile, and even more curiously, some were being all out denied.  A deeper look revealed a potential cause of the problem: billing codes.  Typically, BLS and ALS transports are submitted to MTM with the codes A0380 and A0390, respectively, whereas the code reserved for stretcher vans is A0425 with a reimbursement rate of $1.75. 

“On some shorter trips, the difference wasn’t that much and might not be immediately obvious as it would on the long-distance transfers.  Depending on the services typical number of MTM transports and their distance, they may not have even noticed a change in their reimbursement rates for MTM trips.  It was a few long-distance trips that really raised the flag for us.”
—Patrick Ryan 

Patrick started making phone calls to other PAAW members to find out if they had noticed any of the same with their MTM authorizations and claims; sure enough, Patrick wasn’t alone.  He then reached out to MTM and DHS to find out more.  After many phone calls and email conversations, it appears the issue was one of miscommunication and misunderstanding. 

DHS has submission requirements that MTM must follow when submitting claims to DHS.  This is not to say that DHS can, in any way, enforce MTM’s provider submission expectations; so, when DHS made a request to MTM regarding code A0425, it should not have affected how ambulance service providers were being reimbursed from MTM.  As of this morning, PAAW received confirmation that MTM has revised their position on the ambulance codes and will allow providers to submit under codes A0380 and A0390 so they can be paid appropriately for the level of service provided.  MTM will also be pulling all claims that were denied for not being coded as A0425 and will be working to get them corrected and paid.  At this point, it looks as though there will not need to be any action taken on the part of the Ambulance Service Provider, however, you may want to look at your recent MTM transfers to see if you were affected. 

This is a great example of how PAAW benefits its members by building a network of professionals who are willing to step in, take the lead and find the answers; not only for their own service but to the benefit of services across the state.  Way to go, Patrick—PAAW is proud to have you! 

This has been a great week for EMS in Wisconsin, with several key bills signed into law, including AB654 for dispatcher-assisted CPR, and AB872 for EMS and public safety career ed tech grants. PAAW President Dana Sechler attended both signings. Great job to all who collaborated to make this happen!

Staff from several PAAW member organizations, including Bell Ambulance, Paratech Ambulance Service, and Baraboo District Ambulance were selected for AAA's national Stars of Life program. Meet the Wisconsin Stars at http://ems.zone/18WIstars!

Has the current shortage of controlled medications or saline affected your ability to provide high quality care to your patients? 

PAAW is working to collect data on how these, and other, medication shortages impact ambulance services throughout the state of Wisconsin as well as how services are adjusting to meet the needs of their patients. 

Please complete our short survey here► https://www.surveymonkey.com/r/1804paawshortages

View a list of drug shortages on the FDA website.

The open EMS Section Chief and Regional Coordinator positions have been filled.  If your email is up to date in the e-licensing system, you likely received the communications yesterday and today from the EMS Office.  Both Mark and Ela appear to have impressive credentials and valuable experience throughout their EMS careers.  PAAW is looking forward to working with them, once they officially start their positions! 

In case you missed the emails, here are the excerpts:   

EMS Section Chief

We are very happy to announce that Jonathan “Mark” Lockhart has been selected to fill the role of Emergency Medical Services (EMS) Section Chief for the Office of Preparedness and Emergency Health Care, EMS Section. Mark, as he prefers to be known, and his family will be moving to Wisconsin from Virginia, and Mark will begin his new role with the EMS Section on May 29, 2018.

Mark’s professional experience includes 8 years at Stafford County (VA) Fire and EMS, where he served as Deputy Chief and Chief.  Prior to his work in Virginia, Mark spent 23 years at Maryland Heights (MO) Fire District, progressively serving as a firefighter/paramedic, the EMS Officer, Battalion Chief, Deputy Chief, and Chief.  Mark is a Nationally Registered Paramedic, Firefighter I/II, and has held Fire Officer I and Fire Service Instructor certifications.  Mark's experience as an EMS and Fire Instructor includes teaching here in the US, as well as in Mexico, the United Kingdom, and Sweden. Mark has also been a contributing author for several EMT, Paramedicine, and Trauma/Life Support publications. Over his career, Mark has been an active participant in many professional associations, including: NREMT, NAEMT, and the International Association of Fire Chiefs. 

EMS Regional Coordinator

We are very happy to announce that Elizabeth “Ela” Rybczyk will be joining OPEHC as the new EMS Regional Coordinator for Regions 4 and 5 (Western and Southwestern WI).  Elizabeth’s first day in the office will be Monday, May 14, 2018.

Elizabeth, or Ela as she prefers, has a Bachelor of Arts in Health, Behavior, and Society  from the University of Rochester (NY), and a Certificate in Public Health Fundamentals and Principles from the University of Albany (NY).  Ela started her career as an EMT in 2008, and became a certified Paramedic in 2010, serving at several ambulance services in upstate New York.  Ela holds certifications in Remote Medicine for Advanced Providers, Paramedicine, and Critical Care Paramedicine.  She has also served as an Administrative Lieutenant and Training Director for the Greece (NY) Volunteer Ambulance and EMS Service, and as a member of the Monroe-Livingston Regional Patient Safety Committee.  

By Samantha Hilker

I’m not the smartest person in the room, and that is what I love most about my job. 

Being an EMS educator is a tough job; it takes a special person to pour their heart into educating others.  It takes someone who can stand behind their team to celebrate their accomplishments and also support them through mistakes.  A person who will pick up the phone at 3 a.m. to help a crew through a tough call, discuss a protocol, or work through the transport decision trees with dispatch without a second thought.  Someone who is OK with not being the smartest person in the room because they live in constant learning and embrace new challenges. 

I had the good fortune of speaking with several EMS educators about what they really want their clinical team(s) to know.  Here are the highlights:

Mistakes are not the end of the world.

Let’s be real, everyone makes mistakes. EVERYONE. The important thing is that you (1) realize the mistake and take steps to correct or communicate it, (2) learn from your mistake and (3) help others learn from you. Making a mistake once is part of the learning process – making the same mistake twice is foolish.

I am here for you.

Call me. Anytime. I’d honestly rather have you ask a question if you’re unsure of something – or call me right away to discuss a concern than receive a complaint or find something concerning on QA reports a few days or weeks later. A lot of times, the mistakes people think they made really aren’t that big of a deal – especially if we know about them and understand the why right away.

I don’t like doing QA any more than you like me calling you about QA concerns.

While looking at high-level outcome data and trends is interesting, I don’t like having to call you about protocol or documentation compliance issues. QA is necessary – it lets us know how we’re doing, how I’m doing as an educator…but please know that I do not spend time pouring over reports just looking for reasons to call you. Trust that I am looking for every reason not to call you before that phone rings.

It’s not always as exciting as I’d like it to be.

I know the education isn’t always the most exciting and sometimes we repeat things – but sometimes we need to repeat things for the benefit of the whole team. I would love to do exciting, cutting edge, new education all the time…but there is also value in getting back to the basics.

Practice how you play.

It is so important to train how you work…meaning realistic scenarios via simulation or low-fidelity equipment, partner configuration, uniforms and using the tools you use in real life. A lot of what we do in high-stress, time-sensitive situations is done without implicit thought – muscle memory – the more realistic our training the more efficiently we’re able to react in a real situation.

As I write this article, I am about midway through a virtual instructor-led paramedic refresher and never have I been more thankful for the EMS educators that helped shape me through the years, and the services who supported the role of an internal educator.  When education is viewed as a burden or requirement you meet just to maintain your license, it is easy to dismiss the value of a passionate educator providing face-to-face or hands-on transfer of knowledge.  I encourage you to take full advantage of the educators in your life, both formal and informal, especially if you are fortunate enough to work for a service willing to support that role internally. 

A special thank you to the following EMS educators who took time out of their day to contribute to this article:

• Thomas Carpenter, EMS Educator with Gundersen Health
  
• Rick Barton, EMS Educator with Gundersen Health
  
• Nick Romenesko, Clinical and Quality Manager with Gold Cross Ambulance Service, Inc.
  
• Robert Whitton, Education and Quality Assurance Coordinator with Paratech Ambulance
  
• Michael Barrow, Founder/Co-Author CPR Podcast, and Educator with Centura Hospitals 
  

Complete the online survey►

With the passage of Act 59 in September 2017, the Legislature directed the Department of Military Affairs to submit a report by January 1, 2019 that addressed the following questions:

• Recommended changes to statutory authority of the Interoperability Council
  
• Progress toward creating a statewide public safety interoperable communication system
  
• Obstacles hindering progress toward interoperability
  
• Recommendations for the legislative/executive action to promote interoperability
  

In order to provide a comprehensive report to the Legislature, the DMA’s Office of Emergency Communications is seeking your responses to several important questions. The resulting survey can be taken online, or responses can be emailed to Lauraine.vanderjagt@wisconsin.gov. Responses are due April 6.

Complete the online survey► | Download Question in a Word Document

One of the highlights for EMS in 2017 was the EMS at the Capitol day that took place in November; 5 organizations coming together to move EMS forward in Wisconsin.  As we look further into 2018, we want to inform you that a legislative day of this nature will not be possible due to the short session and election year.  That being said, we do not want to lose the momentum!  We are feverishly working with the American Ambulance Association, Office of Rural Health, and others to arrange some equally amazing opportunities to influence how EMS is governed from a state and federal level.  

Stay tuned!  Detail on 2018 opportunities will be released as events are finalized and open for registration. 

You can also look forward to an EMS at the Capitol Day in early 2019. 

It just got even easier for PAAW professional members to catch up on board activities! Visit the Meeting Archive for quick access to past minutes and upcoming agendas. 

(Going forward, this page will replace the previous separate Agenda and Minutes pages.)