Dear Ground Ambulance Providers and Suppliers, We wanted you to be aware that we posted the following announcement on our Ambulances Services Center website: Calendar Year (CY) 2025 Physician Fee Schedule (PFS) Proposed Rule CMS issued the CY 2025 PFS proposed rule: https://www.federalregister.gov/public-inspection/2024-14828/medicare-and-medicaid-programs-calendar-year-2025-payment-policies-under-the-physician-fee-schedule that announces proposed policy changes for Medicare payments under the PFS and other Medicare Part B payment policy issues including ambulance services. CMS is proposing to modify the definition of advanced life support level two (ALS2) at 42 CFR §414.605 by adding the administration of low titer O+ whole blood transfusion (WBT) to the list of ALS2 procedures. For patients in hemorrhagic shock, the use of WBT has demonstrated a survival benefit when compared to traditional hemorrhagic resuscitative therapy. Under this proposal, a ground ambulance transport that provides WBT would itself constitute an ALS2-level transport. We are also seeking comments on whether we should add alternative blood product treatments such as the administration of packed red blood cells and plasma to the list of ALS2 procedures. We are aware that some established Emergency Medical Services (EMS) systems may already provide WBT to treat patients in hemorrhagic shock, while other jurisdictions, including those in rural areas, may rely on alternative blood product treatments.  We encourage you to submit comments on this proposal by September 9, 2024, to the website provided in the CY 2025 PFS proposed rule.

NHTSA’s Office of EMS Hosts Education Workshop on August 14

NHTSA’s Office of EMS will host a 4-hour workshop to discuss and prioritize the responses to the EMS Education Agenda 2050 (EEA2050) Request For Information (RFI). Published in the Federal Register in October of 2023, the RFI remained open until the end of March 2024. It requested responses to twenty-two questions from all sources about the vision of EMS Education in the United States by the year 2050. The EEA2050 workshop will take place as a pre-National Association of EMS Educators (NAEMSE) Symposium workshop. Date: Wednesday, August 14, 2024 Time: 1 - 5 p.m. ET Location: Wyndham Grand Pittsburgh, 600 Commonwealth Pl, Pittsburgh, Pennsylvania 15222 All EMS Education stakeholders are encouraged to attend and participate in this discussion. Register Here This workshop is free to attend, but only registrants will be permitted to participate. No CEUs will be issued. Contact Clary.Mole@dot.gov if you have any questions.

Task Force on Emergency Medical Services
Thursday, July 25, 2024 at 12:30 PM
Co-Chairs: Rep. John Huot and Sen. Judy Seeberger
Location: State Capitol, Room G3

Agenda

I. Call to Order and Opening Remarks from the Co-Chairs

II. Status Update: Office of Emergency Medical Services transition, pilot programs & relief funding

III. Preview of Legislative Coordinating Commission Task Force Report

IV. Preview of remaining Task Force plans for 2024

V. Hearing Adjourns

The Legislative Task Force on Emergency Medical Services expires December 31, 2024. You may view further details, meeting documents, and sign up for the task force listserv by visiting the Task Force web page.

Be Sure Your EMS Agency is Ready to Care for Children in an Emergency Your clinicians must be ready to provide optimal emergency care if you provide 911 response to incidents with sick or injured children. Whether you transport, or if your EMS agency is fire-based or a private company, you should know if you’re really “pediatric ready.” The Prehospital Pediatric Readiness Project (PPRP) Assessment, led by HRSA’s EMS for Children Program, is providing EMS clinicians, their agencies, and their EMS systems a self-assessment now through July 31, 2024. Here’s what your EMS colleagues are saying about the assessment: “EMS needs help on improving our pediatric readiness. We are so overwhelmed and understaffed that this often gets pushed to the back burner of priorities, unfortunately. I think there are some great learning points in the questions asked.” – Paramedic/EMS Director “This survey has given our agency a lot of information. We are currently updating all our policies to be more specific in many of the areas discussed in this survey.” – EMT, Volunteer Fire Department Get to it: Confirm who in your agency is responsible for completing the PPRP Assessment and encourage them to complete it – or volunteer to help Watch a video that illustrates the importance of pediatric readiness Access free tools and resources to improve specific aspects of your “readiness” About the HRSA MCHB EMSC Program: For 40 years, the Health Resources and Services Administration’s Emergency Medical Services for Children (EMSC) Program has worked to improve outcomes for acutely ill and injured children and reduce rates of serious injury, illness or death. Through research, practice and partnership, the EMSC Program strives to ensure that—no matter where a child lives—the health systems in their area provide high-quality, equitable emergency care.

Sign up to receive the latest news from the Office of EMS, including webinars, newsletters and industry updates.

Contact Us 1200 New Jersey Avenue, SE Washington, DC 20590 nhtsa.ems@dot.gov

2024 Ambulance Ride-Along Toolkit

Educating your members of Congress about ambulance industry issues makes them much more likely to support your efforts. An easy and effective way to educate them is to invite them to participate in a local Ambulance Ride-Along! The House and Senate will be adjourning for summer recess at the end of July and members of Congress will return home to their districts and states. This is the perfect opportunity for you to educate your members of Congress about issues facing our industry, in particular the extension of our Medicare add-on payments, the VA Final Rule,  and the EMS workforce shortage, which are important to your operation. For additional information on these issues, visit the AAA Advocacy Page, which includes one pagers about all of our initiatives. The most effective way to deliver these key messages is to host your member of Congress or their staff on a tour of your operation and an ambulance ride-along. The AAA has made the process of arranging a ride-long or scheduling a meeting easy for you with our 2024 Congressional Ride-Along Toolkit.  Are you willing to host a Member of Congress at your service but unsure of how to set it up? Email  Meghan Winesett at mwinesett@ambulance.org! Everything you need to arrange the ride-along or schedule a meeting is included in the Toolkit.  Act now and invite your elected officials to join you on an Ambulance Ride-Along!

The Minnesota Ambulance Association (MAA) is thrilled to announce the launch of our brand-new Jobs Board, a valuable resource designed to support the hiring needs of our EMS community. This latest member benefit is tailored to connect MAA members with top talent, fostering growth and excellence within the EMS field.

For MAA Members: As part of our ongoing commitment to providing exceptional value, MAA members can post job listings on the Jobs Board at no cost. This platform offers a streamlined and efficient way to reach qualified candidates, making it easier than ever to fill crucial roles within your organization. Whether you are looking for paramedics, EMTs, dispatchers, or administrative staff, the MAA Jobs Board is your go-to resource for finding the best fit for your team.

For Non-Members: Non-members are also welcome to utilize this dynamic platform for a nominal fee. By posting your EMS-related job openings on the MAA Jobs Board, you gain access to a vast network of skilled professionals dedicated to the EMS industry. This is an excellent opportunity to attract top-tier talent and ensure your organization continues to thrive.

Key Features of the MAA Jobs Board:

• Easy-to-Use Interface: Posting and managing job listings is simple and intuitive.
• Wide Reach: Connect with a broad audience of EMS professionals across Minnesota.
• Targeted Listings: Ensure your job postings reach candidates with the right skills and experience.

Join us in celebrating the launch of the MAA Jobs Board and take advantage of this fantastic new benefit. Together, we can strengthen our EMS workforce and continue to provide outstanding care and service to our communities.

To post a job or learn more about this exciting new feature, visit our MAA Jobs Board today!

Dear Members,

As we wrap up the legislative session, we want to keep you informed about the recent changes affecting emergency medical services in Minnesota. Below, you'll find a summary of the bills that were passed and those that did not make it through.

We will share additional information about implementations and impact in the coming weeks and months for those initiatives that continue to take shape. 

Bills Passed by Legislature

Office of EMS, alternative response model, staffing, emergency ambulance aid

• HF4738
• Establishes the Office of EMS. Eliminates the EMSRB and transfers powers to the Office of EMS.
• Creates the “sprint medic” pilot program in Otter Tail/Grant and St. Louis Counties. Provides $6 million to fund the two pilots.
• Changes staffing requirements by allowing RNs to staff ambulances and for ambulances to be staffed by a non-certified driver.
• Provides $24 million in one-time funding for rural, non-health system ambulance services.

Emergency Medical Training

• HF5237
• Provides $250k to St. Cloud ISD 742 for an EMS training facility.
• Adds $500k annually to the K-12 budget for Emergency Medical Training in High Schools. 

Earned Sick and Safe Time

• HF5247
• Excludes volunteer and paid on-call ambulance services personnel from the definition of an employee.

EMS Training in Cook and Lake Counties

• SF5289
• Provides a $00k grant to Lake County Ambulance Services for training of high school students in Cook and Lake counties interested in pursuing EMS careers. 

GIS Mapping of Schools

• HF5216
• Provides $7million to regional emergency communications boards for GIS mapping of school facilities. 

Medical Debt Collection

• HF5247
• Restricts providers from denying care to patients who have unpaid debt. Requires policies on medical debt collection and notices to patients. Prohibits collection agencies from reporting medical debt to consumer reporting agencies.

Bills NOT Passed by Legislature

Revenue Recapture

• Revenue Recapture was in earlier bills but removed.
• Municipally owned hospitals, hospital districts and ambulance services continue to have access to the Program

Fire Protection and EMS Special Taxing District Aid

• HF5410 | SF5461
• Would establish a state aid program for fire and EMS special taxing districts.

Prompt Payment of Emergency Room and Ambulance Bills (First-dollar Coverage)

• HF3840 | SF4012
• Would require very high deductible health plans(VHDHP) to pay emergency department and ambulance service bills directly if the policy holder has not met their deductible.

Ambulance Supplemental Payment Program

• HF643 | SF595
• Would establish a supplemental payment program to include all ambulance services licensed under 144E. The Program would increase Medicaid rates. 

Rural EMS Uncompensated Care Pool

• HF5449
• Would establish a fund to reimburse rural ambulance services for responses that don’t result in a billable transport.

Volunteer Education Reimbursement Changes

• HF5053 | SF5165
• Would add MRUs as qualifying agencies and EMRs as qualifying individuals to receive reimbursement for training expenses.

Protected Class Transport Rate Increase and Grants

• HF3743 | SF3701
• Would increase reimbursement for trips over 100 miles and establish one-time start-up grants for Protected Class Transport Providers.

Hometown Hero Outdoors Funding

• HF3569 | SF4377
• Would appropriate $25k in 2024 and 2025 to Hometown Hero Outdoors to fund outdoor recreational activities and mental health services for current and former LE, Fire and EMS personnel.
• Requires every ambulance in service for patient care to carry an opiate antagonist.

Licensure and Primary Service Area Modifications

• HF2736 | SF2691
• Would redefine Primary Service Area Boundaries and the issuance of licenses.

• MAA Membership: 

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• The Minnesota Legislature is three weeks away from its mandatory adjournment date of May 20, 2024. To add intrigue to the session, yesterday’s floor sessions (April 30) marked the 108^th legislative day of the biennium. By rule the legislature can only meet in regular session (floor sessions) on no more than 120 days. Between now and May 20^th, the legislature only has 12 days left to hold floor sessions; this leaves quite a bit of work to get done with limited time to do so!

  Recent developments regarding Senator Nicole Mitchell (DFL – Woodbury), who was arrested and charged with first-degree burglary, have raised questions about how the session will proceed and ultimately end. The Senate has spent a good amount of time during floor sessions over the past week debating how to best handle Senator Mitchell’s involvement with voting during the remainder of the session. The DFL party has a one-vote majority. If Senator Mitchell does not cast a vote, it is possible that remaining bills will fail due to a 33-33 tie vote. We are hopeful that EMS funding is a priority to all legislators and will receive bi-partisan support if brought to the floor.

  The House of Representatives has been very active in moving bills out of committee and off the floor. We assume they will continue to be active in moving bills and await action from the Senate. Unlike the number of days remaining to complete the work of the 93^rd Legislature, the amount of activity will not be limited.

  Thank you to everyone who took the time to send a letter, make a phone call, or meet with their elected officials in early April; your efforts are noticed and do make a difference!
  
  We are asking members to continue reaching out to your legislators to share the importance of passing an Emergency Ambulance Service Aid bill this session. If you would like assistance in this, please reach out to Samantha at office@mnems.org. She will assist you in navigating the process.

  Priority Summary 

  Emergency Ambulance Service Aid

  HF3992 (Lislegard) has been the primary ambulance aid bill since it’s introduction on February 19^th. The bill has made all deadlines and continues to make its way through the process. It currently sits in the Ways and Means Committee awaiting a hearing to set the funding level. The Ways and Means Committee serves as the committee which controls the money. As you may recall, the Governor proposed $10 million in funding for ambulance services in the northeast and central regions.

  SF3886 (Hauschild) is the companion to Rep. Lislegard’s bill. The bill was heard in Taxes back on March 6^th. The committee had a good conversation around the need for the funding. The bill was laid on the table for further discussion, which is where it currently sits.

  Representative Huot introduced the governor’s proposal in HF5275, which was never heard. HF5399 (Backer) was introduced as a companion to SF5433 (Rasmusson) to provide aid to ambulance services based on a formula that takes into account geographic area served and run volume. The MAA and Coalition of Greater Minnesota Cities (CGMC) have met with Rep. Backer and Senator Rasmusson several times over the past few weeks. Our efforts have been focused on finding common ground between all the bills, leadership’s budget targets, and ultimately the needs of ambulance services.

  Please contact your legislators to request that they support this one-time aid for ambulance services. There is quite a difference between the $10 million recommended by the Governor and the $120 million originally requested. In your conversations with legislators, please encourage them to support funding at the $120 million level. Receiving the full funding amount is unlikely but that does not mean we shouldn’t keep our message focused on the full need of the EMS system in Minnesota.

  Establishment of the Office of EMS

  The establishment of the Office of EMS language is in the Omnibus Health Finance bills of both bodies. HF4571 (Liebling) and SF4699 (Wiklund) contain identical language including an amendment that the MAA brought forward to ensure that the Deputy Director of Medical Services is a physician.

  The original bills, HF4738 (Huot) | SF4835 (Seeberger), are moving along separate from the Omnibus Health Finance bills. The Huot bill is awaiting a hearing in the Ways and Means committee. It is very likely that this and Rep. Lislegard’s emergency aid bill, HF3992, will be taken up by the committee together to establish funding for both.

• • HF4738 (Huot) | SF4835 (Seeberger) Establishment of the Office of EMS – Both bills have been heard in the Health committee of their body. HF4738 was heard in State and Local Government Finance and Policy and rereferred back to the Health Finance and Policy Committee. SF4838 was heard in State and Local Government and Veterans Committee and laid over for possible inclusion in an omnibus bill.
  • Both bills have also had the Alternative EMS Response Model Pilot Program amended to the bill which would establish a “sprint medic model” to be tested in selected communities.
  • $6 million is budgeted for the transition from the EMSRB to the Office of EMS and for the sprint medic model.
  • The MAA had initially opposed the bills as physician involvement was minimal. After the authors amended their bills to include a physician in a director role, the Association moved their position to neutral.

Please reach out to your legislators to share the importance of keeping EMS a physician-led industry in Minnesota.

• Licensing and Staffing Bill

  The licensing and staffing language is included in the Omnibus Health Finance bills of both bodies. HF4571 (Liebling) and SF4699 (Wiklund) both include the CFRN and CEN language along with alternative staffing and the removal of the restriction on the large cities regarding staffing variances. The bills update educational requirements and extend the period for which a person with a lapsed license can apply for reinstatement.

• • HF4600 (Huot) | SF4697 (Seeberger) Licensing and Staffing Bill – HF4600 was heard in the House Health Finance and Policy Committee on March 21st. The bill was amended to include certified flight registered nurses (CFRN) and certified emergency nurses (CEN) as ambulance service personnel. The amendment also removes the restriction on the metro counties, and the cities of Duluth, Mankato, Moorhead, Rochester, St. Cloud with regards to the staffing variances. The intent of the amendment is to allow all ambulance services to apply for a variance to use alternative staffing. The bill, as amended, was laid over for possible inclusion in an omnibus health bill.
  • SF4697 was heard in the Senate Health and Human Services Committee on March 15^th. The bill does not include the same language regarding certified flight nurses, certified emergency nurses, or the removal of the metro and urban cities restriction.

There are several other EMS related bills introduced this session. If you’re interested in the status of them please take a look at the MAA Bill Tracker.

You can contact the Buck McAlpin or Mark Jones, the MAA lobbying team, if you have any questions on these or other bills making their way through the process. We also encourage you contact our Legislative Committee Co-Chairs (Tom Fennell, Dane Meyer) or your Regional Board Representative to share your perspective on these issues. Our next board meeting is Friday, June 14^th in Wilmar, MN – we hope to see you there!

MPR Reporter Ellie Roth did a ride-along with Dodge Center Ambulance. 

Read the full article - Minnesota’s rural ambulance providers look to state Capitol for their own lifeline

The audio will be available on their 12 noon show - "Politics Friday." It airs on 91.1 FM and will livestream on mprnews.org on Friday, April 5, 2024. 

EMS Harm Reduction and SUD Treatment Webinar Hosted by NHTSA’s Office of EMS on March 22 at 2 PM ET / 11 AM PT

According to the National Harm Reduction Coalition, “harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.” This can include improving access to naloxone (Narcan) to prevent death from opioid overdose, providing sterile syringes to reduce the spread of HIV and hepatitis C, and fentanyl testing programs, among other types of help.  EMS clinicians are often on the frontline of addiction and the unintended consequences of both legal and illicit drug use and substance use disorder (SUD). In addition, drug use greatly impacts the larger context of our nation’s roads and highways through impaired driving and the resulting risks to the impaired driver, other drivers, passengers, bicyclists, and pedestrians. A 2022 NHTSA study of seven trauma centers around the U.S. found that nearly 56% of people injured or killed on roadways tested positive for one or more drugs, including alcohol. The most prevalent drug category was cannabis, and opioids made up 8.5% of cases at the trauma centers. In this EMS Focus webinar, panelists will discuss: Harm reduction and SUD treatment in the context of EMS care Recent research  How innovation and intervention can drive overdose prevention in your community and reduction of other health risks, including traffic crashes that may be a result of impaired driving REGISTER HERE

Panelists Include: Kate Elkins, Emergency Medical Services/911 Specialist, NHTSA’s Office of EMS (moderator) Gerard Carroll, M.D., EMS Medical Director, Cooper University Health Care; Division Head of EMS/Disaster Medicine; and Program Director, EMS Fellowship Program John Ehrhart, Paramedic; EMS Manager, San Diego Health Connect; Co-Founder, California Paramedic Foundation; and Founder, Mission Critical Protocols Simon Taxel, Paramedic Crew Chief and Public Safety Diver, Pittsburgh Bureau of EMS; Bloomberg Fellow, Johns Hopkins Bloomberg School of Public Health

About EMS Focus EMS Focus provides a venue to discuss crucial initiatives, issues and challenges for EMS stakeholders and leaders nationwide. Be sure to visit ems.gov for information about upcoming webinars and to view past recordings. We are committed to providing equal access to this webinar for all participants. Persons with disabilities in need of an accommodation should contact nhtsa.ems@dot.gov to request an accommodation no later than Friday, March 19, 2024.