Dear Ground Ambulance Providers and Suppliers, We wanted you to be aware that we posted the following announcement on our Ambulances Services Center website: CY 2025 Physician Fee Schedule Final Rule CMS issued the CY 2025 Physician Fee Schedule (PFS) final rule that announces finalized policy changes for Medicare payments under the PFS and other Medicare Part B payment policy issues, including ambulance services. For CY 2025, we proposed to modify the definition of advanced life support level two (ALS2) at § 414.605 by adding the administration of low titer O+ whole blood transfusion (WBT) to the list of ALS2 procedures. We also solicited comments on whether we should add alternative blood product treatments, such as the administration of packed red blood cells (PRBCs) and plasma, to the list of ALS2 procedures. After consideration of public comments, and considering further that the indications for use, storage requirements, administration, monitoring, and training for the use of PRBCs and plasma are similar to those previously described for WBT, we are finalizing our proposal to modify the definition of ALS2 at §414.605 by adding the administration of prehospital blood transfusion (PHBT) which includes low titer O+ and O- whole blood transfusion therapy, PRBCs, plasma, or a combination of PRBCs and plasma. A ground ambulance transport that provides one of these PHBTs would itself constitute an ALS2 level transport.

IV Fluid Conservation Briefing and Supply Update On Monday, October 28th, the U.S. Department of Health and Human Services hosted a briefing on intravenous fluid (IV) conservation best practices.  This session was recorded and is now available at the link below.  Up-to-date information on shortages related to Hurricane Helene’s impact on Baxter’s North Cove, NC, facility can be found on the U.S. Food & Drug Administration’s Hurricane Helene webpage, as well as on Baxter’s website. View the Recording

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

The latest in a series of MAA roundtable events was held on Friday, Oct. 25 at Mayo Clinic Ambulance in Duluth.

A great crowd of local residents, EMTs, ambulance service providers, elected officials and staff were in attendance for the conversation. Panelists were MAA President Michael Juntunen, Cloquet Area Fire Chief Jesse Buhs, and Minnesota Rural Health Association Executive Director Mark Jones, with the discussion moderated by Kate Raddatz of McClung PR.

Topics included issues facing rural EMS, the role ground ambulance services play in the healthcare system, the impact recent state legislation has had, and recommendations for a sustainable future and continued, equitable access to care for all Minnesotans. Elected officials in attendance included State Rep. Natalie Zeleznikar (HD 3B, Hermantown) and State Rep. Roger Skraba (HD 3A, Ely), as well as Jacob Warkentin from the office of Congressman Pete Stauber (MN-8). Media in attendance included WDIO-TV, Fox 21, and the Star Tribune Duluth bureau. Newly appointed director of the Office of Emergency Medical Services Dylan Ferguson was also there for the conversation.

The next MAA roundtable will be held in Dodge Center on Wednesday, November 20 at 1:00 pm.

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.

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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.