L ook out, Washington, here comes EMS. Paramedics and EMTs from across the country went to the hill for the third time to talk to members of Congress about what’s important to the EMS community and its patients.
There’s only so much that can be done on the local and state levels. Federal funding and guidance is needed in some areas. And that’s why we saw the third EMS on the Hill Day, hosted by the National Association of Emergency Medical Technicians (NAEMT).
Legislators have to hear from their constituents if there’s any chance of them understanding what’s going on outside of Washington. EMS providers go to talk to their representatives and senators about what they see as a non-partisan issue: providing quality care to their patients.
NAEMT President Connie Meyer, EMT-P, EMS captain for Johnson County Med-Act in Olathe, Kan., was excited about this year’s EMS on the Hill Day. She says they expected 190–200 EMS personnel to attend—up from 145 in 2011. Something new this year was a partnership with the American Ambulance Association (AAA). AAA participation replaced their regular lobby day.
EMS on the Hill Day attendees were invited to participate in AAA’s Reimbursement Task Force meeting on Tuesday afternoon, March 20, for discussions on reimbursement issues, healthcare reform, Medicare ambulance relief and other emergent topics.
Tuesday evening included a pre-visit briefing with the opportunity for attendees to mingle and see old friends or network with new contacts.
Wednesday morning, the visits to Congressional offices began. Armed with their talking points (more on that below), EMS professionals met with their representatives and senators or staffs. The meetings not only gave EMS personnel the chance to speak of legislature issues that touch them professionally and personally, but they also allowed the legislators the opportunity to learn more about EMS. During a previous visit, one staffer asked, “So you’re not a fire man?”
And the knowledge exchange has already led to an event that Meyer characterized as “huge.” What she’s referring to is a request from a federal legislator for NAEMT input on a bill being written. An elected official in Washington came to NAEMT for advice.
While visiting the Congressional offices, attendees have talking points, supplied by NAEMT. This year’s issues include the following talking points:
>> The Medicare Ambulance Access Preservation Act of 2011 to provide for a more permanent solution to below-cost Medicare ambulance reimbursement;
>> The extension of death and other benefits under the Public Safety Officers’ Benefits (PSOB) program to non-profit, nongovernmental paramedics and EMTs who die or are severely injured in the line of duty; and
>> The legislation to establish new EMS grant programs; enhance research initiatives; and promote high-quality, innovative and cost-effective field EMS.
To assist active members in attending EMS on the Hill Day, NAEMT awarded grants of up to $1,200 each to four active members.
One of the grant recipients was Jason Scheiderer, EMT-P, of Indianapolis, Ind. He’s employed by Indianapolis EMS and teaches paramedic courses at Indiana University-Purdue University Indianapolis. Scheiderer has advocated for local issues, walking the fine line between concerned taxpayer and public employee. NAEMT’s state advocacy coordinator for Indiana, Scheiderer appreciates NAEMT’s focus on improving EMS on a grand scale. “Not getting into local issues like fire department vs. private EMS providers,” he says.
W. Mike McMichael III, EMT-B, and 2011 NAEMT grant recipient from Delaware, returns to Washington for the 2012 event. McMichael says, “I’m tickled to death to be involved” in this endeavor that “will help everyone in the country.” Although he personally knows his representative and Delaware’s two senators, he liked the opportunity to see them working.
On May 4, 2011, in Washington, D.C., 145 EMS professionals from 39 states and the District of Columbia and Puerto Rico met with more than 217 U.S. Senators, House Representatives and their congressional staff at the second annual EMS on the Hill Day.
The fourth EMS on the Hill Day is tentatively scheduled for the first week in March 2013. That would coincide with 2013 EMS Today, so you could attend both on one plane ticket.
Mark your calendar and watch the NAEMT site for more details in the months to come.
Mardi Gras No Party for EMS
New Orleans EMS responded to more than 2,000 calls during a 10-day period in February. That’s 67 more than their normal activity. Despite all the strange weather across the country this winter, the increased call volume in New Orleans wasn’t because of hurricanes or other natural disasters.
It was Mardi Gras—definitely a man-made, and perhaps unnatural, event. Weeks of reveling take their toll on the thousands of residents and tourists who show up for the 60 Krewe parades and other celebrations.
Deputy Chief of EMS Ken Bouvier says, “Obviously, there’s a lot of alcohol poisoning.” Perhaps, not unrelated, there are also falls from ladders and balconies in the French Quarter.
Bouvier says their transportation fleet included 25 ambulances, six Fast Cars, an ASAP mini-ambulance, two bicycles and an 18-stretcher mobile ambulance bus.
The parade route is approximately 60 city blocks, according to Bouvier. “We try not to cross parades, so we have staff on both sides of the streets.”
The Red Cross saw about 1,000 patients in its four first aid tents. The tents were staffed with six to eight volunteers ready to treat such minor complaints as sprains, foreign objects in the eye or requests for a Band-Aid. Red Cross first responders also wandered through the crowds keeping an eye open for anyone in need of medical assistance. Armed with radios, the first responders called EMS as needed.
Bouvier characterized this year’s Mardi Gras as “well attended” without violence along the parade route—evidently that’s noteworthy when you talk about Mardi Gras.
Planning is paramount for a city-wide, three-week celebration. Bouvier says they start planning for the next year about a week after Mardi Gras ends. They look at the statistics and reports to see what worked and what could be improved. For example, the city made more use of the Red Cross this year, “because it works,” says Bouvier. The mini ambulance and bike teams are new additions, too.
As Mardi Gras draws near, New Orleans EMS has to make sure it has enough medications on hand, enough staff ready to work—forget about ever getting time off to enjoy the festivities with your family or friends—and enough ambulances ready to roll.
Next year’s Mardi Gras will be an enhanced challenge, says Bouvier. New Orleans hosts Super Bowl XLVII on February 3, 2013, so the city has decided to split up the Mardi Gras events to bookend the Super Bowl. That is, there will be a week of Mardi Gras celebration, a week devoted to Super Bowl activities and then another week of Mardi Gras.
Bouvier says they will be ready. And they’ll all probably be ready for a long vacation in March. —Ann-Marie Lindstrom
2012 National EMS Memorial Bike Ride
The National EMS Memorial Bike Ride (NEMSMBR) is gearing up for the 2012 Ride, with routes beginning in Boston, Mass., or Paintsville, Ky., on May 19—both finishing in Alexandria, Va., on May 25.
During the ride, participants will travel through the states of Massachusetts, Kentucky, Rhode Island, Connecticut, New York, New Jersey, Pennsylvania, Maryland and Virginia.
“To see these parts of the United States on a bicycle is such a unique perspective,” says Tim Perkins, NEMSMBR public information officer.
“It’s also great to interact with the providers and agencies along the route, not to mention the reason for the ride: honoring over 30 individuals who have given the ultimate sacrifice providing EMS care,” says Perkins.
Additional rides are scheduled for Colorado in June and Louisiana in September.
The healthcare industry has come a long way since Health Insurance Portability and Accountability Act (HIPAA) went into effect almost a decade ago. For the most part, EMS providers now have a much better understanding of how HIPAA applies to their day-to-day operations. Nevertheless, many “HIPAA myths” still exist. Here are some of the top myths in the EMS industry today.
>> Myth: HIPAA prevents EMS agencies and facilities from sharing patient information.
All healthcare providers should know that HIPAA permits them to freely share patient information for treatment-related purposes. That means that facilities can give EMS providers medical records about patients, and crews can look at those records for treatment purposes. It doesn’t matter that another provider created the medical record.
Ambulance services may also provide a copy of their trip reports to facilities because such practice would also fall under the “treatment” umbrella. Under HIPAA, “treatment” includes the provision, coordination and management of healthcare between providers.
>> Myth: Law enforcement officers are automatically entitled to patient information.
Many EMS providers believe that if a law enforcement official asks for information about a patient, they’re automatically entitled to it. Although there are circumstances under which ambulance services may release patient information to law enforcement, there’s no general provision in HIPAA that broadly permits providers to release patient information to law enforcement. To the contrary, providers can only give patient information to law enforcement officials under specific circumstances.
If an ambulance service receives a request for healthcare information from law enforcement, the service must check to see whether HIPAA contains a specific exception that permits the release of the information. Some of the more common exceptions include reporting a crime in an emergency or disclosures that are required by state law (e.g., gunshot wounds and dog bites). Check with your HIPAA privacy officer before you release information to law enforcement. If you improperly disclose information, you risk violating HIPAA, and that information might not be allowed to be introduced as evidence because it was improperly obtained.
>> Myth: It’s OK to post as long as the patient isn’t identified.
EMS providers have a legal and ethical duty to refrain from posting any “protected health information” (PHI) on the Internet. Most of us know that PHI is anything that could directly identify a patient. However, what many fail to consider is that some information might reasonably identify a patient, even though it doesn’t mention a patient by name. The bottom line is that if someone reading the post might be able to figure out who the patient is, the information might be PHI, and posting it could violate HIPAA.
For example, a post stating, “Was on a pretty crazy trauma on I-95 tonight … that guy had no shot,” might convey enough information to enable friends or family members of the deceased patient to identify him because they undoubtedly know about the incident.
Because others can determine the identity of the patient from the limited information provided, this post improperly divulges PHI. Generally, no legitimate reasons justify posting any information about a patient on the Internet. Moreover, it’s unethical—and unprofessional—to refer to a patient, in any manner, on the Internet.