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EMS Section Resources

Administration and Planning

Fire-based EMS strategic planning document (MS Word file)
The EMS Section has developed a strategic planning document that a state or local fire-based EMS entity can use as a template to develop a collaborative and influential position in their political environment. It is designed to provide a nine step process for a fire-based EMS department to use to develop a significant voice within their specific EMS system and then their state’s EMS management structure.

Salary & Workplace Survey: Conducted annually by the Journal of Emergency Medical Services (JEMS):

• 2010
• 2009

Centers for Disease Control (CDC) EMS Materials

Blast Injury Fact Sheets for Professionals

Field Triage Decision Scheme

Guidelines for Field Triage of Injured Patients (PDF) - Recommendations of the National Expert Panel on Field Triage (January 2009)

Injury Response

Mass Casualty Event Preparedness and Response

Communications and Technology

IAFC comments on FCC broadband effort focused on emergency medical responders (pdf)

EMS Vehicles

NFPA Standard for Automotive Ambulance Report (pdf) February 2010

EMS Education & Professional Development

National Fire Academy final open spots for first semester (FY12) EMS courses (pdf)

Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions
CoAEMSP Report: April 2010 (pdf)

IAFC-EMS Section issues joint statement of support for the Chief Medical Officer Designation (pdf)

EMS Education Standards

National standards represent the next steps in implementing the EMS Education Agenda for the Future: A Systems Approach, headed by the National Highway Traffic Safety Administration and the Health Resources and Services Administration. Comments submitted by EMS Section 7/31/07 (pdf)

EMS and the Volunteer and Combination Fire Service

Orange Ribbon Report: Leading and Managing EMS in Volunteer and Combination Fire Departments (pdf, 6.4 mb)

Emerging Diseases

Anthrax

Meeting summary: DHS Office of Health Affairs round-table discussion (pdf) of local and state capabilities for responding to an aerosolized anthrax event, held December 2008

Pandemic Flu

May 6, 2009: Joint IAFF/IAFC/EMS Section letter to House and Senate Appropriations Committee leaders calling for increased pandemic influenza funding for the EMS community in the Fiscal Year 2009 Supplemental (pdf)

Guidance on Allocating and Targeting Pandemic Influenza Vaccine (pdf 1.3 mb)
By the U.S. Departments of Health and Human Services and Homeland Security

Ryan White Reauthorization Act

Ryan White HIV/AIDS Treatment Extension Act of 2009 Signed

Joint IAFC and IAFF call to reinstate necessary public safety source-patient notification provisions removed in 2006:

• To House Committee leadership (pdf)
• To Senate Committee leadership (pdf)

Federal Issues

HHS Clarifies Patient Outcome Information Sharing
HHS has responded to requests to clarify HIPAA implications for sharing patient outcome information for EMS quality improvement purposes. This letter from the Department of Health and Human Services (pdf) outlines when patient information can be shared between EMS agencies and healthcare providers in order to improve overall quality of care.

CMS document explaining Medicare ambulance services (pdf)

IAFC Comments on Lead Federal Agency for EMS (pdf)
Apr. 14, 2011... As part of their review of the current and future role of the federal government in EMS, the Federal Interagency Committee on EMS (FICEMS) requested input from stakeholders. The IAFC submitted comments crafted by the EMS Section, stating that the Department of Homeland Security (DHS) would be the appropriate home for a lead federal agency for EMS, a discussion that an argument can be made that DHS already has this authority with citations to federal statute and a list of what a lead agency should do.

IAFC Comments on CMS 2010 Proposed Rule on Mileage and Productivity (CMS-1503-P) (pdf)
Aug. 20, 2010... The IAFC submitted formal comments, developed by the IAFC EMS Section and its Medicare/Medicaid Committee, to the Centers for Medicare Services (CMS), concerning proposed changes to the reporting of fractional mileage, the multifactor productivity adjustment for reimbursements, enrollment requirements, and the urban/rural/super-rural bonus payments. The letter also requests that the National Rule Making Committee be reconvened to deal with issues raised in 2000 and in the subsequent GAO funding report and to consider Treat and Release and Non-Traditional Destination issues, especially in urban areas.

Change to Medicare Billing Reporting
May 7, 2010… On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act. One week later, on March 30, the President also signed into law the Health Care and Education Reconciliation Act of 2010. These two new laws have a significant impact on the Medicare program and many of the provisions have effective dates prior to this point in time. Over the past several weeks, the Centers for Medicare & Medicaid Services (CMS) has begun implementing various provisions of the new laws, including those with past effective dates. In addition to implementing these legislative changes, the Medicare Physician Fee Schedule is being updated to include certain corrections, retroactive to January 1, 2010.

Once Medicare contractors have the new payment files in place, per the above, all claims going forward will be processed at the revised rates. However, we continue to work on the best way to address the many claims that are paid at the rates that were in place before the current corrections and updates are made. Please be on the alert for further information about how CMS will address past claims. Until then, providers should NOT resubmit previously-processed claims affected by the payment changes, as it is likely that these resubmissions may be denied as duplicate claims.

CMS Deadline a Challenge to EMS Billing Software Providers
The EMS Section and its Medicare/Medicaid Committee wrote a letter to the Centers for Medicare Services (CMS) (pdf), requesting it extend the deadline of CMS change request #6372 so software vendors can modify the existing electronic billing systems for municipal emergency services to reflect the new CMS date of service for ambulance services.

CMS Proposes Modifications to Patient Signature Regulations
IAFC comments to CMS regarding the proposed modifications to patient signature regulations (pdf)
August 2008

The Centers for Medicare and Medicaid Services (CMS) proposed more changes to the beneficiary signature regulations that would modify the regulations that went into effect on January 1, 2008. The new changes would, in part, add language requiring ambulance services to make "reasonable efforts" to obtain the patient's signature before they can rely on a signature of a legal guardian, power of attorney or other authorized signer on the patient’s behalf.

The section’s comments opposed this modification on the grounds that:

• "Reasonable efforts" were not well defined
• In consideration of the increased administrative burdens on both EMS services and patient care in obtaining the signature, either at first contact or after the fact.

The comments explained that in order to submit a Medicare claim, the EMS field or department billing personnel would have already obtained all of the secondary documentation—signed contemporaneous statements or facility signatures—required by the CMS to submit the Medicare claim without the beneficiary’s signature. If the CMS already has adequate authorization to accept a claim, it seems redundant and a waste of local EMS resources to have to chase down patients weeks after the event.

The section’s comments supported the proposed rule’s addition of an exception to the beneficiary signature requirements for emergency ambulance transport services to non-emergency services as well.

CMS Proposed Ruling: State Medicaid Spending
IAFC comments to CMS regarding the proposed state medicaid spending rule (pdf)
March 2008

In late February, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule in the Federal Register dealing with state Medicaid spending, under which:

• States will be permitted to submit amended state Medicaid plans to eliminate non-emergency medical transportation as a covered Medicaid benefit.
• Those state Medicaid programs that cover such services would no longer be required to pay for non-emergency transport services for many categories of Medicaid enrollees.

As this aspect will adversely impact the EMS community, the EMS Section Executive Committee encourages all section members to review the proposed rule (pdf) and consider submitting comments against its adoption.

Fire Service-Based EMS Issues

Watch the Fire-Service Based EMS "The Right Response" video:

• IAFC and IAFF reaffirm their support for fire service-based EMS 
• IAFC Position Statement: Fire-based Emergency Medical Services (pdf) 
• Press Release: White paper on 9-1-1 Emergency Medical Response released (pdf)
• White Paper: Prehospital 9-1-1 Emergency Medical Response: The Role of the U.S. Fire Service in Delivery and Coordination (pdf)
  This document, prepared by top EMS physicians from across the United States, describes fire service-based EMS and the time-critical role of the fire service in providing emergency medical care. 

An Assessment of the Institute of Medicine Recommendations: Emergency Medical Services at the Crossroads (pdf)
This document, prepared by the IAFC's EMS Section, has been adopted as official IAFC policy.

10/5/2009: NBC Response to Criticism of Trauma Show (pdf)
9/30/2009: Chair of the IAFC EMS Section’s Letter to NBC Network Criticizes New Show Trauma (pdf)

NFPA 1584