solving the ems problem: working toward a solution
TRANSCRIPT
Solving the EMS Problem:
Working Toward a Solution
Centers for Disease Control and Prevention. (2012). Suicide Facts at a Glance. Retrieved Aug. 7, 2015,
fromwww.cdc.gov/violenceprevention/pdf/suicide-datasheet-a.pdf
"What change would you make to better EMS?" Beyond pay and benefits, frequent responses
included:
•Improving work-life balance
•Recognition
•Increased education
•Participative management
Career advancement has been consistently identified in recent EMS Trend Reports as a
significant factor in improving employee satisfaction.
1. Doesn’t Tolerate EMS as a Mission
2. Only Tolerates EMS as a Mission
3. Fully Accepts EMS as a Mission
4. Fully Embraces EMS as a Mission
1-3 = System Danger & Vulnerability
Projected Population Change 2015-2035
Source: WI Dept. of Administration Demographic Services Center and U.W.-Madison Applied Population Lab
WI = 12.0%
Percent of Population Aged 65 & Over
10%
12%
14%
16%
18%
20%
22%
24%
26%
2010 2015 2020 2025 2030 2035 2040
US WI
Source: WI Dept. of Administration Demographic Services Center and U.W.-Madison Applied Population Lab
EMS Average Hourly Wages
Area Employment Mean Wages
Chicago-Naperville-Elgin, IL-IN-WI Metropolitan Statistical Area 7,390 $23.29
Minneapolis-St. Paul-Bloomington, MN-WI Metropolitan Statistical Area 2,440 $22.66
Racine, WI Metropolitan Statistical Area 180 $22.51
Janesville-Beloit, WI Metropolitan Statistical Area 140 $20.55
Fond du Lac, WI Metropolitan Statistical Area 60 $19.80
Eau Claire, WI Metropolitan Statistical Area 220 $19.09
Duluth, MN-WI Metropolitan Statistical Area 300 $18.26
Milwaukee-Waukesha-West Allis, WI Metropolitan Statistical Area 1,420 $17.11
Madison, WI Metropolitan Statistical Area 790 $17.06
Wausau, WI Metropolitan Statistical Area 160 $16.79
Wisconsin 6,460 $16.72
Appleton, WI Metropolitan Statistical Area 140 $15.68
Oshkosh-Neenah, WI Metropolitan Statistical Area S $14.86
Green Bay, WI Metropolitan Statistical Area 290 $14.48
Source: Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES)
Sources of Job Openings
Source: OEA Projections, 2016-2026
40.2%
54.2%
5.6%Total, All Occupations
Annual Exits Annual Tansfers Annual Growth
27.7%
65.4%
6.9%Emergency Medical Technicians and Paramedics
Annual Exits Annual Tansfers Annual Growth
http://nkenterpriseconsulting.com/2019/01/generational-preferences-v-differences/
HIGH SCHOOL EMT CLASS
https://www.ems1.com/ems-trend-report/
Act 336 creates a new Public Safety Certification Incentive
Grant Completion Award which provides a $500 student
award payment upon successful completion of Firefighter I,
Firefighter II or EMT Basic. In addition, school districts would
receive up to $1,000 when these students graduate,
consistent with the existing Career and Technical Education
Incentive Grant program.
Taxpayers Deserve
Answers, Not Shell Games
The joint fire departments or joint emergency medical services
district's total charges assessed for the current year (not just your
municipality's share) compared to the prior year, increased less than or equal
to the percentage change in the Consumer Price Index (CPI) from September
1 through August 31 of the current year, plus 2 percent. Note: The percentage
change in CPI from October 1, 2019, through September 30, 2020, is 1.4
percent.
All municipalities covered by the joint fire department or joint emergency
medical services district must adopt a resolution supporting the increase
State Medicaid Rates 2020Last Raise was Gov Doyle
The Community Paramedic Mobile Integrated Healthcare Program began as a pilot
project in the fall of 2015 after an analysis by the department revealed that 7% of the
62,763 calls for emergency medical services the year before — 4,288 responses —
came from the same 100 people.
Once the program was initiated, from October to December 2015, calls from such
patients who participated fell 26%.
In 2016 those calls fell by 56%, and fell by 62% in 2017, fire department officials said.
https://www.jsonline.com/story/news/2018/04/13/911-calls-chronically-ill-drop-after-milwaukee-launches-community-paramedic-initiative/511123002/
The Need to End Kingdom Building
911 ALS Emergency Response
Ready - Community Paramedics
https://www.hmpgloballearningnetwork.com/site/emsworld/article/1224069/role-mobile-integrated-healthcare-and-community-paramedicine-covid-19-pandemic
COMMUNITY PARTNERSENHANCING
QUALITY OF LIFE
COMMUNITY EMS PROGRAM
Community EMS (BLS & ALS)
Community EMS Bill Passes Assembly Madison – Today, the Wisconsin State Assembly passed Assembly Bill 151 (AB 151), authored by Representative Amy Loudenbeck (R-Clinton) and Representative Katrina Shankland, (D-Stevens Point) by a bipartisan, unanimous vote. AB 151 will advance opportunities for non-emergency health care services to be provided in Wisconsin. AB 151 creates and defines community paramedics (CPs) and community emergency medical technicians (CEMTs). It will allow for Emergency Medical Services (EMS) to operate in a non-emergency setting, under the medical direction of a physician, to provide treatment outside of a hospital.
Community Paramedicine
In community paramedicine programs, EMS paramedics receive extra training so that
they can provide basic primary care services in areas with limited medical resources.
Services can include wound care, suturing, and antibiotic administration.
Mobile Integrated Healthcare
Mobile Integrated Healthcare (MIH) programs are designed to use providers and
organizations of all types to provide the best care in the home and other nonclinical
environments. MIH programs may use paramedics with advanced training as
physician extenders to treat minor illnesses, as adjunctive mobile care to perform
home visits and provide post-hospitalization care, to perform patient triage to non-
hospital locations like detox or urgent care centers, as community health service
providers to provide immunizations or fall assessments, or any combination.
Considerations for your community
1.What problem are you trying to solve? Programs that are created simply to copy
another community’s model may not be appropriate and are likely to fail. Conversely,
programs that are tailored to your community’s issues are likely to succeed. Are there
too many “super users” or “frequent flyers” using your EMS system unnecessarily?
Tailor your program to address that specific issue.
2.Potential partners. Are there hospitals or home health care agencies in your
communities that you can partner with for funding, training, or personnel?
3.Regulatory climate. Scope of practice is being crafted now, but there is already so
much prevention that you can do
https://icma.org/articles/article/moving-your-communitys-ems-system-future
These Programs Can Help AnswerCommunity Well-Being Concerns
On-Site Services We Provide
✓ Schedule the home visit after discharge hospital notification.
✓ In-person initial home visit and follow-up visits in-person or by phone.
✓ Ensure that the customer understands discharge orders.
✓ Ensure that the customer understands their medications.
✓ Ensure that medications are organized to prevent over/underdose.
✓ Ensure the customer has a follow-up appointment with primary.
✓ Ensure the customer has transportation to the follow-up appointment.
✓ Assist in securing transportation for non-emergent needs.
✓ Monitor the social structure and that all utilities are working.
✓ Collect expired medication(s) and dispose of properly.
✓ Monitor for potential neglect or abuse scenarios.
On-Site Services We Provide
✓ Assess mental status.
✓ Assess mobility status.
✓ Review and/or check blood sugar.
✓ Review patient’s weight log/assess for fluid retention signs/symptoms.
✓ Assess vital signs.
✓ New on-set sepsis monitoring and check temperature.
✓ Install smoke/CO alarms, check or change battery.
✓ Assess for trip hazards, loose handrails, and overall home safety.
✓ Assist in making the residence safe if problems are identified.
✓ Facilitate discussion with primary care or hospital designee.
✓ Forward the results of the visit to the hospital liaison.
✓ Customized requests.
• Ground Emergency Medical Transport
– The Medicaid Ground Emergency Medical Transportation (GEMT) program provides supplemental payments to GEMT providers, using Federal dollars. The supplemental payments cover the funding gap between a provider's actual costs per GEMT transport and the allowable amount received from Medicaid.
What’s on the Horizon for $$
http://worh.org/sites/default/files/Medicaid%20GEMT-final.pdf
First Milwaukee Fire Department Community Paramedic Class - 2015
• Jerry Biggart, EMT-P, B.S. Fire Department Management
• Chairman of the Wisconsin EMS Board for Governors Walker and Doyle
• Contact:
– Jerry Biggart on Facebook
– @JRBiggart2 on Twitter
If I can Further Assist Don’t be a Stranger!