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Public Safety Workers’ Collective Bargaining Bill Progresses

Firefighters, EMS personnel and other public safety workers employed by state or local governments could be guaranteed collective bargaining rights if senators follow the lead of their House colleagues and approve an amendment to the Supplemental Appropriations Act of 2010, the Public Safety Employer-Employee Cooperation Act.

The amendment, which passed the House in July, was attached to the appropriations bill to provide continued funding for U.S. efforts in Iraq and Afghanistan, Haiti and other countries, as well as for several domestic programs. It comprised the language of the public safety employee collective bargaining bill, formerly a standalone bill pending in the House and Senate (see May 2010 Best Practices). While the amendment guarantees public safety workers collective bargaining rights, it prohibits employers, employees and labor organizations from engaging in lockouts or strikes. If signed into law, the bill would not invalidate existing collective bargaining units and agreements.

The House and Senate bills must contain the same language before the bill can be signed into law, so the appropriations bill, together with the collective bargaining amendment, must now be approved by the Senate.

Disaster Mitigation Program Reduces Responder Risk

The Predisaster Hazard Mitigation Act would continue to fund states’ natural disaster damage-prevention programs, which reduce injuries, loss of life and property damage in disaster-prone areas. Passed by the Senate in June, the bill would authorize appropriations to the Federal Emergency Management Agency (FEMA) Pre-Disaster Mitigation (PDM) program for grants to states to fund such projects as constructing levies, relocating homes from flood areas and earthquake-proofing buildings. With the PDM grant program due to expire in September 2010, the bill would extend grants through 2015 and authorize appropriations of $180 million in fiscal year 2011, increasing to $200 million in the final three years of the program, for a total of $970 million during the five-year period.

The bill would require the FEMA administrator to make grants through a competitive process. However, the amount of financial assistance to a state could not fall below $575,000, or 1 percent of the total funds appropriated, whichever is less. No state could receive more than 15 percent of the total funds appropriated for a fiscal year.

The PDM program has been hailed by state and local emergency managers for reducing risk and helping communities survive disasters with greater resiliency at a lower financial cost. A 2007 Congressional Budget Office report found that each $1 spent on the program cut future losses by about $3 and reduced the need for federal post-disaster assistance.

The House passed similar legislation in April 2009 but authorized $130 million more during the 2011 to 2012 period while funding the program only through 2012. The two bills must be reconciled before the president can sign the legislation into law.

House Votes Down WTC Responder Health Bill

House Democrats used a parliamentary maneuver on a vote on a bill that would improve health care services to 9/11 World Trade Center (WTC) emergency responders and recovery workers, which ended up working against them. Calling for a suspension of the rules and an immediate vote on the bill, a move that required the support of two-thirds of the members for passage rather than a simple majority, 255 members voted in favor of the bill and 159 against, largely along party lines. The bill was defeated.

Named for one of the first responders at the WTC site, the James Zadroga 9/11 Health and Compensation Act would extend and expand federal health services for WTC responders who became ill following their exposure to toxins during recovery work. The bill would create the World Trade Center Health Program within the National Institute for Occupational Safety and Health to provide medical monitoring and treatment to eligible WTC emergency responders and recovery workers; provide an initial health evaluation, monitoring and treatment benefits; establish the WTC Health Program Scientific/Technical Advisory Committee; establish the WTC Responders Steering Committee and the WTC Community Program Steering Committee; provide for education and outreach on services under the WTC program; provide for research and data collection of WTC-related health and mental health conditions; and provide for grants to address related mental health needs. The bill would also extend the deadline for filing a compensation claim.

House sponsors of the bill said they would bring it up again when they return in September from their summer break. The Senate bill is identical to the House version and was referred to the Senate Committee on Health, Education, Labor, and Pensions, which held hearings in June 2010.

Ambulance Services Relieved from Retroactive Billing

The Office of Inspector General (OIG) has released a policy statement advising ambulance providers that they will not be subject to sanctions if they choose to waive the increased cost-sharing expenses due from service recipients resulting from the extension of Medicare fee increases retroactive to Jan. 1, 2010. Urban fees were increased 2 percent; rural and super-rural were increased 3 percent. The changes were contained in the recently passed health care reform legislation.

Providers are not required to provide waivers, but if they do, they must be offered to all affected beneficiaries to avoid sanctions. In addition, the waivers must not be advertised.

In the absence of such an OIG decision, providers who did not seek the additional funds from service beneficiaries could have been viewed as being in violation of federal anti-kickback and related fraud laws and faced OIG administrative sanctions.

For the OIG statement, click here. The Centers for Medicare & Medicaid Services has posted the revised Public Use File with updated reimbursement rates under the Medicare ambulance fee schedule for 2010, reflecting the above increases. Click here to view the file.

Seasonal and H1N1 Flu Guidelines Revised for 2010-11

The Centers for Disease Control and Prevention has proposed new guidance for the upcoming 2010–2011 flu season, which will replace the 2009–2010 seasonal flu guidance and the Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings.

Because of the success and widespread availability of the H1N1 vaccine, the updated guidance emphasizes the importance of administering and promoting vaccinations as well as minimizing exposure through respiratory hygiene practice in health care facilities and prehospital settings; ensuring that ill health care workers, including EMS workers, stay home; taking droplet and aerosol avoidance precautions; conducting surveillance; and implementing such environmental and engineering controls as standard cleaning and disinfection procedures and shielding health care workers and patients from infected individuals.

The draft guidance is available at edocket.access.gpo.gov/2010/pdf/2010-15015.pdf. When the guidance update is completed, following the consideration of solicited comments on the initial draft guidance, links to the new information will be published at cdc.gov/h1n1flu.

Produced in partnership with NEMSMA, Paramedic Chief: Best Practices for the Progressive EMS Leader provides the latest research and most relevant leadership advice to EMS managers and executives. From emerging trends to analysis and insight, practical case studies to leadership development advice, Paramedic Chief is packed with useful, valuable ideas you simply can’t get anywhere else.