If a bill pending in the Senate becomes law, air ambulance services will have to adhere to an accreditation system in order to remain eligible for Centers for Medicare & Medicaid Services (CMS) fee reimbursement. The Air Ambulance Medicare Accreditation and Accountability Act would create three levels of increasingly demanding standards of patient care; air ambulances would have to meet the requirements of one of the levels to comply.
A Level I accreditation, the lowest level of capability and scope of practice, would require a service to be capable of providing advanced resuscitation during transport. A Level II accreditation would require Level I capabilities plus medical care equivalent to that provided by a hospital emergency department, while a Level III accredited air ambulance would achieve the prior two levels of service and meet the standard of care available at a tertiary-level intensive care unit. The standards address personnel skills, medical oversight, necessary equipment and other provisions required to ensure a high caliber of patient care.
An accreditation organization, to be created, would oversee standards development, review accreditation applications, conduct audits, report on the program and take other actions to ensure the program’s integrity. The CMS air ambulance fee schedule would be adjusted to reflect the costs involved in providing the different levels of service.
The bill, introduced in July, would take effect two years after becoming law. The Senate referred the legislation to the Committee on Finance; the House has no companion bill.
No Cancer Coverage for WTC Responders
Firefighters seeking health care benefits for cancer they’ve developed since working at the World Trade Center (WTC) recovery site following the 9/11 attacks must wait longer for help. The National Institute for Occupational Safety and Health (NIOSH) has ruled that cancer is not a condition related to their work in searching for missing people and clearing debris at the site.
The bad news came in the First Periodic Review of Scientific and Medical Evidence Related to Cancer for the World Trade Center Health Program, released in July. The NIOSH director serves as the administrator of the WTC Health Program as mandated by the James Zadroga 9/11 Health and Compensation Act, passed in December 2010.
The document lists toxins released at the site, some known human carcinogens, and acknowledges that responders were exposed to one or more of these. The problem is peer-reviewed medical studies, upon which the decision to omit cancer from the list of WTC-related health conditions was based. There is little in the research that shows a direct connection between personal exposure and the development of cancer among responders, according to the review authors.
The NIOSH director says the second periodic review will be conducted in early to mid 2012, when any new scientific evidence will be weighed and the decision to omit cancer could be reversed. For more information, visit cdc.gov/niosh/docs/2011-197/pdfs/2011-197.pdf.
New EMS Agenda Targets Future Workforce
In its latest contribution to the discussion of critical EMS issues, the National Highway Traffic Safety Administration (NHTSA) offers, in its Emergency Medical Services Workforce Agenda for the Future, a vision of a robust EMS workforce by 2020 and a strategy for achieving this goal.
Shifting its focus from the education and training of EMS workers to a broader perspective that considers recruitment, retention, health, safety and other workforce issues, NHTSA identifies four areas of improvement necessary for an educated, trained, credentialed EMS workforce that is well compensated, healthy and safe, and large enough to serve as an integral part of a community-based EMS system:
1. Health and safety: Collecting workforce illness and injury data through a national EMS Workforce Injury and Illness Surveillance Program for the creation of evidence-based health and safety standards and practices
2. Education and certification: Implementing the EMS Education Agenda, including national certification, and the National Incident Management System National Emergency Responder Credentialing System
3. Data and research: Developing an integrated system of uniform data collection on all aspects of the EMS workforce
4. Workforce planning and development: Adopting an evidence-based approach to workforce planning and development to meet future needs across geographic service areas and the identification of recruitment and retention best practices
In this vision, a National EMS Workforce Technical Assistance Center would be established to collect and disseminate information to aid national, local and private stakeholders with workforce development. The document, which provides greater details on all of these programs, is at ems.gov/pdf/2011/EMS_Workforce_Agenda_052011.pdf.
New USFA Head Named
President Obama announced in August his intent to nominate Ernest Mitchell Jr. as administrator of the U.S. Fire Administration. A past president of the International Association of Fire Chiefs, Mitchell served as fire chief and assistant director of disaster emergency services with the Pasadena (Calif.) Fire Department from 1998 to 2004.
If confirmed, Mitchell would replace Deputy Administrator Glenn Gaines, who has been functioning as interim administrator since Administrator Kelvin James Cochran resigned the position in June 2010, after serving less than one year.
