EMS Industry Trends | Cyber Liability | Employment Law Legislation S UMMER 2014 2014 Stars of Life Recipients | Annual Convention Plans Find out why others have trusted the Multi-Grip since 1989. The Multi-Grip was designed by a fire-fighter in 1989. Today this effective CID is used across the US as well as in other countries. It comes in three sizes: adult, child and pediatric. This is a complete system for your head immobilization needs. Its design makes it a universal head immobilizer appropriate for a variety of situations. Based on a truss system, the Multi-Grip maintains superior strength, and any patient movement will tighten the straps to create the ultimate immobilization. It’s simple and it works. Home of the Tank Boss Portable O2 Cylinder Lift Manufacturing Find out why others have trusted the Multi-Grip since 1989. The Multi-Grip was designed by a fire-fighter in 1989. Today this effective CID is used across the US as well as in other countries. It comes in three sizes: adult, child and pediatric. This is a complete system for your head immobilization needs. Its design makes it a universal head immobilizer appropriate for a variety of situations. Based on a truss system, the Multi-Grip maintains superior strength, and any patient movement will tighten the straps to create the ultimate immobilization. It’s simple and it works. Home of the Tank Boss Portable O2 Cylinder Lift Manufacturing S UMMER 2014 CAA Vision Assure delivery of excellent pre-hospital care to the people of California by promoting recognized industry best practices. Table of Contents CAA Mission 3 | Chair’s Message | Helen Pierson • Serve as the voice and resource on behalf of private enterprise emergency and non-emergency 4 | Executive Director’s Report | June Iljana ambulance services. • Promote high quality, efficient and medically 6 | Legislative Update | Chris Micheli, Esq. appropriate patient care. 7 | Member News: Peter Brandon Receives Lifetime • Advocate the value that pre-hospital care provides in achieving positive patient outcomes. Achievement Award | Medic Ambulance Expansion • Promote effective and fiscally responsible EMS 8 | EMS Commission Report | Jaison Chand systems and establish standards for system design. 8 | CAA Political Action Committee | John Surface CAA Leadership 9 | Feature Article: Cyber Liability for Health Care Employers | Spencer Hamer, Esq. BOARD OF DIRECTORS 11 | Feature Article: Current Legislation Impacting Chair | Helen Pierson Employment Law | Chris Micheli, Esq. Vice Chair | Alan McNany 12 | Feature Article: CAA Members Teach Hands-Only Secretary/Treasurer | Eb Muncy CPR at the State Capitol Directors | Richard Angotti | Edward Guzman | Carol Meyer | Fred Sundquist, Jr. 13 | Feature Article: EMS Industry Trends and Best Sergeant-at-Arms | Josette Mani Practices | Bill Bullard STAFF 16 | 2014 Stars of Life Recipients and Event Photos Executive Director | June Iljana | [email protected] Administrative Director | Kim Ingersoll | [email protected] Editorial Information Legislative Advocate | Chris Micheli | [email protected] The views and opinions in the articles herein are not to be taken as official expressions Accountant | Tricia Schrum, CPA | [email protected] of the publishers unless so stated. The publishers do not warrant, either expressly or by implication, the factual accuracy of the articles herein, nor do they so warrant any views or opinions offered by the authors of said articles. Manuscripts and queries should be directed California Ambulance Association to Editor, the Siren at the address listed below. 2520 Venture Oaks Way, Suite 150 © Copyright 2014 California Ambulance Association. No material can be reproduced without Sacramento, CA 95833 the express written consent of the publisher. (877) 276-1410 (toll free) (916) 924-7323 (fax) Circulation among California’s private ambulance providers, elected officials and EMS www.the-caa.org administrators. Chair’s Message Determination and Working Together Will Lead to Success! “Continuous effort – not strength or intelligence – is the key to unlocking our potential.” - Winston Churchill Helen Pierson | Chair of the Board n May 13th Governor Brown provided by private ambulance services. Our annual “Stars of Life” Celebration and reported California’s Medi-Cal Our Medi-Cal reimbursement rates haven’t Legislative Summit was held on April 1st expansion, which he called “a huge changed since 1999! in Sacramento. This year we honored 41 Osocial commitment,” will soon cover 30% paramedics, EMTs, and staff from across the of the state. The state budget shows Medi- Once again, Senator Dr. Ed Hernandez has state. As a special treat this year, the Stars Cal growing from 7.9 million in July 2013, authored a bill on our behalf to address this were recognized from the Assembly Floor to 10.5 million Californians today, and inequity, SB 1374. I request that all members while visiting with their local legislators. that enrollment is projected to grow to 11.5 write letters to your Senate and Assembly million by June 2015. I applaud Governor representatives. Although the bill stalled in During the celebration dinner, the repeated Brown’s successful effort to get more the Senate Appropriations Committee, it is stories of heroism and service reminded Californian’s insured, and I do agree with important that we continue to press our case. us all that we are fortunate to have these him that it is a “huge social commitment.” Ask them to help our industry. We need to “special angels” working with us and serving What I don’t understand is how he expects work together in order to be heard in the their communities. We were also honored ambulance providers to serve 30% of legislature. Determination by all of us to to have outgoing Speaker of the Assembly, Californians at current Medi-Cal rates. educate our legislature of these facts. Thank John Perez, recipient of the CAA Legislator you to Dr. Ed Hernandez for supporting the of the Year award. Our guest speakers were Statewide, ambulance providers already California Ambulance Association. Assemblumember Freddie Hernandez, who deliver an estimated $165 million in is an alumnus of the Stars of Life, and Dr. uncompensated care to Medi- Cal I would like to express my appreciation Howard Backer, Director of the State EMS beneficiaries. While hospitals and to everyone who participated in our Authority. physicians receive a portion of their losses Community Paramedicine Panel on May for uncompensated care back through the 30th in Sacramento. The information Internally, your Board of Directors has Maddy EMS fund, through an increase shared by our presenters was important worked diligently in balancing a budget in fines for moving violations, ambulance for the advancement of our industry and for our Association with the assistance service providers DO NOT. Air ambulance gave us all plenty to think about as we of Executive Director June Iljana, service providers receive a Medi-Cal look at how the changing landscape of Administrative Directors Jennifer Blevins reimbursement supplement also based on “mobile integrated healthcare” may affect and Kim Ingersoll and CPA Tricia Schrum. an increase in fines for moving violations. our business models. Thank you to Brenda We are looking into the future and working Public agencies get reimbursement through Staffan of REMSA, Lou Meyer from the on a strategic plan with the assistance of our the GEMT fund. Currently, no state California EMS Authority, Jim Pierson from Legislative Advocate, Chris Micheli, that or federal funding is provided to offset Medic Ambulance in Solano County, and will keep our organization strong, viable and uncompensated care and charity care Bill Bullard of The Abaris Group. respected in the California Legislature. Continued on page 15 California Ambulance Association | 3 Executive Director’s Report Helping Patients is the Easy Part... Getting Paid for it is Tough June Iljana | Executive Director y far, the steepest learning curve routinely audited, denied and otherwise sent higher rates to private insurers to remain I’ve experienced since joining the into appeal purgatory for months. solvent. This “cost shifting” is both expected CAA has been related to billing. A and forced by government payers and rates Byear and a half ago I couldn’t tell Medi-Cal In a recent meeting with the CAA, Noridian are approved by the counties. and Medicare apart—actually, sometimes indicated that: I still get them confused—but it couldn’t Private insurers have pushed back on cost 1) Unless a specific EMT or paramedic skill be more important to our members. Low shifting over the years, but now their efforts was actually employed during the transport reimbursement rates are bad. Not getting have ramped up. Statewide, ambulance the claim would be denied. paid at all is even worse. companies are receiving payments far below billed amounts with statements that the 2) If the patient could have been transported Fortunately, our Payer Issues Committee, insurer believes they have paid a fair price. In in any other way, regardless of whether chaired by Donna Hankins of American some cases they are instructing the patient another option was actually available, the Ambulance, as well as the entire team not to pay the remainder. California law claim would be denied. of committee members who share their allows ambulance companies to bill the experience and knowledge, ensure that the 3) A physician’s order for ambulance patient for any amount unpaid by the insurer, CAA is out there working hard to address transport can be overturned by the medical but that is a last resort for any provider. some very thorny problems. Below is an review staff at Noridian. overview of two of the challenges billers are We recently met with the Department of facing and the work being done by the Payer Congress recently held a hearing to Managed Health Care and plan to meet with Issues Committee to address them. investigate the high rate of claim denials the California Department of Insurance by Medicare contractors and cited an OIG asking them to support our battle for full Medicare report showing that 56 percent of denials payment by insurers.