Headed to the Hill

A brisk breeze, clear April skies, and throngs of media crews covering Mark Zuckerberg’s Congressional testimony set the backdrop early in April as hundreds of EMS providers, educators, patients, and supporters from across the United States convened in the nation’s capital to advance the causes of EMS and elicit support from lawmakers. 

EMS On the Hill Day is an annual lobbying effort organized by the National Association of EMTs (NAEMT) that brings advocates face to face with legislators to discuss legislation important to the industry and muster support among members of Congress. Registrants were paired with other delegates from their states to attend scheduled visits with lawmakers. Delegations from well-attended states were split into multiple contingents, while those from less-represented states joined others.

This year 235 EMS professionals from 37 states and Puerto Rico attended meetings with 216 congressional leaders and their staff, according to NAEMT. A briefing program and networking reception the evening of April 10 allowed members of state delegations to meet each other, prepare for their visits, and go over the agenda for the day. Leave-behind materials were prepared for distribution, including fact sheets explaining EMS and primers on the legislative items on the agenda.

This year three pending bills were identified as top priorities to discuss:

• H.R. 1876/S. 781, the Good Samaritan Health Professionals Act of 2017, would “shield healthcare professionals, including EMS practitioners, from liability under federal or state law when they volunteer their services during a federally declared disaster.”
• H.R. 1445, the Veterans Reimbursement for Emergency Ambulance Services Act, “would direct the VA secretary to approve emergency ambulance services for reimbursement when a ‘prudent layperson’ would have reasonably expected that a delay in seeking immediate medical attention would have been hazardous to the life or health of the individual.”
• H.R. 5429, the Supporting and Improving Rural EMS Needs Act (SIREN Act), would “create a grant program for public and nonprofit EMS agencies in rural areas, many of which are at the forefront of the opioid epidemic, to support the recruitment, retention, education, and equipment for EMS personnel, specifically in rural areas.”

Also included in the leave-behind materials was a personalized letter from Rep. Timothy Walz of Minnesota imploring colleagues to join him on the EMS Caucus, a group of legislators that “helps promote, educate, and increase awareness around the federal policy issues impacting EMS.” As a result of these efforts, seven members of Congress agreed to sign on as new members of the caucus, NAEMT reported. The EMS Caucus must be reassembled following each congressional election.

Read on for reflections from the EMS World staff who traveled with their respective state groups and sat in on the meetings.

Maryland: A United Cause

When members of the U.S. Congress opened their door to the Maryland delegation for EMS On the Hill Day, they were probably surprised we weren’t a bunch of providers in Class A uniforms. In fact, the group’s makeup was quite unique, ranging from a fire department operations specialist to a director of online EMS continuing education to a CEO of a private ambulance company. While each brought a unique perspective to the crowded tables in the staff offices, all were united by a common cause: to advocate for the important legislation and pressing issues facing EMS.

Four of the five scheduled visits with Maryland representatives were run by congressional aides, who had done their homework for the meetings. They had prepared informed questions and clearly had read up on the legislation we were discussing. 

The advocates presented real-life stories about the issue of national drug shortages. Paramedic Trevor Hankins, who works for a private ambulance service in Maryland, shared his experiences resorting to second- and third-line medications for cardiac emergencies.

“When we cannot provide the medication that is most effective for our patients, it puts the patient’s health at risk,” Hankins told congressional aide Joshua Izaak of Sen. Ben Cardin’s office.

Maryland EMS advocates were thrilled to meet with Rep. Andy Harris, a physician in the field of obstetric anesthesiology and cosponsor of the Good Samaritan Health Professionals Act. Harris shared his appreciation with the Maryland advocates for the efforts of the EMS providers who responded to the January train-vs.-truck crash in Crozet, Va., where a truck driver died in a collision with an Amtrak train carrying lawmakers to a retreat. Harris also asked pointed questions about the Veterans Reimbursement for Emergency Ambulance Services Act and expressed interest in the EMS Caucus, which would clearly benefit from his medical expertise. 

—Hilary Gates

Pennsylvania: High Turnout

With D.C. just a two-hour drive from a few of the state’s main population centers, Pennsylvania was well-represented by a strong contingent of EMS professionals and supporters, which had to be split into two groups to cover the scheduled visits with lawmakers.

“The event has definitely grown, and it was encouraging to see the swell of support for EMS and issues important to the field,” said Keith Widmeier, BA, NRP, FP-C, director of education at Good Fellowship Ambulance & EMS Training Institute in West Chester. Widmeier has been attending EMS On the Hill for the past four years and stresses that ongoing personal interaction with representatives and staff is critical to keep EMS top of mind as healthcare laws are proposed and debated.

A highlight of the day was spending unhurried face time in the office of Glenn “G.T.” Thompson, who represents the expansive 5th District of Pennsylvania, which covers a wide swath from State College in the central region all the way to the coast of Lake Erie on the northwest border.

Explaining EMS issues of import to Thompson was not required—as a volunteer firefighter with more than three decades of service, active EMT, member of the EMS Caucus, and overall ambassador to the industry, Thompson was well-versed on the reasons for the visit and appreciative of the group’s time and service. Thompson pledged ongoing support both through bill cosponsorship and rallying support for the caucus.

Even when a representative wasn’t available—several were attending the Zuckerberg testimony or voting on the floor—legislative aides were responsive and conversant on the bills being presented, notably Brendan Fulmer, legislative assistant to Rep. Mike Kelly of Pennsylvania’s 3rd District, and Julie Nolan, deputy chief of staff and legislative director for Rep. Patrick Meehan.

“EMS is so fractured in terms of systems, methods of delivery, reimbursement, and patient populations,” said Kim Holman, executive director of Good Fellowship Ambulance & EMS Training Institute. “It’s incredibly important that we unify and present one voice, one message to our legislators.”

Both Pennsylvania groups (as well as the legislative aides they met with) were most interested in H.R. 1445, citing its importance in keeping veterans from footing the bill for an ambulance transport. Currently the VA requires medical records to be received, including the records of treatment after the emergency service has taken place, prior to reimbursing the provider. But HIPAA laws often prevent the agency from acquiring these records. The agency’s only recourse is to bill the veteran.

H.R. 1445 would bring VA reimbursement policies in line with Medicare, Medicaid, and most major third-party payers, which adhere to the “prudent layperson” standard of reimbursement.

“In today’s political climate, it’s become expected that professional groups such as ours gather to discuss legislation important to us,” said Timothy Bossert, COO of Good Fellowship Ambulance & EMS Training Institute. “It’s critical we come together at events like this. I also feel that if you have disagreements about the way the current system works or suggestions to improve it, you have an obligation to make those points heard to the people who can do something about it. If not, you’re just complaining.”

—Jonathan Bassett

Arizona and Nevada: The Western Front

I’ve been attending EMS On the Hill since it began in 2010, and this was the most fruitful one. Having spent the first seven years on the Hill representing Wisconsin, this was my first time attending from Arizona. And because the Arizona contingent was small (only me and John Guignon from Stryker EMS in Scottsdale), we joined our colleagues from Nevada: Troy Tuke from the Clark County Fire Dept. and Sarah McCrea and Jon Stevenson from Las Vegas Fire & Rescue.

I’ve certainly met legislators previously, but this was the first visit when one joined the discussion. Congresswoman Jacky Rosen from Nevada not only took the time to sit down with us but was fully engaged in the meeting. She was interested in everything presented, including joining the EMS Caucus, which she did shortly thereafter. Reps. Tom O’Halleran and Kyrsten Sinema from Arizona had already signed on.

In addition to the meeting with Rep. Rosen, we also held notable meetings with Camille Lepire, legislative aide to Rep. David Schweikert of Arizona, and Blair Bjellos, legislative aide to Sen. Dean Heller of Nevada, who in addition were keenly interested in each of the bills we discussed. 

I encourage you to take part in this important legislative event that truly makes a difference for EMS on a national level. And while you’re there, be sure to do what I do each Hill Day: Take time to visit a new monument, museum, or historical site. The city is rich in history and culture, much of which is free to see. Take the time—you won’t regret it.

—Scott Cravens

New Jersey: Connections

The experience of the New Jersey contingent was encouraging and fairly successful, considering how receptive the state legislators’ staff members were to the legislation presented. Before the day began, we’d been told this would likely not be the case, and that many staff members would probably be in a hurry to end our meetings. We were pleasantly surprised by their active listening and how they expressed compassion and understanding regarding the significance of the bills.

Robert Butora, health legislative aide to Rep. Leonard Lance, and Chris Griswold, health legislative aide to Rep. Tom MacArthur, both asked engaging questions to further understand the issues and confirmed they would bring them to the attention of the legislators.

Sarah Reingold, health policy advisor to Rep. Bill Pascrell, quickly warmed up once she found common ground with one of our members, a Marine veteran and EMT, because a friend of hers is also a former Marine now pursuing EMS work.

This shed light on the significance of reaching people on a level they can relate to; when trying to communicate ideas and goals, it’s not all about facts and figures or even partisanship. It became clearer throughout the day that people are more open to conversations and willing to provide support if they have a personal connection to an issue—especially in the field of EMS, where the community is so tight-knit and dedicated to quality improvement. 

Juan Gomez, legislative correspondent for Sen. Cory Booker, gave us a lot of time—more than we would have anticipated, at about 40 minutes. He was very engaged and seemed to be very much aware of Booker’s positions and past legislative participation on the healthcare front.

Of the legislation presented to him, Gomez was most interested in the VREASA legislation. He mentioned the senator’s interest in supporting veterans’ benefits and health, so this legislation seemed to resonate with him.

Jeff Rascoff, healthcare legislative assistant for Rep. Josh Guttheimer, met with us in the hallway outside the representative’s office and was asked to thank Rep. Guttheimer for joining the EMS Caucus. The group stressed how valuable initiatives such as EMS On the Hill are, as they achieve awareness but also tangible results, such as Rep. Guttheimer’s participation in the Caucus. While Rascoff did not weigh in specifically on any of the legislation during his few moments with us, he was generally supportive of EMS awareness.

—Val Amato and Joshua Hartman

‘Overwhelming Experience’

Above all, attendees stressed the camaraderie, energy, and enthusiasm of the event as the reasons behind its success.

“I was awestruck,” said Jennifer Smith, a board member of the Wisconsin EMS Association, EMT at St. Croix EMS in Hudson, Wisc., and the NAEMT 2018 Advocate of the Year. “Every bit of our time was spent in constructive dialogue. We are building key relationships and being proactive rather than reactive. We were organized, articulate, and able to get our points across. It was an overwhelming experience.”

To find out whether your senator or representative is a member of the EMS Caucus, visit www.naemt.org/advocacy/ems-caucus. Next year’s EMS On the Hill Day will be held April 10, 2019. A pre-event briefing will be hosted the evening before at the Hilton Crystal City in Arlington, Va. 

Val Amato, Jonathan Bassett, Scott Cravens, EMT, Hilary Gates, MAEd, NRP, and Joshua D. Hartman, MBA, NRP, are members of the EMS World staff.