EMS News Briefs from Mike McEvoy

EMS Coordinator Mike McEvoy, Ph.D., NRP, RN, CCRN
NYSAFC EMS Committee

Medicare Ground Ambulance Data Collection

The Centers for Medicaid and Medicare Services issued a report on the first two years of their cost reporting system, affectionately known as the GADCS (Ground Ambulance Data Collection System). Overall, 95% of the ambulance agencies selected to report in Year 1 and Year 2 started their reporting; 85% completed it on time. This is the first comprehensive look ever at the actual costs of providing ambulance service. You can view the report here. The numbers certainly suggest that insurance monies come nowhere near reimbursing actual costs.

Governor Kathy Hochul’s Initiatives for Fire and EMS

In her State of the State address on January 14, Governor Kathy Hochul unveiled multiple initiatives to assist fire and EMS in New York. You can view the book of all the governor’s proposals here. Those specific to fire and EMS are:

Ensure Access to Emergency Medical Services
New York has taken major steps in the last two years to buttress the state’s emergency medical services (EMS) system. However, there are areas across the state where EMS services are not consistently and reliably available. Governor Hochul will introduce legislation defining EMS as an essential service and requiring counties to ensure all residents have adequate access to these services. Such legislation will also require counties to develop a county EMS mapping that will allow New York state to identify and fill gaps in coverage, coordinated statewide by the State EMS Task Force, which was established by Governor Hochul in 2022.

Amend Legislation to Allow Paramedics to Administer Buprenorphine
Buprenorphine is a highly effective medication used to treat opioid use disorder, but paramedics cannot currently administer buprenorphine due to statute that limits first responders’ ability to provide treatment upon contact. EMS interactions are a unique opportunity for interventions, especially in rural areas where distance and limited providers increase barriers to post-overdose care. Governor Hochul will propose legislation to allow paramedics to administer buprenorphine.

Expand Intensive and Sustained Engagement Teams
Individuals with lived experience are uniquely positioned to help others navigate difficult transitions, whether it’s finding stable housing, reentering the community after involvement with the criminal justice system, or managing other complex challenges. Peer support has been shown to be an effective way to engage individuals with mental illness, helping them build natural support systems and take control of their care. The Intensive Support Engagement Team (INSET) program provides voluntary, peer-led support to individuals on their recovery journey. These 24/7 multidisciplinary teams, led by peer specialists, offer trauma-informed, culturally responsive care tailored to individuals’ unique needs. INSET improves quality of life, reduces repeat hospitalizations and justice involvement, and strengthens natural support networks. Its flexible, person-centered approach ensures individuals receive care without rigid timelines or eligibility restrictions. Governor Hochul will expand the INSET program to ensure more individuals benefit from this effective, compassionate model of care.

Secure Additional Funding for Volunteer Fire Infrastructure and Response Equipment Grant Program
Volunteer fire services protect over 45 percent of New Yorkers, yet many departments lack the tools and infrastructure required for modern firefighting. Outdated equipment and aging facilities put both firefighter safety and operational readiness at risk. Governor Hochul will secure additional funding for the V-FIRE grant program, allowing departments to renovate or construct compliant fire stations equipped to meet the needs of a diversifying workforce.

Keep Our Firefighters Safe with Better Protective Gear
Our brave firefighters selflessly risk their lives to protect our communities, facing immense heat and hazardous conditions. To safeguard these heroes, they rely on specialized protective gear designed to withstand extreme temperatures and repel water and oil. For years, this essential equipment has unfortunately contained the emerging contaminant per- and polyfluoroalkyl substances (PFAS). Evolving evidence has revealed the potential dangers of PFAS exposure, raising concerns about the long-term health and safety of our firefighters even as we continue to work to limit the release of this contaminant into New York’s air, lands, and waters. Recognizing the need to protect both our firefighters and the environment, Governor Hochul will introduce legislation to ban the sale of firefighter gear containing PFAS in the state. This measure will help ensure our firefighters have access to the highest quality and safest protective equipment available while mitigating the potential public health and environmental impact of these chemicals. The legislation will take effect in 2028.

Expand Access to Medical Care in the Workers’ Compensation System*
There are approximately 80,000 medical providers in New York state, but only 10 percent are authorized to treat workers’ compensation claimants – significantly fewer than under Medicare. Access to quality medical care is critical for both the injured worker and for the employers who rely on their workers returning to the workforce. To expand the pool of workers’ compensation providers, Governor Hochul will advance legislation to automatically authorize all medical providers licensed in New York state and allow medical and surgical residents and fellows to treat workers’ compensation claimants. Providers also cite inadequate reimbursement levels as a barrier to caring for injured workers, and the current process to change the reimbursement levels is difficult. To ensure regular and automatic updates, Governor Hochul will increase the fee schedule and tie it to the Medicare fee schedule. Finally, in December 2006, the Department of Financial Services (DFS) issued legal guidance directing health insurers to cover medical treatment for injured workers while the workers’ compensation claim is being contested. To ensure injured workers do not have a gap in payment of medical bills, Governor Hochul will advance legislation codifying this guidance and permitting workers’ compensation insurers to temporarily pay medical bills without admitting responsibility for the workers’ compensation claim.

*I’d note that if workers’ comp can tie to the Medicare fee schedule, why can’t EMS?

The governor’s budget is likely a little over a month away so we will soon see where the rubber hits the road on these and other items.