SB 66 funds on the fast track

By JOHN HULTGREN
Kentucky EMS Connection

FRANKFORT — Senate Bill 66 grant funds are on the fast track to being reinstated, but it may be a few more weeks before they are a reality.

Patricia Bausch, temporary legal counsel for the Kentucky Board of Emergency Medical Services, reported at today's board meeting in Frankfort that she had made some grammatical corrections to the emergency regulation passed at the last board meeting. The board approved these corrections and Bausch said she will now submit them to the Kentucky Legislative Research Committee.

However, because the new emergency regulations must replace existing regulations, then those existing regulations must first be repealed.

"There has been no repealer from [the Cabinet for Health Services] of the original bill," Bausch said. "I realize money is important, but we have to follow the law."

Senate Bill 66 grants are "still on the front burner," board chairman Mark Bailey said.

The board also approved filing emergency regulations 202 KAR 7.010E - 160E.

"We need to have these emergency regulations in place [on Jan. 1] or shortly thereafter," Bausch said. The new board plans to assume total responsibility for administering EMS in Kentucky on that date.

Bausch also explained that emergency regulations have an effective lifetime of 170 days. Since it takes 120 to 160 days to implement new regulations that have substantive changes, Bailey called for all regulation sub-committees to meet within the next week.

The board also approved all pending new and renewal paramedic certifications for consideration at December's Kentucky Board of Medical Licensure meeting. Under the old law, all paramedic certifications must also be approved by the KBML. After Jan. 1, KBEMS will be able to approve paramedic licensure directly.

The board also acted on the following ALS protocols and related issues, which must also gain final approval from KBML this month. After Jan. 1, KBEMS will also be able to approve medical protocols directly.

• Georgetown-Scott County EMS protocol revisions: approved.
• Medical Center at Bowling Green Ambulance Service protocol revisions: approved.
• Grayson County EMS protocol revisions: approved.
• Monroe County Ambulance Service protocol revisions: approved.
• Breathitt County Ambulance Service protocol revisions: approved with a precautionary statement that magnesium sulfate, when used as a tocolytic, requires two ALS providers attending to the patient.
• Breck County Ambulance Service protocols: sent back for revision.
• Marshall County EMS' new medical director, Louis Forte, M.D.: approved.
• Dayton Fire & EMS' new medical director, Daryl Emery, M.D.; approved.
• Franklin-Simpson EMS protocol revision regarding pediatric SVT and newborn resuscitation: approved.
• Adair County EMS protocol revision regarding determination of death, amiodarone, 12-lead ECG, morphine, potassium chloride for intrafacility transport, and use of capnography: approved with a precautionary statement that amiodarone is not approved for the endotracheal route of administration.
• Dayton Fire & EMS protocols: sent back for revision.
• Breathitt County Ambulance Service's medical director, G. Edward Burnette, M.D.: not approved due to lacking qualifications.
• Waynesburg Area Rescue Squad protocols: sent back for revisions.
• Res-Q Ambulance Service protocols: sent back for revisions.

In other actions, the board heard a report from board member Michael Swift about the current AdminaStar-Federal Medicare reimbursement crisis. Swift said that the Health Care Financing Administration is currently reviewing 18 Kentucky ambulance providers to see if they are eligible for reimbursement advances. Swift said that this review is expected to be completed within a week.

Swift also said that AdminaStar is processing reimbursement claims for emergency transports "on a fast track," but that claims for non-emergency transports are still going through a complete review. Emergency transports only account for an estimated 40 percent of all Medicare ambulance claims in Kentucky.

Swift also reported that April 2000 reviews are currently being processed, but batched reviews are now running one year behind.

KBEMS executive director Brian Bishop gave the board a report on the status of the transition.

Bishop reported that the state's transition coordinator has left for another job. "We are currently waiting for a transition coordinator to be named," Bishop said.

Bishop explained to the board an administrative order that establishes the office and staff structure.

"We can now begin to look at staffing positions," Bishop said. The process will start with the hiring of a medical advisor and legal counsel for the board.

A demonstration of new software to manage certification and licensure was given to the board.

The board, lacking any rules for conducting meetings, adopted the Kentucky Board of Nursing's guidelines until the rules and regulations committee can meet and draft guidelines specifically for KBEMS.

Board meetings were also set for the rest of the fiscal year. These meetings will be held Jan. 4, Feb. 1, Mar. 1, April 5, May 3, and June 7, 2001, at 1:00 p.m. Meeting locations will be announced at a later date. Because the state legislature must now meet annually, meeting space in Frankfort is becoming hard to obtain.

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