Arkansas has become the 25th state to join the United States EMS Compact. This will enable EMS clinicians to deliver care across state lines.

The Recognition of EMS Personnel Licensure Interstate Compact (REPLICA) enables Emergency Medical Services (EMS) personnel to practice across state lines. Over 20 states have already enacted this compact. It grants licensed EMS professionals from one member state the Privilege to Practice in other member states, supporting efficient and flexible EMS response.

To join the EMS Compact, states must enact uniform model legislation without making substantive changes.

The Arkansas Department of Health issued a press release on April 10, 2025 confirming an active measles case in Arkansas for the first time since 2018. 

The Department of Health has provided some guidelines for all EMS personnel that provide clinical guidance for responders. See guidelines here:  PPE-Transport Measles Guidance for EMS 4-11-25 .pdf

Adopted March 1, 2025: Joint Position Statement on Criminal Liability for Alleged Deviations from Clinical Standards of Care in Emergency Medical Services 

This Joint Position Statement from several National EMS Organizations outlines guidelines for determining when criminal liability should apply to EMS clinicians for alleged deviations from clinical standards of care. It stresses that:

EMS clinicians should be held accountable within a just culture, which emphasizes organizational systems that contribute to errors.

Criminal liability for medical errors should be carefully considered, as it can deter EMS professionals from reporting errors, potentially worsening patient safety.

The statement proposes a four-part inquiry to evaluate whether criminal charges are appropriate:

• Was the action within the EMS clinician's duties?
• Did the action involve a deviation from clinical standards?
• Was it intentional or grossly negligent?
• Will criminal liability serve justice?

The statement also highlights concerns about the impact of criminal liability on EMS recruitment and retention, especially during a workforce crisis, and advocates for non-criminal forms of accountability such as civil or administrative actions for medical errors.

MedPac Meeting RECAP (3/6/25): Ground Ambulance Data

The Medicare Payment Advisory Committee (MedPAC) held the first of several Commission discussions related to the statutorily mandated report to review ground ambulance payment policy in light of the Ground Ambulance Data Collection System on March 6, 2025. In addition to the Ground Ambulance Payment Report, the agenda covered physician fee schedules updates, updates on reduction in cost-sharing for critical access hospital outpatient services, an overview of Medicare insurance agents, overview on Medigap, overview on home health care in Medicare Advantage, and institutional special needs plans.

The Bipartisan Budget Act (BBA) of 2018 required CMS to collect data on ground ambulance services through the Ground Ambulance Data Collection System (GADCS). MedPAC must analyze this data to assess Medicare payment adequacy and geographic cost variations, with a report due by June 15, 2026. Commissioners will review the data and guide the workplan. The American Ambulance Association noted the analysis will include cost data stratification by service type and level, as well as potential staffing differences. It will also examine data from a range of organizations, challenges for rural and super-rural providers, and comparisons of rural definitions. Additional focus areas include hospital vs. on-scene treatment, ownership data, treatment in place, payment impacts on response and transport decisions, the effect of “wall time” on costs, and differences between “loaded” and “unloaded” miles. 

MedPac Mandated Report: Payment for Ground Ambulance Services

Stay tuned for more information and updates on upcoming MedPac meetings!

The International Journal of Emergency Medicine Continuous published an article on a study that evaluates the impact of the American Heart Association's Mission Lifeline initiative on STEMI care in Polk County Fire Rescue (PCFR). By analyzing EMS data from 2015 to 2023, researchers found that Mission Lifeline protocols, such as prehospital 12-lead ECGs and hospital pre-activation, significantly improved EMS-to-balloon (E2B) times and STEMI triage accuracy. The percentage of patients meeting the 90-minute E2B time improved from 74% in 2015 to 84% in 2019, while under-triage rates dropped below 1% after 2020. These findings highlight the effectiveness of standardized, protocol-driven EMS interventions in optimizing STEMI care and improving patient outcomes.

EmergencyInsights - Infectious Disease Preparedness

EMS providers face significant risks from infectious diseases while responding to emergencies. Common threats include respiratory viruses, tuberculosis, hepatitis, HIV, meningitis, MRSA, and gastrointestinal illnesses. Effective infection control measures—such as proper PPE use, hand hygiene, sharps safety, equipment decontamination, vaccination, and exposure management—are crucial for reducing transmission. EMS agencies must ensure ongoing training, stockpile essential supplies, and implement outbreak response protocols. By staying informed and following best practices, EMS professionals can protect themselves, their patients, and the public while delivering high-quality care.

Learn More Here

JEMS: Safe guarding EMS Clinician Data

The Interstate Commission for EMS Personnel Practice has adopted Position Paper 2025-01 to strengthen data security protections for EMS clinicians. Amid rising cyber threats, EMS personnel face increased risks of identity theft and data breaches due to inconsistent licensure data safeguards. The Commission’s initiative aims to balance credential transparency with security by limiting public access to sensitive information, restricting bulk data disclosures, and implementing stricter verification processes. Recognizing EMS data protection as a national security issue, the Commission urges all states to adopt these standards, ensuring EMS professionals receive the same protections as other frontline responders.

https://www.jems.com/ems-management/safeguarding-ems-clinician-data-a-critical-step-in-protecting-the-workforce/

JEMS: EMS Staffing White Paper Released by NAEMT

Emergency Medical Services (EMS) play a critical role in saving lives and protecting communities. While traditional models focus on rapid response and ALS staffing, research shows that most EMS calls don’t require lifesaving interventions. This presents an opportunity to optimize resources while continuing to deliver high-quality care.

Key Challenges Faced by EMS:

• Workforce Shortages: Despite an increase in certified EMTs and paramedics, EMS agencies struggle to fill field positions due to low wages, burnout, and competition from other healthcare sectors.
• Financial Strain: EMS agencies often operate under financial pressure, with reimbursement rates falling short of covering operational costs, leading to service cuts and staff reductions.
• Unrealistic Expectations: While fast response times are important in critical cases, studies show that for most calls, patient outcomes are not impacted by rapid arrival times, allowing for smarter deployment strategies.

Solutions to Empower EMS:

• Tiered Response Models: Implementing a combination of ALS and BLS responses ensures critical patients receive advanced care while maintaining system efficiency.
• Evidence-Based Response Times: Aligning response time goals with clinical needs prioritizes patient outcomes and reduces unnecessary strain on EMS resources.
• Innovative Dispatch Strategies: Utilizing triage systems, telemedicine, and non-ambulance personnel for low-acuity calls ensures ambulances remain available for life-threatening emergencies.

Conclusion:
EMS providers are the backbone of community health and safety. By embracing data-driven strategies and flexible response models, we can strengthen EMS systems, support frontline providers, and ensure high-quality care for every patient. Investing in EMS means investing in safer, healthier communities.

EMS Staffing White Paper Released by NAEMT - JEMS: EMS, Emergency Medical Services - Training, Paramedic, EMT News

The document, An International Community Paramedic Career Structure: A Synthesis of the Literature, Regulatory Frameworks, and Community Paramedicine Expert Advice, investigates the emergence and structuring of community paramedicine (CP) as an essential extension of emergency medical services (EMS). This review synthesizes findings from global research, regulatory standards, and expert consultations to establish a career framework for community paramedics.

Key insights include:

• Core Competencies: Identifies the unique skillsets required for community paramedics, blending emergency response capabilities with public health and primary care knowledge to address underserved and remote populations.

• Training and Education: Highlights the need for specialized and standardized educational pathways that align with international best practices, ensuring community paramedics are adequately prepared for expanded roles.

• Integration with Healthcare Systems: Stresses the importance of community paramedicine being recognized as an integral part of broader health systems to enhance access to care and reduce strain on emergency departments and hospitals.

• Regulatory Support: Advocates for uniformity in certification and licensure processes to ensure career mobility and adherence to a standard scope of practice across jurisdictions.

• Sustainability: Emphasizes the role of structured career progression, ongoing professional development, and supportive workplace policies in sustaining a skilled CP workforce.

This comprehensive approach aims to enhance the effectiveness, accessibility, and continuity of community-based care, positioning community paramedic programs as a vital solution to contemporary healthcare challenges.

Assessment of The ImPACTS Project

An article recently published in the Pediatric Emergency Care journal discusses how the ImPACTS program (Improving Acute Care Through Simulation) fosters partnerships between pediatric specialty centers (hubs) and general emergency departments (spokes) to enhance pediatric care through simulation-based training. The study highlighted key success factors, including strong institutional support, leadership buy-in, effective communication, and the role of Pediatric Emergency Care Coordinators (PECCs). Barriers like resource logistics and lack of engagement were mitigated through collaboration. Outcomes included improved pediatric readiness, stronger clinical education, and enhanced institutional partnerships.