By Jason White 

While the legislative session was wild and wooly this year, as most are for various reasons, EMS faired pretty well.

A new ‘Do Not Resuscitate’ law was passed.  While 45 or so states already have such a law, we finally completed this important legislation for Missouri.  A coalition of the “Right to Life” groups, the “End of Life” groups and EMS met and worked on a DNR bill since June of 2006. 

During a state-declared disaster, health care workers who respond to provide assistance will have increased protection from lawsuits.  The storm experience of 2006 showed that increased legal protection was needed in order to attract health care workers to volunteer to staff temporary medical facilities.  This bill is listed as HB 579.

Medicaid reimbursement for ground ambulance services was increased by $1,000,000.  It has been many years since there has been an increase in the amount of money Medicaid had to disburse to ground ambulance services.  While the House Appropriations Committee had recommended an increase of $1.2 million in state money the final decision had been to provide only an additional $400,000 in state money.  For every 39 cents of state money, the federal government will provide an additional 61 cents to support the Medicaid program, thus the additional $400,000 in state money this year will mean a little over $1,000,000 in new money for ground ambulance services.

Highway and bridge naming is now possible for EMS personnel who die in the line of duty.  HB 732 allows for the naming of bridges and highways in honor of emergency services personnel who die in the line of duty.  This is certainly a nice opportunity for remembrance.  The Missouri Department of Transportation has a formal process for the naming of these assets.

New Ambulance District Board members will be required to attend a one day class covering the basics of how to perform their job. This comes as a result of the passage of SB 22.  This will require that all board members first elected after January 1, 2008, will attend the seminar.  Presently, the Missouri Ambulance Association conducts a one day seminar for Ambulance District Board members and we expect them to continue to offer the program.

Seatbelt Law -  The effort to pass the seatbelt law failed.  Presently 24 states have a seatbelt law where the police can pull you over for not wearing your seatbelt.  States that have this primary enforcement have a 10-12% improvement in seatbelt use.  Had this increase in seatbelt use existed in Missouri we would have expected 90 fewer deaths a year and over 1,000 serious injuries down graded because of the lifesaving benefit of seatbelts.

Motorcycle Helmets - Current Missouri law requires that motorcycle riders wear helmets.  There was a serious effort made to repeal that law.  The effort failed meaning that helmets will remain a required item for all motorcycle riders.

Rogue Fire Departments - The rogue fire department bill passed.  SB 47 requires all fire departments to register with the fire marshal.  Through this mechanism rogue fire departments should be controlled.  The problem language which impacted ambulance services was corrected during the legislative process.

Medicaid Reform - SB 577 which reformed the Medicaid program passed at the last moment during the legislative session.  The new law creates some new expectations on health care providers regarding Medicaid.  There will be protections for employees who turn in suspected Medicaid fraud (whistleblower protections) just as there are similar protections regarding Medicare fraud at the federal level.  The new law also sets the goal of increasing Medicaid payments to the federal Medicare level. 

Peer Review - The Trial Attorneys killed peer review numerous times.  Peer review was attached to three bills, all of which passed, but in each case the power of the trial attorneys was more than enough to kill our issue.  Preparations are already being made for next year’s effort so that EMS workers get the same legal protections that doctors and nurses have had for many years.

Death Benefit - The State Council of Firefighters worked hard to create a death benefit from the state which would have provided $100,000 to the families of EMS staff who died in the line of duty.  Several amendments got attached to the bill which drove the total cost higher than the state could afford thus killing the bill.

Minimum Wage Correction - The minimum wage law passed in November contained some language which led some lawyers to think that the federal protections regarding over time for firefighters and police officers had been vacated and thus cites would need to pay overtime for all hours worked over 40.  The effort to make the correction failed in some classic power politics.

Busy year but overall a good year for EMS legislation.

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