The Department of State Health Services created a memorandum of agreement (MOA) for DSHS-licensed EMS providers to sign. The purpose of the MOA is to establish a mechanism whereby staffed ambulances may be deployed throughout the state to provide mutual aid in a pending or actual disaster.
DSHS has reviewed the initial MOA and made some changes based on input from EMS providers. Watch for the revised MOA on the Office of EMS/Trauma Systems Coordination website at www.dshs.state.tx.us/emstraumasystems/
These questions pertain to the MOA for ground units.
Q. Is it mandatory that our EMS provider respond after signing the MOA?
A. If you sign up for the state mission only, it is an optional mission. DSHS will contact you and determine whether you are able to respond. If you sign up for the state facility evacuation, it is a mandatory mission. If you sign up for both the state facility evacuation and subsequent state missions, you will be utilized for the mandatory state facility evacuation and then will be given a choice if further state missions are needed.
Q. How many EMS personnel can I send with each ambulance?
A. DSHS rules require that EMS providers staff each ambulance with two personnel at the appropriate level for the designation of the ambulance. Additional staff may be necessary for specific missions; however, this must be pre-approved by DSHS before the costs will be eligible for reimbursement.
Q. What time frames will we be paid for?
A. DSHS is the agency that will officially deploy an EMS provider after consultation with the State Operations Center (SOC). DSHS will consider the mission complete when your ambulance(s) arrive(s) back in your home area.
Q. Do the response-time requirements in the MOA refer to the time we leave our home area (en route) or the time we must arrive at the designated staging area?
A. It is the intent of DSHS to alert providers about an impending disaster situation as early as possible. The three-hour (state facility evacuation) and eight-hour (state mission) response times to have properly staffed ambulancesen route to a designated area (not AT the designated area) begin only after the EMS provider receives an official notification-of-deployment letter from DSHS.
Q. We have heard the original MOA changed. Is that true?
A. Yes, DSHS amend the MOA slightly after taking into account conversations with EMS providers. The following are changes to the MOA:
• As mentioned above, DSHS plans to reimburse EMS providers from the time ambulances leave their service area until they return.
• DSHS will reimburse municipalities or governmental providers actual labor plus fringe benefits for two crew members.
• The EMS provider will be able to invoice DSHS for the net of reimbursement. (Example: If the DSHS-licensed EMS provider receives $300 from a primary source of reimbursement such as Medicaid, Medicare, private insurance or a third-party provider, the $300 will be deducted from the total hourly rate for the mission.)
• DSHS removed the clause that the EMS provider would be reimbursed for “response-ready” time. DSHS will reimburse the EMS provider for the total hours deployed minus the payments received from primary sources of reimbursements as described above.
• The DSHS-licensed EMS provider is permitted to invoice DSHS for overtime hours (defined by the provider’s current policy during its normal course of business) worked for two crew members required to fill the regularly scheduled shift left empty by the crew that is deployed on a state mission or state facility evacuation. (Example: The “A-shift” crew is on duty and is the crew that is sent for a state mission or state facility evacuation. They are still deployed for their next regularly scheduled shift. The EMS provider can invoice DSHS for only overtime hours for the crew that fills the A-shift’s schedule.)
• DSHS will reimburse the EMS provider a maximum of $50 per crew member per mission (up to a maximum of $100) for items needed for the crew to be self-sufficient for approximately three to five days. These items include food, water and personal care items. The EMS provider must keep receipts for these items and submit them to DSHS when the provider submits an invoice to DSHS.
If you have questions regarding the MOA, please call Phil Lockwood at (512)-834-6700, ext. 2032 or email Phil.Lockwood@dshs.state.tx.us.