As we close out 2023, ACEP’s chapters were invited to share news from the past year and a preview what’s to come. Chapters have been busy advocating for physician autonomy, hosting educational events, and continuing to support their members on a variety of workplace issues.

Alabama

The Alabama Chapter partnered with other health organizations in its state to launch the “Odds Are” Campaign to address fentanyl overdoses. During the campaign’s launch, Alabama Chapter Board Member Bobby Lewis, MD, FACEP, detailed the emergency department perspective and insight into the state’s fentanyl crisis. Find more on the “Odds Are” Campaign at https://vitalalabama.com/get-information/odds-are-alabama/.

Alaska

The Alaska Chapter has worked hard to enhance the impact of emergency physicians throughout the state through legislative advocacy in Juneau, including the 80 percent rule and other reimbursement issues. Additionally, the chapter collaborated on clinical guidelines such as frostbite, trauma, and stroke.

Arizona

AzCEP achieved several legislative victories that were enacted into law, benefiting various health care professionals, including rural clinicians and the EMS community. Many of these successes were championed by AzCEP Board Member, State Rep. Amish Shah, MD, FACEP. These laws were collective wins for the hospitals, emergency physicians, and patients.

Arkansas

Arkansas ACEP has been busy at work with outreach activities, including an upcoming visit to the University of Arkansas for Medical Sciences (UAMS) Emergency Medicine Residency program and an Arkansas ACEP event planned for Northwest Arkansas. The chapter also plans CME opportunities in emergency obstetrical care and treatment of opioid use disorder.

California

The State Legislature passed the first Medi-Cal rate increase in 20 years. The initial proposal included increases for primary care and mental health clinicians but did not include emergency physicians, who care for a disproportionate share of this patient population. (One-third of the state’s population is insured by Medi-Cal, yet 42 percent of ED visits are made by Medi-Cal patients.) CalACEP staff and member physicians engaged in aggressive lobbying and grassroots efforts on this access, equity, and reimbursement issue—and their advocacy efforts literally paid off. Starting in 2025, $200 million will be devoted annually to increase emergency physician reimbursement. This would not have happened without the chapter’s work, which resulted in emergency physicians being the only physician specialty specifically identified in the legislation!

Colorado

During the 2023 legislative session, physician assistants (PAs) pursued the ability to practice medicine without physician supervision. CO ACEP fought hard to assure that PAs are liable for the care they provide and requiring supervisory agreements for new PAs, PAs changing their specialty and PAs practicing in the ED at Level I and II trauma centers. The chapter continues to work on this scope of practice issue as the rules and regulations for its implementation are developed. In addition to the change in the PAs scope of practice, CO ACEP worked to enhance extreme risk protection orders while preserving patients’ HIPAA right and ensuring emergency physicians carry no liability in such circumstances.

Connecticut

CCEP was actively involved in many pieces of legislation during the 2023 session, including establishing a task force to examine the increase of patient boarding in emergency departments statewide. The task force is charged with providing recommendations to the CT General Assembly during the 2024 and 2025 legislative sessions.

Delaware

During ACEP’s Leadership and Advocacy Conference, the Delaware Chapter members had successful meetings with Rep. Lisa Blunt-Rochester’s team, Sen. Chris Coons and his team, and Sen. Tom Carper and his team regarding emergency department crowding and boarding, workplace violence in the ED, and the Medicare Physician Fee Schedule. Delaware ACEP sponsored several members to attend a pediatric skills course this year.

District of Columbia

The DCACEP Chapter submitted two resolutions that were passed by the ACEP Council in October 2023: “Declaring Firearm Violence a Public Health Crisis” and “Clarification of and Taking a Position Against Use of Excited Delirium Syndrome.” The DCACEP Chapter is also the proud chapter of the new national ACEP President, Aisha T. Terry, MD, MPH, FACEP.

Florida

FCEP’s events and annual conference continue to grow exponentially in attendance and member value. During its Emergency Medicine Days event, 25 attendees met with more than 30 state legislators to discuss the chapter’s 2023 legislative priorities. The Life After Residency conference provided more than 60 PGY-2 & PGY-3 EM residents the opportunity to meet employers, learn valuable life lessons and spend time together outside of the hospital in a relaxed but educational environment. Symposium by the Sea 2023 featured a balance of scientific presentations, networking/social events, resident competitions, and unique opportunities for attendees to engage with their peers in a family-friendly atmosphere.

Georgia

GCEP completed the second year of applications for its Georgia Diversity Scholarship, designed to help an underrepresented, minority, 4th year medical student participate in an emergency medicine rotation in the state. GCEP continues to support a successful leadership fellowship program that equips its participants for advocacy at multiple levels. The chapter will have three new leadership fellows in 2024, and many graduates are actively involved in GCEP, ACEP, and the AMA. GCEP hosted three excellent CME conferences. The Rural Emergency & Critical Care Conference continues to draw attendees from many states and is considered the premier course for this topic. The chapter also hosted a Leadership and Advocacy conference, as well as the Coastal Emergency Medicine Conference, which is a tri-state event among Georgia, South Carolina, and North Carolina.

Government Services

In 2023, GSACEP hosted its largest Government Services Symposium in Austin, Texas, welcoming more than 150 participants. The event featured three days of outstanding educational programming, product exhibits, a research showcase, KSA labs, friendly residency program competition in its annual SimWars, and the opportunity for collaboration between active duty and reserve military, VA and other federal agency physicians. GSACEP also selected CPT Katey Osborne, MD as the inaugural COL (Dr.) Dave Barry Leadership Development Fellow, designed to develop and prepare future military and federal EM leaders by combining elements of coaching with skills in organization, education, advocacy, and involvement. At the ACEP23 Council meeting, GSACEP also sponsored two resolutions – Metric Shaming and Compensation for Required Training – which both passed with minor amendments. GSACEP also continued its advocacy efforts to decrease boarding in military and federal hospital facilities, ensuring health care readiness in the military, and providing mental health resources and support for GSACEP physicians, their patients, and members of the U.S. armed forces.

Hawaii

Hawaii ACEP had several legislative successes this year, including:

• Incorporation of Senate Bill 397 into the state budget (originally SB397), which mandates an increase in Medicaid reimbursements to be equal to Medicare reimbursements.
• Passage of SB674, the Interstate Medical Licensure Compact, which creates an expedited pathway for currently licensed physicians to become licensed in multiple states.
• Incorporation of HB661 into the state budget, which provides an addition of $10 million in fiscal year 2024 and $20 million in 2025 for the Hawaii State Loan Repayment Program for Healthcare Professionals.

Idaho

With the partnership of the Idaho Academy of Family Physicians, the Idaho Medical Association, and the American College of Obstetricians and Gynecologists, the Idaho chapter achieved greater clarity on abortion-related language. HB 374 eliminates the affirmative defense standard (guilty until proven innocent), but solely focuses on the life, not the health, of the mother. The bill includes exceptions for ectopic or molar pregnancy, the removal of a deceased unborn child, and the treatment of a woman who is no longer pregnant. For the upcoming year, the chapter plans to collaborate with IMA to designate EMS as an essential service and reform the process for mental health holds, aiming to enable physicians to release the hold, aligning with practices in other states.

Illinois

During the past year, ICEP has made significant strides in advancing the chapter’s advocacy priorities:

• The introduction of Illinois Senate Bills 1621 and 1622 marked a pivotal moment in the chapter’s fight against violence targeting health care workers in the emergency department.
• The chapter’s efforts to combat boarding issues have resulted in constructive dialogues with health care leaders and policy makers.
• In the chapter’s campaign against scope creep, chapter leaders successfully established a foundation for future regulatory clarity.

Indiana

The Indiana Chapter advocated for the passage of SEA 400, which states that emergency departments must have an on-site and on-duty physician at all times that is responsible for the emergency department.

Iowa

The Iowa Chapter advocated for tort reform and non-economic damage caps.

Kansas

Kansas ACEP worked in close collaboration with the state’s elected officials and helped push for increased funding for behavioral health emergencies, securing $22.5 million dollars in funding to help create a new Behavioral Health Emergency Department. The chapter is also arranging a large advocacy event in Topeka, where many KSACEP members will meet with legislators to discuss issues currently impacting emergency medicine.

Kentucky

Kentucky ACEP has focused on physician scope of practice. In addition to this work, the chapter added an emergency pediatric section to its Board of Directors to further involve that community. The chapter’s annual meeting has provided a venue for statewide research poster presentations and the “Battle of the Bluegrass” emergency medicine residency competition.

Louisiana

During 2023, the Lousiana Chapter celebrated its members’ achievements in excellence, including Dr. Nicole McCoin’s honor as recipient of the ACEP National Emergency Medicine Faculty Teaching Award. Dr. Keith Van Meter was elected by the LA-ACEP Board to serve as its representative on the Governor’s Louisiana Emergency Response Network. Dr. Jamie Kuo was elected by the chapter Board to represent LA-ACEP at the 2023 Louisiana State Medical Society House of Delegates. She was also appointed to serve on the National ACEP State Legislative and Regulatory Committee, where she joins veteran members Dr. Debbie Fletcher and Dr. Luke LeBas.

Maine

This year, the Maine Chapter created a new political action committee (PAC). The chapter PAC will focus on state legislative issues related to emergency medicine and Maine emergency physicians.

Maryland

The Maryland ACEP Chapter Practice Management Committee successfully organized two highly attended virtual events. The first event centered on the current and future state of EMS offloading, and the second event explored potential strategies for the future of the Global Budget Revenue program in emergency medicine. Additionally, prominent chapter leaders regularly participate in the HSCRC ED Flow Committee, advocating for emergency physicians in Maryland.

Massachusetts

MACEP is known as a strong advocate for emergency medicine and was invited by the State Legislature to participate in several State workgroups focused on boarding and crowding, as well as stroke.

Michigan

MCEP hosted another successful Michigan Emergency Medicine Assembly that was well attended and featured a balanced mix of exceptional educational presentations, networking/social events, resident rapid-fire lectures, family fun, and ended with a special reception to honor the chapter’s past presidents and 2023 award recipients. MCEP’s continued advocacy efforts include:

• Celebrated having the largest chapter contingency at ACEP’s Leadership and Advocacy Conference.
• Applauded the House passing the chapter’s Violence in the ED bills. Members of MCEP’s leadership testified at the House Criminal Justice Committee hearing on the legislation.
• Started conversations about pursuing an increase in Medicaid reimbursement with the state’s Medical Services Administration, which is part of the DHHS.
• Continuing to support ACEP’s efforts working with the FTC on consolidation’s effects on the emergency physician.

Minnesota

The Minnesota Chapter is committed to advocating for emergency physicians at the Capitol each year—fighting not just for the professionals in this specialty, but also for patients. This year, the chapter started significant initiatives to enhance its presence and reach, including the development of a new logo and website. These changes reflect the chapter’s commitment to adapt and grow in response to the evolving needs of the members and the communities they serve. Also, the chapter will host the MN Emergency Medicine Summit for the first time post-pandemic.

Mississippi

The Mississippi Chapter of ACEP has been able to strengthen its engagement with its lobbyist, establishing frontline access to EM-relevant legislation. Each week during Mississippi’s legislative session the chapter’s Board of Directors receives an itemization of relative initiatives, as well as a comprehensive summary, and timelines for tracking of initiatives from the lobbyist. The chapter Board gets informed early to monitor and identify potential threats, as well as opportunities for growth, to best serve emergency medicine in the state.

Missouri

MOCEP had a productive legislative year where the chapter battled and protected the scope of practice. Chapter leaders recognize that this will be an ongoing effort for many years to come, and are committed to continuing the fight. The chapter reported an excellent turnout at the Missouri Emergency Medicine Summit, its Advocacy Day, and the Missouri Reception at ACEP23. The chapter’s EPIC newsletter was revamped this year to provide more content that the members want to read. For more about the chapter’s 2022-23 work, their annual report is on MOCEP.org.

Montana

Montana ACEP held a successful Spring Symposium in Bozeman, showcasing local EM experts in a sunny outdoor setting beneath the Bridger Mountain range. Chapter members advocated at the State Capitol for the prioritization of physician-led teams, worked with state leaders to expand mental health services and eliminate ED mental health boarding, and embarked on an advocacy campaign opposing legislation of medical practice standards.

Nevada

NV ACEP is committed to advocating for emergency physicians at the state capital during the biennial Legislative Sessions. In 2023, without a budget for a lobbyist, the chapter successfully interfaced with other organizations to yield reasonable outcomes on two issues: med-mal reform and PA practice independence. As a small state chapter with limited resources and availability, it has been challenging to have the chapter’s interests represented in Carson City when it counts most. The chapter has avoided some onerous bills over the years, which have been significant threats to both patients and physicians’ livelihood, but the challenges are not over. The chapter’s goal for 2024 is to increase membership and re-engage the current members to leave a mark at the next Legislative session. The ACEP24 Scientific Assembly will come to Las Vegas, Nevada, Sept. 29 – Oct. 2 next year.

New Hampshire

Signed by Gov. Christopher Sununu, SB 58 allows law enforcement to arrest people engaged in threatened or actual violence, while in the care of a medical professional on the premises of a residential care or health care facility. A physician member of NHACEP testified and helped get this important legislation passed.

New Jersey

New Jersey ACEP advocates for emergency physicians by actively engaging with legislators on critical legislative priorities, addressing matters related to scope of practice and other issues affecting members and their patients. Additionally, chapter leaders regularly visit medical schools and residency programs in the state to better understand their needs and provide support for the next generation of emergency physicians in New Jersey.

New Mexico

The chapter’s commitment to the future of emergency medicine continues to grow with the establishment of the New Mexico Medical Student Council. The chapter’s recently formed Recruitment and Retention Committee is dedicated to amplifying member engagement in legislative and advocacy activities. NM ACEP was represented at the ACEP Leadership and Advocacy Conference by six members who met with House and Senate officials’ staff on Capitol Hill to advocate on issues related to ED boarding, workplace violence in the ED, and Medicare reimbursement for ED care. The NM ACEP Political Action Committee welcomed new Board members and is set to undergo revitalization.

New York

New York ACEP Chapter advocacy efforts included defeating independent practice for physician assistants, supporting and passing authorization for the Community-Based Paramedicine Demonstration program, as well supporting non-patient specific orders a registered professional nurse may perform. New York ACEP continues to work on advancing legislation to address violence in the emergency department, as well as practitioner identification and advertising.

North Carolina

After many years of work, Medicaid expansion is set to begin in North Carolina on December 1, 2023. The chapter also was able to get substantial legislation approved in the General Assembly to combat violence in the ED by requiring each hospital to have a law enforcement officer on site or conduct a security assessment. The new law also requires that data be collected each year on the number of assaults, any charges made and convictions for those charges. NCCEP member Dr. Seth Bleier was invited to speak to Congress about the implementation of the No Surprises Act and NCCEP is actively working on related issues. The chapter is also proud that NCCEP Past President Dr. Abhi Mehrotra was elected to the ACEP Board of Directors during ACEP Council 2023!

North Dakota

Members’ voices are essential to identifying and solving the problems that emergency physicians face throughout the state and country.

Ohio

Ohio ACEP members met with 36 legislators on Advocacy Day to discuss strengthening the prudent layperson law, violence in the ED and ED boarding. The chapter hosted both the Midwest Medical Student Symposium and Residents’ Assembly, attended by more than 360 individuals. Multiple Ultrasound, LLSA Review and Simulation Based Neonatal & Maternal Skills Courses were also offered, and Dr. Amal Mattu oversaw updates to the Carol Rivers’ Emergency Medicine textbook for a 2024 release of the 11th Edition.

Oklahoma

The Oklahoma College of Emergency Physicians has a new website coming in early 2024, with a revision in look and user-friendly content, featuring member spotlights and advocacy updates. OCEP reports a successful 2023 legislative session in which OCEP members communicated directly with Gov. Kevin Stitt to effectively advocate against nursing practitioner independent practice. OCEP leadership continues to prioritize a voting resident member on its chapter Board of Directors and a full Councillor spot dedicated to a resident member, highlighting OCEP leadership development of our next generation of Oklahoma emergency physicians. OCEP is proud to support its members Dr. Bo Burns as President-Elect of CORD, Dr. Derek Martinez as Director of Leadership on the EMRA Board of Directors, and Dr. Jeffrey M. Goodloe as Chair of the ACEP Board of Directors.

Oregon

The Oregon Chapter’s biggest accomplishment in 2023 was developing, advocating for, and shepherding through the State Legislature a bill to greatly expand Narcan availability throughout the state.

Pennsylvania

In May of 2023, PACEP hosted our largest PACEP23 Scientific Assembly at Kalahari Resorts & Convention Center with a record attendance of 282! Great educational sessions, PACEP Olympics, and Spivey, CPC, and the Keystone Case Competition were just a few of the highlights.

Puerto Rico

Through grassroots efforts and national ACEP’s support, ACEP PR was able to derail Senate Bill 1134 that proposed an alternate pathway to emergency medicine specialty certification.

Rhode Island

The chapter’s executive board actively worked on the boarding crisis in our emergency departments with the Governor’s office and authored an op-ed featured on the front page of The Boston Globe. The chapter is nearing success working with the Executive Office of Health and Human Services to raise the rates of Medicaid reimbursements for critical care billing. Additionally, chapter members successfully advocated for emergency medical dispatch statewide, which will increase bystander CPR rates and subsequent improved outcomes from out-of-hospital cardiac arrest. The chapter also actively engaged in several initiatives to address climate change’s impact on human health. Chapter members testified before the U. S. Senate Finance Committee, hosted an Earth Day event, secured funding for a 2024 climate change and health symposium, contributed to environmentally friendly design planning for Alpert Medical School’s new life sciences research building, and aided in the development of a Planetary Health curriculum for Alpert Medical School.

South Carolina

The South Carolina Chapter is experiencing sustained growth and success, including a flourishing Leadership Fellows program and dynamic Legislative Day. The chapter maintains involvement in the Coastal Emergency Medicine Conference. On the legislative front, SCCEP successfully advocated against allowing APRNs and PAs to establish independent practice. Additionally, the chapter supported legislation aimed at helping emergency physicians and obstetricians find career pathways in rural areas, while also paving the way for potential freestanding emergency centers to bolster the strength of the state’s safety net.

South Dakota

With the assistance of local resources and national ACEP, the South Dakota Chapter was successfully able to defeat SD SB 175, which would have allowed for a path to independent PA practice, as well as SD SB 87, which would have allowed for optometrists to perform eye and laser surgeries. Going forward, scope of practice legislation will continue to be SD ACEP’s top priority.

Tennessee

TCEP hosted a successful 2023 educational symposium featuring presentations on various topics and issues impacting emergency medicine in Tennessee. The chapter is committed to the future of emergency medicine as continues to mentor and provide support for residents attending ACEP’s Leadership and Advocacy Conference. All Tennessee ACEP Chapter Councillors demonstrated their personal commitment to the political future and research initiatives of the specialty by supporting NEMPAC and EMF.

Texas

Texas is a great state for both practicing and receiving medical care because of its amazing tort law that was passed in 2003. Being involved with TCEP helps ensure that the chapter continues to protect this tort law every legislative session.

Utah

UCEP hosted its annual Emergency Physician Summit in Salt Lake City, headlined by Dr. Scott Weingart of EM:RAP and EMCrit, and Dr. Christopher Kang, then-ACEP President, among other esteemed speakers. The event brought top-notch education and EM insights, along with free CME, to Utah’s emergency physicians. UCEP also sent five delegates to ACEP’s Leadership and Advocacy Conference to lobby the Utah legislators on Capitol Hill for decreased ED boarding, increased opiate use disorder resources, and maintaining current Medicare and Medicaid rates. UCEP’s jail clearance task force met with state law enforcement administrators and establish an improved process that eliminates the detailed forms emergency physicians were required to complete that made them liable for “clearing” a patient for jail and now allows emergency physicians to perform an MSE to determine if an arrested person has an emergency medical condition, just as with any patient.

Vermont

Multiple chapter members have been involved in active advocacy to pass VT S36 which relates to crimes against health care workers at hospitals and against emergency medical treatment professionals. This allows law enforcement to remove individuals who assault or engage in violent, tumultuous, or threatening behavior directed at emergency physicians with a warrant-less arrest. Additionally, in October, the ACEP Council passed Resolution 27, “Addressing Interhospital Transfer Challenges for Rural EDs,” which was co-sponsored by Vermont ACEP.

Virginia

In 2023, the Virgina Chapter:

• Ended a state budget policy known as the “downcoding” provision that reduced 790 of the most common ED diagnoses to a Level 1 reimbursement of $15, costing Virginia ED groups millions annually. After years of VACEP advocacy, a federal judge ruled in favor of emergency physicians, saying the policy is not in accordance with federal law and the prudent layperson standard. ED groups are in the process of being reimbursed for downcoded visits.
• Passed legislation requiring off-duty police or security officers trained in de-escalation and restraint in every ED 24/7. The bill passed with bipartisan support and was the first of its kind in the nation.
• Prevented NPs from gaining the ability to practice independently with only two years of training.
• Passed a bill allowing paramedics to administer medications in an ED within their scope of training.
• Improved the process for emergency physicians to gain temporary medical detention orders.

Washington

The chapter’s biggest accomplishment was holding a re-envisioned and revitalized Annual Meeting at Suncadia Resort. This new, family-friendly location proved to be a hit with attendees and was accompanied by increased registration and exciting speakers on topics ranging from reproductive care in the ED to rural health. Additionally, in the chapter’s efforts to reengage membership, a new Membership Committee was established with the goal to make sure the chapter is meeting the needs of its members and demonstrating value. As part of the chapter’s outreach campaign, chapter leaders are working to directly engage EDs across the state. Legislatively, the chapter said goodbye to its lobbyist of many years and embarked on a new lobbying relationship with the Washington State Medical Society, an arrangement that will help facilitate the chapter’s access to legislators and increase its leverage on key issues. Through the generosity of its membership, WA ACEP supported two senior medical students going into EM to attend the ACEP Leadership and Advocacy Conference.

West Virginia

The chapter’s Emergency Medicine Summit took place on September 7, 2023, at Stonewall Resort and approximately 25 percent of WVACEP’s membership attended. WVACEP has had watchful eye on the state capital. The continuing concern of the state’s opioid epidemic is emerging from the shadows of COVID, along with other issues such as EMS coverage, payment and tort reform, sexual assault, child abuse, helmet use, and ATV use. More recently, topics such as issues of vaccine mandates and scope of practice are pushing to the forefront. WVACEP is at the table and actively involved in these important matters on behalf of its members.

Wisconsin

The Wisconsin Chapter continued to prioritize increasing the Medicaid reimbursement rates associated with emergency codes. Largely because of grassroots efforts by WIACEP members, another increase was approved to help bring Wisconsin more in line with other states. WI-ACEP continues to collaborate with state residency programs to present the Annual Wisconsin Emergency Medicine Research Forum. The chapter is focused on overall member engagement and increasing its support to those in more rural areas of the state.

Wyoming

The Wyoming Chapter is using 2024 to begin re-engaging the WY ACEP chapter members and identifying the most pressing topics and membership needs within the state.