Northeast Colorado RETAC Strategic Planning November 16 th 2004 –Morgan Community College

NCRETAC History High Plains Regional EMS Council –Not mandated –Grant from State –Formed by local providers Northeast Colorado Area Trauma Advisory Council –Mandated by Legislation –Also formed by local providers –No Funding for first year Funding for subsequent years came from EMS Account, –Reverted funds from grants

Formation of the Northeast Colorado RETAC Senate Bill 180 established formation of and funding Taskforce formed by chairs of both the Northeast ATAC and the High Plains Regional EMS Council –Taskforce established working council started work on establishing not for profit status and application to state for grant funds to combine and form Regional EMS Trauma Advisory Council

Senate Bill Mandates for RETAC’s –(c) Regional emergency medical and trauma advisory councils - plans established - process. –(I) These rules provide for the implementation of regional emergency medical and trauma system plans that describe methods for providing the appropriate service and care to persons who are ill and injured in areas included under a regional emergency medical and trauma system plan. In these rules, the board shall specify that: –See Handouts

CRS Emergency medical services account - creation - allocation of funds. –(b) (I) To the department for distribution for each Colorado county within a RETAC no less than fifteen thousand dollars and seventy-five thousand dollars to each RETAC, in accordance with section for planning and, to the extent possible, coordination of emergency medical and trauma services in the county and between counties when such coordination would provide for better service geographically.

CRS (2.5) (a) On or before October 1, 2003, and on or before October 1 each year thereafter, each RETAC shall submit to the council an annual financial report that details the expenditure of moneys received. Such report shall be in a format specified by the council and the department. In instances where the council finds such report inadequate, the RETAC shall resubmit the report to the council by December 1 of the same year.

CRS Cont. (3) Funds distributed to counties and RETACs pursuant to this section shall be used in planning the improvement of existing county emergency medical and trauma service programs and shall not be used to supplant moneys already allocated by the county for emergency medical and trauma services. –Main Entry: sup·plant 1 : to supersede (another) especially by force or treachery 2 a (1) obsolete : UPROOT (2) : to eradicate and supply a substitute for b : to take the place of and serve as a substitute for especially by reason of superior excellence or powerUPROOTsupply

To qualify for funding; state mandated or contractual deliverables must be met! Mandated by Statute –Biennial Plan –Needs Assessment –Financial Reporting Regional Funding Program Overview Budget Variance Budgets Contractual Obligations –Agency profile sheets –Quarterly Reports –Attendance at quarterly RETAC Forum Meetings –Others, as determined by SEMTAC

NCRETAC Funding Processes In accordance with statute and rules for RETAC’s the Northeast Colorado RETAC has submitted two financial reports to the department. –October 2003, October 2004 These reports show expenditures according to the Biennial Plan Submitted in July 2003 –Regional Funding Program Overview These documents can be accessed at

Biennial Plans On July 1 st 2003 the Northeast Colorado RETAC submitted to the state the first Biennial Plan according to statutes and rules. This plan was developed through local processes, –Strategic planning meetings –EMS Needs Assessment –Compiling local County Plans submitted to the NCRETAC in December 2002

Accomplishments Strategic planning, –Setting goals, Developing SWOT analysis (Strengths, Weaknesses, Opportunities, Threats) –Set direction for identified tasks,

Accomplishments Cont. –Assisting EMTS providers/Law Enforcement/District Attorneys regarding Health Insurance Portability and Accountability Act of 1996 (HIPAA) and how it affects their interaction. Health Insurance Portability and Accountability Act of 1996 (HIPAA) –Assisting agencies with Medicare, Medicaid, Billing, reimbursement issues Teleconferences through varied sites in NCRETAC, –Training calendar to help in informing constituents of training opportunities

Accomplishments Cont. Supporting and assisting with state EMS provider grants –Public hearing process at RETAC level provides for ½ of the scoring for statewide provider grants –Technical assistance given to providers upon request by coordinator in developing grants. –Assisting SEMTAC resource committee and CDPHE provider grants program in developing rules/policies to make process more consistent statewide

Accomplishments Cont. Regional communications grants with NEAHR –800 MHz Console radio’s to be placed in trauma centers –One 800 MHz radio per ambulance service with possibility of one radio per vehicle

Accomplishments Cont. Physician Advisory Board –Chair, Dr. Tim Hutcheson, Airlife Greeley Goals to assist with Mass Casualty Incident planning Provide region wide training for standardized MCI response Long term goals –Develop patient destination protocols –Critical Care Transport education/training

Accomplishments Cont. Regional Data Project –In final deployment phases –Cost to date, $44,000 in RETAC finances –Technical advisor paid for by state wide special projects allocation Sharing of resources between trauma centers –Trauma designation documents –Assisting with Trauma Activation Protocols –Informing SEMTAC on impact of rules for designation of facilities Regional Mass Casualty Incident Plan –Cost $56,000 (Homeland Security Grant) –Regional disaster Exercise (Loveland/Fort Collins Airport) Fire, Police, SWAT, EMS, Facilities, OEM, Hired facilitator to organize and write after action reports. –Second MCI exercise in development stages with OEM, Northeast All Hazards Regional 05 Homeland Security Grants.

Accomplishments Cont. Participation and input with new rules/statutes for certification/recertification of EMT’s –Weekly telephone conferences provide avenue to give input and possible impact of changes in certification processes Completion of a Regional EMS needs assessment –Paid for by State EMS Provider Grant NCRETAC Tool and needs assessment process to be adopted statewide Participation in State meetings, input on policy/rules promulgation

Accomplishments Cont. Jackson County Ambulance billing processes –Helped fund Infrastructure for Weld County Paramedic Services to assist agencies in billing and reimbursement so other agencies can enjoin into the process as needed –Jackson County Ambulance has realized over $100,000 increase in revenue since implementation Cost to date $ in RETAC funds,

Accomplishments Cont. Web page development –Utilized by providers, CDPHE, other RETAC’s, CCI and NCRETAC council –Weld counties involvement in both projects, (Jackson County and Web Page) Cost to date.. App. $3,125.00

Accomplishments Cont. Grants Process Developed Grants Policy’s Scoring Rubric, –Eliminate subjectivity Financial Need Cost Effectiveness Collaboration within county or with other services Service Need as stated in application Agencies Qualifications to complete project Scoring Sheets, Grants Instructions $62,000 awarded in June 2 nd round in calendar year 04 just closed, Online grant form –Grants Guidance Documents Online

Regional training projects Major need seen in Regional Needs Assessment was training

Training Grants Regional –EMT-Intermediate initial course spanning 4 counties providers (Regional Grant) Logan, Phillips, Sedgwick and Yuma, 12 students enrolled $27,500 set aside for 12 students –Yearly Paramedic Refresher (Host sites rotated) Video Conference telecast available per request by local Paramedic providers Cost to date for equipment and instructors –2 courses $13,000 with $8,000 set aside for course just completed and not invoiced. (Equipment is shared between services) –Intermediate transition courses (funded by NCRETAC administered by Aims Community College), also available by video teleconference. One course telecast from Yuma One course in Fort Morgan 3 courses scheduled for Weld County, Union Colony Fire Station Cost to date $10,500

Grants Awarded June 04 Recruitment and retention grants for at risk ambulance service –Haxtun Ambulance grants for First responder and EMT Basic Courses $14,000 –Assisted Haxtun Ambulance in obtaining Rural Health Technical Assistance grant for R&R (rural health funds awarded ($5,000) North Park Hospital District ($2,500 for equipment) Larimer County Search and Rescue ($1,600 for special rescue equipment) Washington County Ambulance Service ($14,000 for local CME) Drive Smart Weld County ($2,500 for injury prevention) PARTY Program (Prevent Alcohol and Risk Related Trauma in Youth, $4,500) Weld County Paramedic Services ($700 for billing infrastructure)

Grants Pending Subject to award Berthoud Fire Protection District Weld County Paramedic Services South Y-W Ambulance Service Morgan County Ambulance Service Morgan County EMS Council Sterling Fire Department

1 st Biennial Plan Goals of the NCRETAC The Northeastern Colorado RETAC should be working towards; 1.Integrated data collection system (incl. pre-hospital/facility) 2.Assisting in training and planning for Mass Casualty Incidents region wide. 3.Exploring future funding opportunity’s 4.Coordination/integration of injury prevention 5.Regional consultant for medical direction 6.System CQI or PI 7.Regionalized HIPAA compliance 8.Provide for a stable infrastructure 9.Regional Training Plan

Future Tasks ?  Develop Pre-Hospital Destination protocols  Trauma team activation standardization  Continue coordination with NEAHR  Communications plans, talk groups, Standardization  Implementation of “new” training strategies to confront changes in increased hours to maintain current certifications  Basic EMT no increase in hours  Category requirements from general to specific  Intermediate Hours increased from 36 hours to 60 hours  Category requirements from general to specific  Paramedic increased from 45 hours to 72 hours  Category requirements from general to specific

Future Tasks ?, Cont.  New rules for Trauma Center designations may adversely affect ability to provide care for rural level III centers  Colorado Plains Medical Center, Sterling Regional Medical Center)  Board certified Emergency Physicians by end of 2005  Can the NCRETAC affect change in rules for rural level III’s ? If rule is not changed, or if facilities cannot recruit (BCEP’s) then both facilities may be forced by rule drop down to level IV designation.

Future Tasks ? Cont.  System Finance  Ambulance Medicare Fee schedule continued implementation  Auto Insurance reimbursements for entire Emergency Medical Trauma Services  Both will require strategies to maintain standard of care  Assist some agencies in increasing percentage of reimbursements  Standard statewide ambulance billing reimbursements are 58% to 65% depending on demographics  Services must follow up on reimbursements from Medicare and insurance companies to stay solvent

Future Tasks ? Cont.  Biennial plan/Budget Reporting/Quarterly Reports  Facility needs assessments  Review past EMS needs assessment re-evaluate need  MCI planning, training and exercises  Data collection