Northeast Colorado RETAC

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					   Northeast Colorado RETAC
• Strategic Planning
  November 16th 2004
  – Morgan Community
           NCRETAC History
• High Plains Regional EMS Council
  – Not mandated
  – Grant from State
  – Formed by local providers
• Northeast Colorado Area Trauma Advisory
  – 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
   Senate Bill Mandates for
– (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.25-3.5-603. 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 25-3.5-605
  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. 25-3.5-605

• (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. 25-3.5-605. 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 <efforts to supplant the vernacular> b : to take the
     place of and serve as a substitute for especially by reason of
     superior excellence or power
  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
  – 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 1st 2003 the Northeast Colorado RETAC
  submitted to the state the first Biennial Plan
  according to statutes and rules.
• This plan was developed through local
  – Strategic planning meetings
  – EMS Needs Assessment
  – Compiling local County Plans submitted to the
    NCRETAC in December 2002
• Strategic planning,
  – Setting goals, Developing SWOT analysis
    (Strengths, Weaknesses, Opportunities,
  – 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.
– Assisting agencies with Medicare, Medicaid,
  Billing, reimbursement issues
  • Teleconferences through varied sites in
– 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
  – 800 MHz Console radio’s to be placed in
    trauma centers
  – One 800 MHz radio per ambulance
    service with possibility of one radio per
     Accomplishments Cont.
• Physician Advisory Board
  – Chair, Dr. Tim Hutcheson, Airlife Greeley
     • Goals to assist with Mass Casualty Incident
     • 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
  – 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
  – 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
    • Cost to date $716.00 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
   • 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
• 2nd 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
     • 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
• 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
       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
      1st Biennial Plan Goals of the
•   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,
 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
      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
    Future Tasks ? Cont.
 System Finance
    Ambulance Medicare Fee schedule continued
    Auto Insurance reimbursements for entire Emergency
     Medical Trauma Services
       Both will require strategies to maintain standard of
    Assist some agencies in increasing percentage of
       Standard statewide ambulance billing
        reimbursements are 58% to 65% depending on
       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
Data collection

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