EMS/Trauma Programming in the FLEX Program Office of Rural Health Policy Grantee Partnership Meeting September 1, 2009

1. EMS/Trauma Programming in the FLEX Program Office of Rural Health Policy Grantee Partnership Meeting September 1, 2009

2. EMS/Trauma Programming in the FLEX Program • Allowable Activities (FLEX guidance): • Trauma/EMS System Assessment • Trauma Designation • Trauma Training • EMS Medical Direction • EMS Recruitment/Retention • Reimbursement/Finance • EMS Leadership Development • EMS “Restructuring” - “Community Paramedicine”

3. Trauma System Assessment • HRSA Model Trauma System Planning and Evaluation • Uses public health framework for state and/or regional trauma system development • System assessment offered through American College of Surgeons (including Benchmarks, Indicators and Scoring, or BIS) • Emerging body of research supports effectiveness of “inclusive” trauma systems Our Vision – Healthy Kansans living in safe and sustainable environments.

4. Trauma Training Advance Trauma Life Support (physicians) Trauma Nurse Core Course Pre-hospital Trauma Life Support (EMTs/paramedics) Comprehensive Advanced Life Support Rural Trauma Team Development Course (ACS) Our Vision – Healthy Kansans living in safe and sustainable environments.

5. EMS Medical Direction Limited training available for EMS Medical Directors www.medicaldirectoronline.org NOSORH working with NASEMSO on state-by-state compendium of EMS Medical Director training Our Vision – Healthy Kansans living in safe and sustainable environments.

6. EMS Recruitment/Retention • Limited “evidence-based” systems for EMS recruitment/retention • http://www.vdh.virginia.gov/OEMS/Recruitment_Retention/RetentionResearch.htm Our Vision – Healthy Kansans living in safe and sustainable environments.

7. Reimbursement/Finance • Budgeting • Budget Model Training (http://www.remsttac.org/products.html) • Group purchasing • http://www.ncemsc.org/ Our Vision – Healthy Kansans living in safe and sustainable environments.

8. EMS Leadership Development • Rural EMS Manager’s Awareness Program • http://www.remsttac.org/products.html • NOSORH working with NASEMSO to develop state-by-state compendium of leadership development training for EMS service directors Our Vision – Healthy Kansans living in safe and sustainable environments.

9. EMS Restructuring • The Concept of Community Paramedicine • Extensive body of literature in other countries • Curriculum now available for “expanded role” • (Universities of Nebraska, Minnesota, and • Dalhousie) • Several states to conduct pilots this year • www.ircp.info Our Vision – Healthy Kansans living in safe and sustainable environments.

10. THE LONG AND BRIAR PROJECT... *1,240 residents *Two islands *Two ferries *Regional hospital 1 hour distant

11. EHS 3-Year Pilot • Phase One: 24/7 paramedic coverage (ambulance base established on Long Island)

12. EHS 3-Year Pilot • Phase Two: Paramedics administer immunizations, perform screenings (blood pressure checks), accept non-emergent calls (diabetic checks)

13. EHS 3-Year Pilot • Phase Three: • Nurse Practitioner employed on island • Paramedics participate in wound care, flu clinics, falls prevention assessments, community prevention education sessions

14. EHS 3-Year Pilot • Paramedics were taught: • Phlebotomy • CHF assessment • Urinalysis assessment • Suture/staple removal • Diabetic assessments • Medication compliance

15. EHS 3-Year Pilot • Outcomes • Patient satisfaction • Employee satisfaction • Reduced hospitalizations

16. Contact Information • Chris Tilden • Director, Bureau of Local and Rural Health • Kansas Dept of Health & Environment • (785) 925-4045 • ctilden@kdheks.gov Our Vision – Healthy Kansans living in safe and sustainable environments.