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Home My WebLink About961738.tiff RESOLUTION RE: APPROVE EMERGENCY MEDICAL SERVICE REPORT AND PLAN TO COLORADO DEPARTMENT OF HEALTH EMERGENCY MEDICAL SERVICES DIVISION AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with an Emergency Medical Service Report and Plan from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Ambulance Service, to the Colorado Department of Health Emergency Medical Services Division, with terms and conditions being as stated in said report and plan, and WHEREAS, after review, the Board deems it advisable to approve said report and plan, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Emergency Medical Service Report and Plan from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Ambulance Service, to the Colorado Department of Health Emergency Medical Services Division, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said report and plan. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 25th day of September, A.D., 1996. BOARD OF COUNTY COMMISSIONERS �� WELD COUNTY, COLORADO 4 Aeadit �, �� . Barbara . Kirkmeyer, Chair ti o ty Clerk to the Board rK J e . axer, P o-T Deputy Cler t• the Board Dale K. Hall APP AS TO F 1O- i,-r_ I A/1—, Constance L. Harbert unty Attorney l (( `/ v,C r, a- ;,' W. H. Webstet CC : AM 961738 AM0009 COUNTY SUBSIDY PAYMENT DISTRIBUTION FORM COLORADO EMERGENCY MEDICAL SERVICES SUBSIDY PROGRAM FOR COUN I lES In accordance with the provision of CRS 25-3.5-605,the undersigned hereby requests an EMS county subsidy distribution payment for the improvement and expansion of prehospital EMS. It is understood that payment is contingent upon approval of the statutory reporting requirements by the State Advisory Council on EMS. Payment to: Weld County Board of County Commissioners 915 - 10th Street Greeley, Colorado 80631 �rr�1 i-' f`1; unty Official 1661 • ✓, iic r/ 4.6 I / .c L DATE oq1"6/ 9k, 1 y SI ND RETURN THIS FORM ALONG WITH ALL REPORTING DOCUMENTATION For use only by the Department of Health Emergency Medical Services Division Amount: $ Approved By: DATE EMS Director Fund Agency Org Appr Code Func Obj GBL 409 FAA 8300 FLWT 5120 005S 961738 EMERGENCY MEDICAL SERVICE REPORT AND PLAN SUBMITTED BY: NAME OF COUNTY WELD DATE PLAN SUBMITTED: Was-/q!0 CONTACT PERSON- the person responsible for submitting this application(this person should be able to answer all questions pertinent to the content and development of your county report and plan). Name: Gary McCabe Address: Weld County Ambulance 1121 "M" Street, Greeley, Colorado 80631 Phone: (970) 353-5700 x 3204 -or- Name: Barbara Foster, Weld County EMS Coordinator Address: Aims Community College P.O. Box 69, Greeley, Colorado 80632-0069 Phone: (970) 330-8008 x 449 Other Phone Numbers: County Commissioners Office (970) 356-4000 County Administrator Office (970) 356-4000 961.738 SECTION I - LICENSING AND INSPECTION 1.1 COUNTY RESOLUTION, LAWS OR ORDINANCES Please answer the following questions regarding your current regulations governing ambulance services. Most county resolutions need to be reviewed on a regular basis. When was your last review? 1996 CHECK HERE AND ENCLOSE A COPY OF YOUR COUNTY RESOLUTION WITH THIS PLAN X 1.2 AGENCY RESPONSIBLE FOR LICENSING, INSPECTING AND REGULATING AMBULANCE SERVICES AGENCY OR GOVERNMENT ENTITY_Weld County Health Department CONTACT PERSON: Charlotte Davis TITLE: Environmental Health ADDRESS: 1517 - 16th Avenue Court Greeley, Co PHONE: (970) 353-0635 x 2239 1.3 INSPECTION AND LICENSING-PROCESS 1. How often do you license ambulance services? Annually_X_Semi-annually 2. How often do you physically inspect ambulances? Annually_X_ Semi-annually 3. Are the policies and procedures for licensure of ambulances included in your county resolution? Yes X No 4. In your inspection of ambulances, do you verify that the vehicle equipment conforms with the minimum essential list contained within the Colorado Board of Health Rules? Yes X No If not, explain: 961738 5. COPY/COPIES OF THE FORMS YOU USE TO LICENSE AND INSPECT AMULANCES MUST BE ATTACHED. 6. Do all of the licensed ambulance services within your county comply with the statewide data collection program through the State EMS Division? Yes_X No (IF THEY DO NOT COMPLY YOUR COUNTY WILL NOT BE ELIGIBLE FOR FUNDING) 1.4 AMBULANCE AGENCIES LICENSED AND INSPECTED List here or attach a list of all the licensed ambulance services and whether they provide advance life support or basic life support. AGENCY NAME DIRECTOR ADDRESS PHONE FAX ALS BLS 1. Weld County Ambulance Service Gary McCabe,Director 1121 "M" Street Greeley, Colorado 80631 (970) 353-5700 BLS and ALS Services 2. Tri Area Ambulance Service Greg Engel, Director 204 Oak Street P.O. Box 708 Frederick, Colorado 80530-0708 (303) 833-2825 BLS and ALS Services 3. Frederick Area Fire Protection District Dominic Chiota, Fire Chief P.O. Box 129 Frederick, Colorado 80530 (303) 833-2742 BLS Services only 961738 SHELL: EAMB01.EPS TODAY FORM: A: \EAMB0I.FRM THIS WEEK OTHER: CERTIFIED * AMBULANCE APPLICATION LEGAL ACTION COVER LETTER * APPROVAL NEEDED? STAMP: YES NO ATTACHMENTS: YES NO ADDITIONAL INSTRUCTIONS: DATE: Certified Letter No. : P *** Dear • Enclosed are your application forms for 199 Licensure of your ambulance service and ambulance vehicle permits. Weld County Ordinance Number 77—C, Sections 3. 10 and 3. 16 states: 3.10 Obtaining or attempting to obtain any license or permit hereunder by fraudulent means or misrepresentation shall be grounds for denial, suspension, or revocation of such license or permit. 3.16 All licenses and permits shall be renewed annually, shall expire on December 31 of the year issued, and shall not be renewed until the application has been approved by the Department. All applications for renewal of licenses and permits shall be made not later than sixty (60 days) prior to the date of expiration. The Department shall notify, by certified mail, return receipt requested, each licensee of the renewal requirements of this section, within ninety (90) days prior to the date of expiration. Be advised that all vehicles, etc. are required to be inspected before a new license can be issued. Therefore, please return your applications to Environmental Protection Services by November 1, 199 961738 St 0-4. DEPARTMENT OF HEALTH lie 1517 - 16 AVENUE COURT GREELEY, COLORADO 80631 Wil ADMINISTRATION (303)353-0586 WELD COUNTY AMBULANCE HEALTH PROTECTION (303)353-0635 COMMUNITY HEALTH (303) 353-0639 LICENSE APPLICATION COLORADO Application year: Application for Exempt Status: Yes No 1. Owner: Name: Address: Phone Number: 2. Operations Manager: Name: Address: Phone Number: 3. List all Emergency Vehicles on the attached vehicle list. 4. Location and description of the place(s) from which this ambulance service will operate. * Street Number: City: State Phone Street Number: City: State Phone *If more than two locations, attach separate sheet with the above information. 961738 Weld County Ambulance License Application Page 2 5. Physician advisor: Name: Address: Phone Number: 6. What area(s) will you be serving? 7. List all emergency personnel who will be responding to an emergency with your ambulance on the attached personnel list. 8. Proof of insurance, as required in Section 4.4 of Ordinance 77-C. 9. Vehicle Maintenance and Safety Inspection Protocol. Describe your vehicle maintenance and safety inspection program including frequency and the facility which performs inspections. 10. Provide a copy of the Colorado Department of Health E.M.S. approval of your quality control program required in Section 3.2, Part B of the Colorado Revised Statutes and Regulations on Emergency Medical Services. 11. Provide as required in Section 3.8-9 of Ordinance 77-C, a current copy of E.M.T. or Paramedic Protocols adopted by the ambulance service in accordance with standards approved by the Ambulance Services' Physician Advisor. 961738 Weld County Ambulance License Application Page 3 12. Provide as required in Section 3.8-10 of Ordinance 77-C, a current copy of the Ambulance Service's Training Standards in accordance with the requirements approved by the ambulance service's Physician Advisor. 13. Provide a notarized statement by the person operating the vehicles or the person in charge of operating the vehicles declaring the purpose of the transportation conducted by that person or entity and the reasons by which the person or entity is entitled to an exemption from the ambulance licensing requirements of Ordinance 77-C. EAMBO5A 961738 7. .{ . it DEPARTMENT OF HEALTH 1517- 16 AVENUE COURT GREELEY, COLORADO 80631 O VELD ADMINISTRATION (303)353-0586 NilHEALTH PROTECTION (303)353-0635 • .D COIINT? HEALTH DEPART.�NT COMMUNITY HEALTH (303)353-0639 COLOR ADO ENVIRONME.WTAL PROTECTION SERVICES Ambulance Service and Vehicle Equipment Survey Report Dace of Inspection: Inspected By: Ambulance Service: NAME: ADDRESS: Tc...'.2?-TONE CONTACT Qualification: Advanced Life Suppor . Basic Life Support: • Motor Vehicle Chassis No. Make & Model Year Weld County License Tag No. Date of Expiration Odometer Vehicle Identification No. 961738 AMBULANCE SURVEY REPORT I• Each ambulance shall contain the following equipment which shall be maintained in good working order: A. Siren operational. YES NO B. Lights operational: Emergency Lights Headlights YES NO Parking Lights YES NO Tail Lights YES NO Brake Lights YES NO Hazard Lights YES NO Turn Signals YES NO YES NO C. Safe tires with snow tires/chainsavailable. YES NO D. Vehicle safety inspection log. YES NO Basic Sanitation. YES NO E. Vehicle preventive maintenance log. YES NO F. Are there always two qualified drivers present on a run who hold valid drivers licenses? YES NO G. Ambulance drivers are: 1. Paramedic 2. Intermediary --EMT 3. Emergency Medical Technician 4. First Responder 5. American Red Cross Advanced First Aid and Cardiopulmonary Resuscitation Card or equivalent. H. When transporting a patient, is there a licensed Emergency Medical Technician present in the patient compartment? YES NO Z. Do you have insurance that complies with the latest Colorado requirements? (Ordinance 77-C Section 4.4) YES NO J. The lighting and space are adequate for the performance of cardiopulmonary resuscitation, airway maintenance, suctioning, hemorrhage control, shock care, dressing of wounds and burns , immobilization of fractures, oxygen therapy, and ceiling light sufficient for adequate administration of IV fluids. YES NO K. Safety belts in forward compartment; safety belts or ocher safety restraining devices available for patients being transported. YES NO 1. c7e38 L. Two-way Radio Equipment - which provides adequate communications between the ambulance in the field and the hospital, clinic or ambulance service physician advisor or medical control point. YES NO II. Minimum required equipment for Colorado Ambulances. "Each ambulance based and licensed in Colorado shall, at a minimum, be equipped in accordance with the following list of equipment, pursuant to CRS 25-3.5-301 (2) (a) . " Colorado Statutes & Regulations on Emergency Medical Services, January, 1985, pg. C13-14. A. Ventilation and Airway Equipment 1. Portable suction apparatus with wide- bore tubing and pharyngeal suction tip. YES NO 2. Hand-operated bag-mask ventilation unit with adult, child and infant sized masks (clear masks are preferable) . Valves must operate in cold weather, and the unit must be capable of use with an oxygen reservoir. YES NO 3. Oropharyngeal and nasopharyngeal airways in adult, child and infant sizes. YES NO 4. Portable oxygen equipment with a variable flow regulator; adequate length tubing; transparent, non-rebreathing valveless masks in adult and child sizes and transparent valveless infant-sized mask; and nasal canula. YES NO B. Bandages and Dressings 1. Large and small sterile dressings. YES NO 2. Roller bandages, both soft and elastic, 4 inch or larger. YES NO 3. Adhesive tape, 2 inch or larger. YES NO 4. Two clean burn sheets (do not have co be sterile) . YES NO 5. Triangular bandages with safety pins. YES NO 3 961738 C. Immobilization Devices 1. Lower extremity traction splint. YES NO 2. Extremity immobilizing devices, eg. inflatable splints or splinting materials for immobilizing the joint above and the joint below the fracture. YES NO 3. Long spine board and appropriate accessories to immobilize the cervical spine. YES NO 4. Short spine board or equivalent stabilization/immobilization device (eg. "KED" type device) and appropriate accessories to stabilize cervical spine. YES NO D. Sterile Obstetrical Kit, Containing: 1. Sterile Gloves YES NO 2. Scissors YES NO 3. Aspiration Device YES NO 4. Umbilical Clamps or Tapes YES NO 5. Sterile Dressings YES NO 6. Towels YES NO 7. Plastic Bags YES NO E. Miscellaneous 1. Blood Pressure Cuff/Sphygmomanometer YES NO 2. Stethoscope YES NO 3. Sterile Irrigation Solution (eg. normal saline) YES NO 4. Roll of aluminum foil, large enough to cover a newborn infant. YES NO 5. Shears or heavy scissors capable of cutting clothing, bandages, boots, etc. YES NO 6. Flashlight with spare batteries and spare lightbulb. YES NO 7. "ABC" fire extinguisher, minimum 5 pound capacity, with current annual inspection. YES NO 4 961738 III. Recommended Optional Equipment It is strongly recommended and encouraged that every ambulance be equipped with, and the ambulance crew be proficient in using, a sec of Pneumatic Antishock (Mast) Garments . Such pneumatic antishock garment should be compartmentalized (separate leg and abdomen compartments) and be equipped with control valves (valves co have closed and open position) and an inflation pump. The pneumatic antishock garments should cover the body from the lower legs to the rib cage only* antishock garments which cover the chest area are not permitted. YES NO NOTE: It is important to note that EMT-Basics may use pneumatic antishock garments only if specifically trained in their use through a Departmental approved course of instruction, and only if they are used under the specific direction and authority of a physician advisor, in accordance with the EMS Rules of the Colorado Board of Medical Examiners (thc so-called "Acts Allowed") . Surveyor: Ambulance Service Representative: General Comments and/or Suggestions: Licensed to operate as the following: Advanced Life Support Ambulance YES NO Personnel: EMT-?aramedic EMT-Intermediate RN with Advanced Cardiac Life Support Certificate Physician with Advanced Cardiac Life Support Certificate Drive with valid Colorado Drivers License and current EMT-Basic Basic Life Support Ambulance YES NO Personnel: EMT-Basic Driver with valid Colorado Drivers License and American Red Cross Advanced First Aid Card and CPR Card or equivalent of both. 5 961738 t‘tt, DEPARTMENT OF HEALTH ip we 1517- 16 AVENUE COURT GREELEY, COLORADO 80631 WELD COUNTY AMBULANCE ADMINISTRATION (303)353-0586 PERSONNEL LIST HEALTH PROTECTION (303)353-0635 COMMUNITY HEALTH (303)353-0639 COLORADO (Also includes driver's which are not EMT's) Name of Ambulance Service : Application Year: Name: Address: Date of Birth: Highest level of certification, licensure or training attained: Attach a photo copy of current Colorado Department of Health EMT-B, EMT-I, or Paramedic Certificate; or an Advanced First Aid Card from the American Red Cross; or a First Responder Course Completion Certificate; or a Cardiopulmonary Resuscitation Card issued by the American Heart Association or the American Red Cross. Attach proof of a valid Colorado Driver's License. Attach a statement of criminal complaint or convictions, including Class I and II traffic violations within the previous twelve (12) months. Section 5.3 of Weld County Ordinance Number 77-C States: Before the state certification of an EMT, EMT-B, EMT-I or Paramedic expires, the ambulance service shall provide the Department with a written statement showing the name of EMT, EMT-B, EMT-I or Paramedic, the date the certificate was issued, the date of expiration, and the certificate number of the new State Certificate. Failure to comply with this section disqualifies an EMT, EMT-B, EMT-I or Paramedic from practice in any Weld County Ambulance Service. EAMB05C 961.738 joriDEPARTMENT OF HEALTH 1517 - 16 AVENUE COURT C GREELEY COLORADO 80631 ADMINISTRATION (303)353-0586 WELD COUNTY AMBULANCE HEALTH PROTECTION (303)353-0635 EMERGENCY VEHICLE LIST COMMUNITY HEALTH (303)353-0639 COLORADO Name of Ambulance Service: Application Year: Vehicle l#1 Make Year of Colorado State Motor Vehicle Manufacture License Number Chassis Number Length of time this vehicle has been in service Location of the Chassis Number Vehicle #2 Make Year of Colorado State Motor Vehicle Manufacture License Number Chassis Number Length of time this vehicle has been in service Location of the Chassis Number Vehicle #3 Make Year of Colorado State Motor Vehicle Manufacture License Number Chassis Number Length of time this vehicle has been in service Location of the Chassis Number Vehicle #4 Make Year of Colorado State Motor Vehicle Manufacture License Number Chassis Number Length of time this vehicle has been in service Location of the Chassis Number 961738 Weld County Ambulance Emergency Vehicle List Page 2 Vehicle #5 Make Year of Colorado State Motor Vehicle Manufacture License Number Chassis Number Length of time this vehicle has been in service Location of the Chassis Number Vehicle #6 Make Year of Colorado State Motor Vehicle Manufacture License Number Chassis Number Length of time this vehicle has been in service Location of the Chassis Number Vehicle 1/7 Make Year of Colorado State Motor Vehicle Manufacture License Number Chassis Number Length of time this vehicle has been in service Location of the Chassis Number Vehicle 1/B Make Year of Colorado State Motor Vehicle Manufacture License Number Chassis Number Length of time this vehicle has been in service Location of the Chassis Number Section 3.11 of Ordinance Number 77-C States: If a vehicle is replaced or an additional vehicle or vehicles are added to a service's fleet, an application for a vehicle permit shall be filed with the Department WITHIN 30 DAYS of receipt of the new vehicle or vehicles. The completed application shall include a description of the vehicle(s) that were replaced. Upon receipt of a new vehicle permit application, the Department shall inspect the new vehicle and issue the new vehicle permit, if appropriate. EAMB05B 961738 Ambulance Report Form Agency Weld County Ambulance Service Phone Number (970) 353-5700 Address 1121 M StrAAr Fax Number (970) 353-5700 x3215 Greeley, CO 80631 e-Mail Address Service Type If System Financing Ambulance District • Check All that Apply Fire Department Tax Supported Fire District User Fees (billings) x Private/For profit Subscriptions Private/Non profit Other Third Service. rater ris uovernimen X Other Number of Station Locations I ,1 I Number of Ambulances 9 Do ambulances have cellular phones? . yes Physician Advisor(s) I Jim Campain; MD Dispatch Center(s) Weld County Regional Dispatch Vehicle Extrication Provider(s) All Weld County Fire Departments Number of Manual Monitor/Defibs 8 Number of AEDs/ Manual (loll) Number of EMS Personnel • First Resp. EMT-B EMT-I EMT-P Full-Time Paid 4 18 Part-Time Paid 9 10 Volunteer 961738 Agency Weld County Ambulance Service Check those drugs carried on transport units- Adenosine x Furosemide Albuterol x Lidocaine - Atropine X Magnesium Sulphate X I Alupent Morphine Sulphate X Bretylium x Naloxone X Calcium Chloride X Nitroglycerin X Charcoal Oral Glucose Dexamethasone Procainamide Dextrose 50% X Racemic Epinephrine X Diazepam X Sodium Bicarbonate X Diphenhydramine X Others - Specify Glucagon X Dopamine X Compazine x Epinephrine 1:10,000 x Ipecac x Epinephrine 1:1,000 x Isuprel X Terbutaline X tra Billing Informationcaine X Base Rate s ALS, BLS, etc. Charge per Loaded Mile ALS $380.00 ALS $ 9.00 $ $ $ $ Approximate Collection Rate 78 % Unadjusted Medicare Participating Provider? I y/N Most significant current problem (recruitment, vehicle replacement, etc): 96173S d. Ambulance Report Form rye tics I2istri_L Phcore Number 3-2742 Frederick, Colo 8.) 30Number 303-831-2742 AGttjf- FC ?co 1�'r Fax t e-Mail Address Service Type _I System Fin;incin _ Ambulance District Check All that Apply Fire Department Tax Supported X Fire District X User Fees (billings) + , Private/For profit Subscriptions Private/Non profit Other, 1 Third Service !r- Other _-__._ ___ ._ __------._ Number of Station Locations 1 2 Number of Ambulances 1 V , { • i Do ambulances have cellular phones? 1 )- , Physician Advisor(s) i Donald lany, IX), North Suburban b`c-Lical Center Dispatch Center(s) 1 Wc].d Crnnty Ccnnninzcatixis Vehicle Extrication Provider(s) S._1f Number of Manual ManitoriDefibs 0 Number of AEDs ___CLA Number of EMS Personnel r -- ---- First Resp. EMT-13 EMT-I EMT-P j F uli-".iimc Paid 2 _ i Pit t-Time Paid Volunteer 1 17 3 96i73S - Agency FA1PD _____ .. ___ Check those drugs carried on transport units- Adenosine Furosernicle __Albuterol Lidocaine __I , Atropine I[_� Magnesium Sulphate + Alupcnt L_J Morphine Sulphate Dretylium I Naloxone Calcium Chloride iIij Nitroglycerin Charcoal i�- Oral Glucose Dexamethasone ,E Procainamide -117 r r""^7 DcxtrosC 500/o Ir_J Rac,eaiic Epinephrine ____.,1____,1 Diazepair, 1 Sodium Bicarbonate - V Diphenhydratnine F____1 Others - Specify Dopamine ' ii 4_ . Epinephrine 1:10,000 - ; J 1r ,.._ 1 pincphrine 1:1,000 -- =i,_�___.__._ __. _ _1_ . Billing Information If used to Trarsr ,, T ir- s Arbullnce Bill, Char Loaded for at , • Qirrent PIS rate. Base Rate s) ALS, is s, etc.) oar a cr ct _ 1 c $ S S S . $ S Approximate Collection Rate °71 o 1 [Medicare Participating Provider? I Y/ N I Most significant current problem(recruitment, vehicle replacement, etc): Financing- for AE , Training Funds 961738 Ambulance Report Form Agency Tn Area Ambulance_District Phone Number 333-€63-4824 Address 1) &a 703 Fax Number 303-$33-3772 Frerierick Coloz-...d:o 8053) e-Mail Address . Service Type System Financing Ambulance District X Check All that Apply Fire Department Tax Supported X Fire District User Fees (billings) X Private/For profit Subscriptions Private/Non profit Other Third Service I Other Number of Station Locations 1 Number of Ambulances 3 T Do ambulances have cellular phones? yes Physician Advisor(s) North Suburt}in iledical Center, t naid Dispatch Center(s) Weld Coisit}- Ccarru icatio1 s Vehicle Extrication Provider(s) FYede ick Area Fire Protection District tbuntain View Fire Protection District Number of Manual Moni:orfDefibs 3 fNumber of AEDs 0 Number of EMS Personnel First Resp. EMT-f EMT-1 _ EMT-P Full-Time Paid 1 4 Part-Time Paid 17 1 8 Volunteer 961739 Agency lr:. NLed Check those drugs carried on transport units- Adenosine _ L.J ..1, ;� Furosemide Albuterol x Lidocaine U r�, Atropine xx'_ Ma ;nesium Sulphate jLJ Alupent Ii Morphine Sulphate x Bretylium ��x Naloxone LJ Calcium Chloride j Nitroglycerin LJ Charcoal Oral Glucose x Dexamethasone I Procainamide { Dextrose 50% I x Racemic Epinephrine Imo' IDiazepam x Sdium Bicarbonate " Diphenhydramine x Others - Specify I Dopamine ' j x I operidol i x lEpinephrine 1:10,000 1 x Alc ine x Epinephrine 1:1,000 ___1j x ______ y. Billing Information Base Rate s) ALS, BLS, etc. Charge •er Loaded Mile Out of District ALS S5CD.CO Out of Ihstrict/mile S 10.tX) In District ALS or In District BLS $125.00 S Approximate Collection Rate 85 °/a Medicare Participating Provider? Y/ Most significant current problem (recruitment, vehicle replacement, etc): Mechanical D,,;1i -rim, Stretching Tax funding/Budget to n et drastic growth within District, Protocol DifferDifferalces with bordering agencies, ie: transport policies of trata patielt6 to a tru u 3 center. 961.738 so ,d YJd 9S: TT f1Hi 95-ZT-d3S 1.5 LIST HERE ALL OTHER AGENCIES WITHIN YOUR COUNTY WHO PROVIDE EMERGENCY MEDICAL SERVICES (ie; search and rescue, fire, police, quick response teams) AGENCY NAME DIRECTOR ADDRESS PHONE Air Life of Greeley Maggie Valcourt 1801- 16th Street 350-6257 Greeley, Co 80631 Ault-Pierce Fire Department P.O. Box 1146 Ault, Co 80610 Briggsdale Fire Department P.O. Box 9 Briggsdale, Co 80611 Eaton Fire Department 224-1st Street Eaton, Co 80615 Evans Fire Department Larry Peterson 3918 Denver Street (970)339-3920 Evans, Co 80620 Frederick Area Fire Department Dominic Chiota P.O. Box 129 (303) 833-2742 Frederick, Co 80530 Fort Lupton Fire Department Gordon Alexander 1121 Denver Avenue (303) 857-4603 Fort Lupton, Co 80621 Galeton Fire Department Doug Batt P.O. Box 697 (no phone) Galeton,Co 80622 Gilcrest Fire Department Glenn Miller P.O. Box 43 (970) 785-2232 Gilcrest, Co 80623 Greeley Fire Department Gary Novinger 919 - 7th Street (970) 350-9500 Greeley, Co 80631 Hudson Fire Department Bob Dechant P.O. Box 322 Hudson, Co 80642 Johnstown Fire Department Nick Stermer P.O. Box F Johnstown, Co 80534 Keenesburg Fire Department Mark Gray P.O. Box 1 Keenesburg,Co 80643 Kodak Fire Department Jean Clark Fire Protection Bldg (970) 686-4200 C-6, Eastman Kodak Windsor, Co 80551 961738 LaSalle Fire Department Gary Sandau P.O. Box 245 284-6336 LaSalle, Co 80645 Milliken Fire Department Dave Meyer 101 South Irene Street Milliken, Co 80543 New Raymer/Stoneham Gary McEndaffer P.O. Box 92 Fire Department (970) 437-5363 New Raymer,Co 80742 Nunn Fire Department Alvin Shipps P.O. Box 128 Nunn,Co 80648 Pawnee Fire Department Rodney Eshelman P.O. Box 66 Grover, Co 80729 Platteville Fire Department Glenn Miller P.O. Box 568 (970) 785-2232 Platteville, Co 80651 Prospect Valley Fire Department Bob Tegtman 4910 Colorado Hwy 79 Keenesburg,Co 80643 Roggen Fire Department Justin Glen 407 -2nd Street Roggen,Co 80652 Windsor Fire Department Jim Abbott 728 Main Street Windsor, Co 80550 961738 INTRODUCTION COUNTY PLAN SECTION OF THE REPORT The law enabling the County Subsidy program requires that all plans submitted include a description of the existing system, deficiencies or improvements, and goals and objectives. You will see that the format we are providing for submission of your plan emphasizes this. Please fill in all categories. Do not reference page and paragraph numbers from a previous plan. The format we are requiring is available on Word Perfect word processing program 5.1 and will be provided for your use upon request. To receive a copy of this format on disk you must send a formatted disk to the EMS Division(the address listed on the first page of this booklet). If you don not have a word perfect program feel free to computerize the following format in your word processing program,use this form, or retype it if necessary_ The following EMS representatives were active in the development of this report and plan- please mark all that apply. County Health Department X_ Physician Advisors X_ County Wide EMS Council X_ EMS Provider Agencies: X Ambulance Agencies -X Fire Departments X_ Search and Rescue Providers X Clinics or Hospitals X Dispatcher Communications -X Training Center Reps. X_ 961738 SECTION II-PLAN ACCOMPLISHMENTS: (List any completed goals or accomplishments in the area of EMS in your county. L Formed committee for revision of protocols and procedures from all areas of EMS in Weld County. Process is underway to construct protocols that are current with new curriculum standards. Each area of the protocols will be consistent from first responder through flight nurse. 2. Revised and updated protocols for Weld County Ambulance Service. 3. Applied for, and was awarded grant with which to purchase Automatic External Defibrillators, all of which have gone "on line". 4. Adopted new EMT-B curriculum for implementation January 1996. 5. Trained instructors and staff at Aims Community College for instruction of new EMT-Basic curriculum. 6. Conducted several transition courses and have held three courses teaching the new EMT Basic curriculum, through Aims Community College. 7. Incorporated the new First Responder curriculum into all applicable courses at Aims Community College. 8. Instituted a CME program for all agencies that wish to participate, through Aims Community College and the Weld County EMS/CME Coordinator. 9. Continue to hold regular multi-agency meetings (EMS Advisory Council)for the purpose of further developing a more cohesive EMS system in Weld County and surrounding agencies. 10. Hired EMS/CME Coordinator to act as a liaison, educator and CQI person in Weld County, working with Fire departments, Ambulance Services and Air Life. 11. Held multiple demonstrations for the purpose of educating the public in EMS. 12. Continued the study of Emergency Medical Dispatch and provided education regarding EMD to local officials. 13. Maintained active participation on regional trauma consortium, getting regular updates to all EMS agencies. 14. Established newsletter to inform all EMS agencies of current and pertinent information.. 15. Weld County Ambulance Service purchased three new ambulances in 1996, and will expand service capabilities to basic transport and advanced medical transport capabilities. 16. Tri-Area has purchased one new ambulance in 1996, and has expanded their response area to include a new Fire Station in Frederick. 17_ Frederick Fire Station #2 opened this past year, and has designated a van for multi-caualty events. 18. Air Life donated the equipment for the van in Frederick Fire Station. 961738 19- Mutual aid agreements updated and revised if necessary. 20 Applied for and was granted training center status for EMT-Basic, EMT-Basic CME, Intravenous Training, AED Training, and, Paramedic CME Training, at Aims Community College. 961738 2.1.A EXISTING SYSTEM DESCRIPTION- COMMUNICATIONS Describe your system. Include the following: 1)Functional description of paging, dispatch, on scene and medical control,ambulance to ambulance,ambulance to hospital, alternate communications, communications to air transport and other agencies, etc... 2) System functional diagrams identifying dispatch,base stations, control stations,repeaters,telephone lines, frequencies etc... Include as much detail as possible. Weld County Regional Communications Center accepts and directs all requests for emergency service through an enhanced 911 system. Notification of emergency calls for emergency medical services are paged on the following channels/frequencies, depending on the circumstance and location. Weld County EMS: VHF, 155.400 (Receive and transmit) Fire A: VHF; 153.785 (Receive and transmit) Fire B: VHF; 154.145 (Receive and transmit) Fort Lupton Fire Department: VHF; 154.235 (Receive and transmit) Greeley Fire Department: UHF; 451.150 (Receive) 458. 150 (Transmit) Air Life NCMC medical channel Medical control is established and maintained either through cellular phones or medical channels on the radio. Cellular phones are generally accessible for all fire departments and ambulance personnel. A systems diagram is included identfing dispatch, base stations, control stations and repeaters. 2.1.B IDENTIFY AREAS NEEDING IMPROVEMENT- COMMUNICAITONS Identify the changes or improvements you plan to make within your current communications system. If none, please state"NONE", and move on the next component. I. Emergency Medical Dispatch is a facet of communications that is supported by the EMS community in Weld County. Even though it is a state wide and regional voluntary system at this time, it is generally felt that the direction of communications for emergency services will include EMD as an accepted standard of care. Considering this and the current standard of care in the industry, it is vital to thoroughly examine the implementation and maintenance of EMD in the County. 2. Digital paging systems need to be researched seriously, and funding found for at least minimal numbers of pagers to be available in the county. 3. Complete the addition of radio towers and repeaters. 4. Currently, documentation revolves around the manual written report. To effect a lasting change for improved patient care, a system needs to be implemented that will evaluate the patient report and provide for a consistent quality improvement program that will be addressed by all levels of care,from first responder to flight nurse and paramedic. 961738 2.1.C State your goals and objectives and place them here. COMMUNICATIONS GOAL# _Is Emergency Medical Dispatch Institute Emergency Medical Dispatch into the communications system currently in place. COMMUNICATIONS GOAL# 2_Digital paging Digital paging would greatly enhance the efficiency of response in Weld County. The County needs to explore the options of digital paging. COMMUNICATIONS GOAL# _3_-GPS system Air Life has requested several hand held GPS modules be available to assist with on scene management for landing zones. COMMUNICATIONS GOAL# _4_-County CQI program Development of a County-wide CQI program, that is all inclusive of each facet of EMS in the County. Then the communication of the data obtained to all agencies, to assure the best possible patient care. List the objectives(process by which you intend to accomplish this goal) and state any progress attaining this communications goal. Objective for Goal# I Continue to gather information for implementing EMD, ie: attending conferences, interviewing other agencies with EMD, investigating financial obligations and forwarding all information to the WC EMS Advisory Council and other interested parties. Objective for Goal# 1 Conduct educational sessions for the County Commissioners, communications staff,field personnel and the public-at-large ref EMD, its potential and its purpose. Objective for Goal# 2 Establish a committee, initiated by the EMS Advisory Council to gather information ref, digital paging and report back to the board by June of 1997, with recommendations. Objective for Goal# 3 Air Life personnel will research and make recommendations to the EMS Advisory Council ref GPS systems and the use of the system on scene. EMS Advisory Council will then make recommendations to agencies for purchase and/or grant funding for the system. Objective for Goal# 4 When the new medical report forms are chosen, (see the section on Documentation) it is essential to determine that the information obtained from the report forms can be useful to agencies to increase the level of patient care, by getting consistent and regular feedback. Communications within the county would be facilitated by a generic format, that serves all levels of care in the county. RFI(request for information) is in process. Completion of that process and the feedback from agencies and various committees is necessary at this time. • 961738 2.2.A EXISTING SYSTEM DESCRIPTION-TRANSPORTATION Describe your current system. Include: 1)the number of ambulance agencies, quick response units, search and rescue, and fire agencies within your county; 2)the number of transport vehicles and their condition; 3)Coverage; 4)Mutual Aid Agreements in place; and 5) coordination of resources. 1. EMS Agencies There are three ALS ambulance agencies domiciled in Weld County. a. Air Life of Greeley, Northern Colorado Medical Center, Greeley b. Tri-Area Ambulance Service, Frederick, Colorado c. Weld County Ambulance Service, Greeley, Colorado There is one BLS transport agency, that will transport BLS patients only at the request of Tri Area Ambulance. a. Frederick Area Fire Protection District Twenty-eight (28)fire agencies that are headquartered and/or have part or all of their districts in Weld County. 2. Weld County has a total of 33 transport capable vehicles in good to excellent condition. a. Air Life- I helicopter b. Tri-Area Ambulance - 3 ambulances c. Weld County Ambulance Service - 9 ambulances d. Fire Departments - 19 Fire Rescue Vehicles, 1 BLS unit (Frederick Fire Protection District) 3. Coverage is provided to all areas of Weld County. ALS ambulances are located in the western third(most populous area) of the county where 98%of the calls for service occur. • Fire Rescue units are also primarily located in the western third of the county. Weld County Ambulance Service is responsible for the vast majority of the 4,004 square miles of the county. Tri-Area Ambulance Service covers 48 square miles. Frederick Fire covers 21 square miles, responding mutual aid with Tri Area. Air Life has a 300 mile flight radius. American Medical Response of Boulder County covers the extreme western portion of the county, in limited areas. 4 Mutual on aegular aid a basis.teCurrent agreements with Weld County A Ambulance Service agreements in effect with most providers. Revision and review of are occurs being updated to better coordinate responses by 911 dispatch centers. 5. Coordination of resources is accomplished in several ways: a. An active county EMS Council b. Representation on the Northeast Colorado Trauma Consortium c. Dispatch is provided and coordinated by Weld County Regional Communications to all EMS providers except Fort Lupton and Mountain View Fire Departments. d. Fort Lupton Fire is dispatched by Fort Lupton Police Department, and, Mountain View is dispatched from Boulder County Communications. 961.738 2.2.B IDENTIFY ANY AREAS NEEDING IMPROVEMENT- TRANSPORTATION Identify the changes or improvements you plan to make in your current EMS transportation system. If none,please state "NONE", and move on to the next component. 1. Tri-Area Ambulance Service plans to purchase one new ambulance in 1997. 2. Weld County Ambulance Service has two ambulances that were replaced and purchased two new ambulances in 1996. 3. A formalized systems status management program will be initiated in 1996. 4. Mutual aid agreement updates with Weld County Ambulance Service are needed and will be completed in late 1996. 5. Tri Area will be updating mutual aid agreements as well. 2.2.C State your goals and objectives and place them here. TRANSPORTATION GOAL # 1_-Purchase of ambulances Tri-Area Ambulance wishes to purchase two new ambulances in 1995-1996 Weld County Ambulance wishes to purchase two new ambulances in 1996. TRANSPORTATION GOAL# 2_ Weld County Ambulance Service is initiating a formalized Systems Status Management plan in 1996, to facilitate more efficient use of the ambulances and personnel. Please list the objectives(process by which you intend to accomplish this goal) and state any progress toward attaining this transportation goal. Objective for Goal# I_Purchase of ambulances Specifications will be written by the respective agency. Bids will be requested and purchases made. Objective for Goal# 2_Systems status management Staffing changes will be implemented in January of 1997. Based on an analysis of the system and the efficiency of the crews, adjustments may be necessary. 361738 2.3. A EXISTING SYSTEM DESCRIPTION -TREATMENT Describe your current system and include the following; 1)treatment protocols; 2) destination policies; 3) medical control; 4)quality assurance; 5)manpower; 6)training; 7)mass casualty; 8)Trauma specific policies, protocols and procedures. 1. Weld County currently has several sets of protocols, one for each of the following agencies or group of agencies: a. Air Life b. Weld County Ambulance Service c. Tri Area Ambulance Service d. Frederick Area Fire Protection District e. Fire Departments in Weld County with the exception of Kersey Fire Department 2. Destination policies are outlined in the treatment protocol,for each agency. 3. Medical control for Air Life, Weld County Ambulance and the majority of the fire departments is provided by North Colorado Emergency Physicians. North Suburban Medical Center provides protocols for Tri-Area Ambulance and Frederick Fire Department. Medical Control for Mountain View Fire Department is Longmont United Hospital. ****Kersey Fire Department at this time does not have a physician advisor. Attempts are being made to obtain sponsorship for them. 4. Quality Assurance is provided retrospectively with chart review, on-line medical control. Currently chart review is done for the fire departments, ambulance services and Air Life as separate reviews. Physician Advisors oversee the process and are always available for consultation, chart review, and problem solving. 5. Manpower need are determined by each individual agency. 6. Training is provided and/or coordinated by Aims Community College for those agencies that so choose. A couple of agencies have elected not to do CME training at all or coordinate with Front Range Community College. 7. Weld County Office of Emergency Management has a disaster plan currently in effect. Mass casualty incidents are addressed by agency protocols and mutual aid agreements. 8. Trauma specific protocols and procedures are listed in the agency's protocol books and are reviewed regularly with CME training. Destination policies are in effect for all transporting agencies. 9617738 DATE: APRIL 18, 1990 DR: J. SCHWARTZ, MD DIR: G. MCCABE • MEDICAL AND TRAUMA DESTINATION POLICY WCAS DESTINATION POLICY - MEDICAL: 1. In general, all medical patients cared for by WCAS will be transported to NCMC. EXCEPTIONS: 1. Unstable medical patients should be transported to the nearest adequate hospital if time is so critical that any delay will compromise the patient's care. 2. Stable medical patients who request transport to facilities other than NCMC, will be treated on a case by case basis. If the patient's condition will not be jeopardized by a more lengthy transport, every effort will be made to accommodate the patient's request,but these transports MUST BE APPROVED BY THE BASE PHYSICIAN. If the patient's request is a hospital closer than NCMC, the patient may be transported without prior approval and the receiving hospital should be notified directly by radio. 3. If the patient's condition warrants immediate intervention, the patient may be transported to a closer destination. Such a change in destination shall be cleared with the base Physician and the referring authority notified as quickly as possible. WCAS DESTINATION POLICY-TRAUMA: 1. Because optimal patient care is dependent upon matching patients with the facility best able to care for their problem via appropriate resource personnel, and proven record, the following. destination policy for trauma patients will be instituted. A. In general, all trauma patients cared for by WCAS will be transported to NCMC. 2. Stable victims of minor trauma(consider the mechanism of injury) will be taken to the hospital of their choice. Base station physician must be contacted when this involves leaving Weld County. **WHEN IN DOUBT, contact the base station Physician for help in the decision making,process and appropriate notification of the receiving hospital. 20 961.738 Denver Metro EMT-Basic Protocols Operational Guidelines DESTINATION POLICY Purpose: To provide a set of guidelines to help ensure proper disposition of the various patients encountered in the field. Philosophy: A. Critical patients with a special medical need should be taken to the nearest facility that can best provide for that need. 8. Cutkal patients without a special need (i.e., cardiopulmonary arrest) should be taken to the dosest emergency department C. All other patients should have their request accommodated,consistent with the ability of that system to meet that request. Special Needs: ' The following list of clinical conditions and facilities best able to care for those clinical conditions is described. A. Carbon Monoxide Poisoning Patients with significant isolated carbonmonoxide exposure as evidenced by: 1. Loss of consciousness 2. Altered mental status 3. Seizures 4. Arrhythrnias should be transported directly to Presbyterian SL Luke's(downtown)or Porter Memorial Hospital, both of which have hyperbaric capabilities. These patients require base contact. Complications of airway compromise,cardiovascular instability, or other life threat require transport to the nearest appropriate emergency department. For example, carbon monoxide exposure associated with burns or trauma should be handled according to burn/trauma protocols. Treat the complications above as per protocol. The receiving facility must be notified. B. Burns Patients older than 12 years of age,with isolated second degree or third degree burns greater than 20% body surface area,should be transported directly to the University Hospital Emergency Department. Patients 12 years of age and younger,with isolated second degree or third degree bums greater than 20%body surface area, should be transported directly to the Children's Hospital Emergency Department These patients require base contact Complications of airway compromise, cardiovascular instability, or other potential injury require transport to the nearest appropriate emergency department. NOTE: In patients with significant burns and carbon monoxide exposure, in the absence of multisystem trauma, consideration should be given for hyperbaric therapy prior to burn therapy. Contact base for assistance. 3/95 m VIII-6 961738 Denver Metro EMT-Basic Protocols C. Trauma 1. Any patient with trauma demonstrating signs of shock or poor perfusion requires transport to a CTI- designated Level I or Level II trauma center. 2. Any patient with penetrating trauma to the neck, chest, or abdomen requires transport to a CTI- designated Level I or Level II trauma center. 3. Patients with isolated head injury demonstrating: a. Penetrating skull injury b. Focal neurological deficit c. Deteriorating level at consciousness d. Coma e. Seizure • require transport to a CTldesignated Level I, II or III trauma center. The trauma center must be notified. 4. Mechanism of injury is an important consideration in trauma patient destination. Studies have shown paramedic assessment to be as valid as any physiologic or kinematic scale. Consider your decision carefully. See"ACEP Indicators of Significant Injury"in Multiple Trauma Overview protocol. D. Pediatrics Destination of pediatric patients should follow the guidelines of this Destination Policy_ Two special circumstances suggest transport directly to The Children's Hospital: 1. Children 12 years of age and younger with significant burns-as described above in Bums. 2. Children whose well-being is dependent upon the long-standing, special medical care they receive at The Children's Hospital These patients require base contact. E. Psychiatric Patients and Mental Health Holds(MHH) 1. Patients placed on MHH by the Denver Police Department or Mental Health Corporation of Denver shall be transported to DGH. 2. Patients placed on MHH by other police departments, private practitioners or other parties shall be taken to their appropriate affiliated institution. 3. Patients with psychiatric problems not on an MHH shall be taken to the closest facility or per patient request 4. Patients with psychiatric problems who have an acute medical or traumatic concern shall be treated according to the appropriate medical or trauma protocol. • • 3195© VIII-7 961738 Denver Metro EMT-Basic Protocols© F. Obstetric/Gynecologic 1. For patients in uncomplicated labor. a. Delivery not imminent 1) If the patient has a private obstetrician or gynecologist, then follow the patients request for destination, when possible. 2) If the patient has no private physician, then follow the patient's request for destination (if expressed),or transport to the closest hospital. b. Imminent delivery: 1) If the patient has a private obstetrician/caregiver, then follow the patient's request for destination, provided the requested facility is no greater than five minutes beyond the closest participating hospital. If the requested facility does not meet these time constraints and the patient still requests the facility, consult with the base physician. 2) If the patient has no private physician, then transport to the closest partdpating hospital. 2. For patients with acute obstetric emergencies(i.e.,prolapsed cord,third trimester vaginal bleeding, suspected placenta previa or abruption, etc.)who require emergent transport a. Destination choices shall be limited to the following hospitals with obstetrical coverage on site 24 hours a day: 1) Aurora Presbyterian Hospital 2) Aurora Regional Medical Center 3) Denver General Hospital 4) Porter Memorial Hospital 5) P/SL Medical Center 6) Rose Medical Center 7) St.Joseph Hospital 8) St.Anthony Hospital Central 9) Swedish Medical Center 10) University Hospital Littleton Hospital(7 p.m. to 7 a.m. only) Lutheran Medical Center(7 p.m. to 7 a.m. only) Patient request of one of these choices may be honored, provided the requested facility is no greater than five minutes beyond the closest of these choices. If the requested facility does not meet these time constraints and the patient still requests the facility, consult the base physician. If the patient expresses no preference, then transport to the closest of these choices. The following hospitals do not have 24-hour/day in-house obstetrical • capability: 1) Mercy Medical Center 2) North Suburban Medical Center 3) St. Anthony Hospital North If patient requests one of the facilities listed here, contact base. `y 3/95® VIII-8 96178 2.3. B IDENTIFY ANY AREAS NEEDING IMPROVEMENT-TREATMENT Identify the changes or improvements you plan to make within your current treatment system. If none,please state "NONE",and move on to the next component. 1. Treatment protocols are in need of review and revision. That process began in September 1996. All arenas of pre-hospital care will be represented on a committee charges with that responsibility. The new DOT curriculum, terminology and some methods will be incorporated.. 2. Medical Report forms are in desperate need for revision. This change will occur at the same time as the revision of protocols. 3. Structure the CME program for the fire departments to reflect changes in the EMT-Basic curriculum with an emphasis on AED 4. Develop a training program to instruct currently certified providers in the new medical field protocols. S. Training programs will need to be developed that educate all citizens of the county ref EMD and its potential and role in the EMS system of the County. 6. Training will need to be developed that incorporates more than the medical and trauma scenarios. We need to explore areas that include EMS management, communication skills, time management, scene choreography, volunteer leadership training,preceptor training, system status management, etc... 7. Complete review and revision of Weld County Disaster Plan is under way, though not completed 8. Encourage and assist Weld County EMS provider agencies to increase first response capabilities with AED, if not already in place, and medical/trauma equipment and training for first response to routine, Mass Casualty and special rescue scenarios. 9. Review emergency response policies and adopt plans to improve safety to public and emergency crews, ie; Emergency Medical Dispatch, compliance with OSHA standards, and review of disaster plans, etc... 10. Develop plans to train all currently licensed ambulance agencies to meet revised certification requirements of Weld County Ordinance 77D. • 961738 2.3.C State your goals and objectives and place them here. TREATMENT GOAL# I Revision of county protocols Revise county EMS protocols that are used by the North Colorado emergency Physicians group, to include updated information and to include all levels of care provided by prehospital care givers. TREATMENT GOAL# 2 Revise Medical Report Forms Revise medical report forms that accurately reflects level of care, treatment and protocol expectations. These must be a priority, while also considering data collection, quality assurance and the application of the medical form from one level of care to the next. TREATMENT GOAL#_3_Structure of CME program Implement and maintain a CME program consistent with the content of the accepted DOT curriculum, and State EMS. TREATMENT GOAL#_4_Field Training for new Protocols Once the protocols are revised, establish a training program to address the needs of all agencies in accepting, and, implementing new field protocols. TREATMENT GOAL# 5 EMD Training Programs Establish committee to develop training programs, using a variety of media,for the EMD program and all its facets. TREATMENT GOAL#_6 EMD Training Programs Establish schedule for education efforts and conduct training ref EMD to fire agencies, Ambulance personnel, hospital staff and the citizenry-at-large. TREATMENT GOALS #_7 Training issues, outside the medical topics of EMS Develop programs that can reach the other areas of interest in the volunteer agencies, professional organizations and agencies. TREATMENT GOAL# 8_ Complete revision of Weld County EMS Disaster Plan. TREATMENT GOAL#_9_ Implement AED capability in as many areas as budgets and time will allow to improve the standard of care and first response capability. 961738 TREATMENT GOAL# 10_ Identify areas for educational programs that will address scene safety, OSHA standards and reviewing the county disaster plan when completed. TREATMENT GOAL# 11_ Identin;all ambulance agencies that operate in Weld County and notes those agencies of all changes/requirements for licensing in accordance with Weld County Ordinance 77D. List the objectives (process by which you intend to accomplish this goal) and state any progress attaining treatment goal. Objective for Goal# 1_County protocols Committee formed to review, revise protocols to reflect new curriculum and a continuity of care from first response to flight care. Objective for Goal #_2 Medical report forms Flight staff, ambulance representatives,fire agency representatives will work together to review formats for medical report forms and have a consensus for a proposed format by May 1997. Objective for Goal# 3 CME Program EMS Coordinator will oversee and direct CME program for all interested agencies. Program outlines, and, guidelines will be established by May 1997. Objective for Goal#_4_Protocol Training EMS Coordinator to oversee and direct all educational aspects of training for new protocol documents, generated by the Protocol committee referred to earlier. Objective for Goal# _5 and 6_EMD Training EMS Advisory Council, in conjunction with the EMS Coordinator, to establish standard training program(s) to address EMD issues with the EMS agencies, and,public at large, by December 1996. Programs will be conducted on an as needed basis, determined by request and assessment of need. Objective for Goal # 7 Aims will develop and be responsible for the implementation of programs that fall outside the direct patient care issues. For example: management, incident command, communication skills,preceptor training, etc.... Programs should be on line for instruction in the Summer of 1997. 961738 Objective for Goal# 8_ Weld County Office of Emergency Management and Weld County EMS Council to revise Weld County Disaster Plan and assist municipalities within Weld County in revising local disaster plans to coincide with the County Disaster Plan. Objective for Goal# 9 Investigate the AED capability of the county to date, and compile information ref the feasibility for acquiring additional AED machines. Objective for Goal# 10 Weld County EMS Council to invite agencies to review emergency response plans with council, and assist in developing policies to reduce risk of injury to emergency personnel and the public. Objective for Goal#_11 EMS Advisory Council will direct communications with all licensed ambulance agencies to assure compliance with WC Ordinance 77D, on an annual basis. Assessment should be accomplished by August 1 of each year to facilitate updating information for the county EMS plan. 961738 2.3.C State your goals and objectives and place them here. DOCUMENTATION GOAL# / In conjunction with the protocol revision, implement a written medical report form that assures accurate and complete information ref patient care. DOCUMENTATION GOAL# 2 Conduct training programs to address the changes in the medical report forms, as soon as possible after the acquisition and distribution of the forms. DOCUMENTATION GOAL# 3 Establish a county wide CQI system that allows for direct communication, consistency and accuracy ref patient care on scene and follow up that is necessary. DOCUMENTATION GOAL# 4 Establish training programs to instruct all EMS agencies of the expectations for documentation, data collection, and the accepted levels of care in the county. List the objectives(process by which you intend to accomplish this goal)and state any progress attaining documentation goal. Objective for Goal #_1 Committee members associated with the protocol revision will be instrumental in choosing the new format for medical reports. This should be accomplished at the same time or shortly thereafter the revision of the protocols. Objective for Goal# 2 Aims staff and the EMS Coordinator will develop a training program with all materials necessary to begin instruction as soon as the protocols have been accepted. Objective for Goal# _3_ CQl programs will be developed for implementation within six months after training for protocols and documentation is completed. Members from each aspect of EMS in the county will be represented while development of the CQI program takes place. Objective for Goal# 4 The EMS Coordinator will be responsible for implementing all training programs developed, in the cases mentioned above. 961.72s 2.4. A EXISTING SYSTEM DESCRIPTION- DOCUMENTATION Describe your existing system and include the following: 1) address any prehospital care reporting system that your county may have other than the statewide data collection system provided by the state; and 2)identify any medical quality control measures your county may have in place to evaluate and improve medical care. Weld County does not have any shared data collection systems other than the State's system at the present time. Air Life has an internal quality assurance program, and information is available upon request for followup. Weld County Ambulance Service has a system of CQI that is available to all other providers. It includes trip review, data review, mortality and morbidity review, and field instructorship. This agency continues to study the feasibility of converting to an automated trip reporting system that will provide: State data,patient reports and CQI concurrently. Tri Area Ambulance and Frederick Fire have their medical reports reviewed by the physician advisor at North Suburban Medical Center on a regular basis. The EMT-Basics with the volunteer fire departments in Weld County have a standardized trip report form that is completed on each medical or rescue call. Greeley Fire Department has a computerized medical report form. Reports are reviewed by the EMS Coordinator, with direction from the physician advisor. 2.4. B IDENTIFY ANY AREAS NEEDING IMPROVEMENT- DOCUMENTATION Identify the changes or improvements you plan to make within your current treatment system. If none, please state"NONE", and move on to the next component. 1. Medical report formats need to be investigated that are user friendly,patient care driven and easily converted in a data base. 2. CQI programs must be in place "across the board"to assure quality patient care. 3. Electronic transmittal of information continues to be investigated. 4. Quality assurance programs are only as valuable as the educational process that informs people of expectations and goals for the county wide programs. 961738 2.5.A EXISTING SYSTEM DESCRIPTION-OPTIONAL COMPONENT State any component of your EMS system that has not already been identified and describe what is in place in your county at this time. 2.5. B IDENTIFY ANY AREAS NEEDING IMPROVEMENT. Identify the changes or improvements you plan to make within your current system in the above stated area. 2.5.C State your goals and objectives and place them here. List the objectives(process by which you intend to accomplish this goal)and state any progress attaining this goal. Objective for Goal # 96173E SECTION III - FINANCIAL (THIS SECTION MUST BE ATTESTED TO BY YOUR COUNTY FINANCE OFFICER IN ORDER TO DOCUMENT EXPENDITURES) 3.1 REPORT ON COUNTY SUBSIDY FUNDING Are you currently holding over any county subsidy funds from the previous year(s)? Yes No If so,how much? List below the intent for use of any funds held over from previous years. Date Payee Purpose Amount Please list below the expenditures of State provided EMS funds for the current calendar year. You must fill in this section even if you delegated the responsibility for expend- iture of the funds. The State sees the County as the responsible party. (All funds may not expended at the time this report is filed, so please indicate where the unexpended funds will be spent and mark those with an"*".) I ATTEST TO THE FACT THAT INFORMATION CONTAINED IN THIS FINANCIAL SECTION IS ACCURATE AND THAT THE COUNTY HAS DOCUMENTA ON FOR ALL XPENDITURES: SIGNED ti///7 7 7%// TITLE Donald Warden Finance Director-Weld County 9617353 FINANCIAL NARRATIVE - (Use this space to explain how the expenditure offunds upgrade EMS in your county) Partial funding for the Weld County EMS Coordinator, responsible for Continuing Medical Education in Weld County for EMS agencies that wish to participate. This currently involves 23 agencies in the county. Other responsibilities include: Protocol revision, distribution and education, Certification checks for all personnel, maintaining training records, call review and quality improvements, liaison for physician advisor and EMS agencies in the county,processing information required by State EMS and writing the county EMS plan, to mention a few. ANTICIPATED EXPENDITURES FOR NEXT YEAR'S SUBSIDY FUNDING: (Please use this space to list anticipated expenditures-we realize that circumstances alter cases and you may not necessarily expend your funds for these anticipated expenditures.) PURPOSE (narrative) sAmount Partial funding for EMS Coordinator All 961738 Hello