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Home My WebLink About980298.tiff RESOLUTION RE: APPROVE 1998 EMS GRANT ABSTRACT 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 the 1998 EMS Grant Abstract between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Ambulance Service, and the Colorado Department of Public Health and Environment, Emergency Medical Services and Prevention Division, with terms and conditions being as stated in said grant abstract, and WHEREAS, after review, the Board deems it advisable to approve said grant abstract, 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 1998 EMS Grant Abstract between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Ambulance Service, and the Colorado Department of Public Health and Environment, Emergency Medical Services and Prevention Division, be, and hereby is, approved. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 18th day of February, A.D., 1998. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: /, � )�L �S.4 EXCUSED Consta ce L. Harbert, Chair Weld Count i ler q s zoa ' �18 ] } a R W. H. ster, ro-Tem Deputy Cl-i �y eo E. Baxter APPR D AS FORM: DaV . all County orney J� a ey/ G�^ '/�'Y,l/�� arbara J. Kirkmeyer / 980298 en: AM AM0010 Cover for Waiver Grant x GRANT ABSTRACT Weld County Ambulance Agency Name Service Location: City Greeley County Weld PROJECT AREA (Mark all that apply): _Communications _Medical/Rescue Equipment _Manual_Automated Defibrillator Extrication _Training Continuing Education Training Equipment _Public Education _Injury Prevention/Pier Projects x Other EMERGENCY VEHICLE: Not applicable Ambulance _Quick Response _Rescue Total dollar amount requested from the State $ Total cash match provided by applicant $ Total In-Kind match provided by the applicant $ Summarize in one paragraph: 1. The need for this project (for instance- Our county wide ambulance service has been MS since its inception. We have become a favorite retirement spot for marry Colorado residents in the past 5 years. The complexity of our calls has increased along with the number. We want to upgrade to ALS within the next year. We need to replace our worn out transport ambulance) Uniform EMS data elements are not being defined, collected, or analyzed in our region. We have no centralized collection or reporting system. Consequently, there is not an objective feedback or research method to convey useful information about our system's performance. 2. A description of the project (for instance-Priority#1 We would like to upgrade the level of service countywide to 24 hr ALS; a) training for 6 new EMT7; b)2 manual defibs; c)radios for EMT-Is, Priority#2 ambulance to replace 1980 Type 1I with 150,000 miles on it, etc.) We want to implement a computerized trip reporting system that includes a file server repository which can be accessed and utilized by all of the participating EMS pro— viders in our region. Average number of EMS runs yearly 6600 980298 Attachment A LEGAL NAME OF AGENCY FEDERAL TAX ID (read instructions carefully on this item) Weld County Ambulance Service 84-6000813 CONTACT PERSON PHONE (DAY) PHONE (NIGHT) Gary McCabe 970-353-5700 same AGENCY MAILING ADDRESS See below STREET CITY ZIP 1121 M Street Greeley, CO 80631 LEGAL STATUS OF AGENCY/ORGANIZATION (Mark all that apply): PRIVATE NOT FOR PROFIT _PRIVATE FOR PROFIT X COUNTY/CITY GOVERNMENT _STATE AGENCY _SPECIAL DISTRICT _OTHER PROJECT AREA (Mark all that apply): Communications _ Training MedicaVRescue Equipment _ Continuing Education _ Manual_ Automated Defibrillator _ Training Equipment _ Public Education _ Extrication x Other EMS Data Collection/Research _ PIER/Injury Prevention Programs Emergency Vehicle Ambulance_ Quick Response Rescue County Wide Grant _ Regional Grant _ State-wide Grant _ Individual Agency Grant 50% CASH MATCH REQUIREMENT MET _ WAIVER HAS BEEN REQUESTED I,the undersigned,do hereby attest that the information contained within this application is true to the best of my knowledge. I also attest that the County Commissioners from the areas impacted by this project will be provided a copy of this application by no later than 9_13_98 . I understand that my application will be disqualified should either of these statements be untrue. Gary M, McCabe Director PRINT NAME TITLE ^'`r\'N. 2-14-98 SIGNATURE DATE 1 980298 WHY IS THIS PROJECT NEEDED In the space below,write a concise statement describing the need(s)addressed by this project. Uniform EMS data are not being defined, collected, and/or analyzed in our region. We have no centralized collection or reporting system. Consequently, there is no objective feedback or research method to convey useful information about our system's performance. This system will provide all that is lacking presently. We hope to initiate the project in March, and complete it by mid-year 1998. Priorities: 1. Complete the RFI/RFP currently in progress. 2. Purchase necessary hardware and software for input devices. 3. Begin input training for providers. 4. Purchase server hardware and software. 5. Contract interface technology. 6. Integrate with existing systems (dispatch, billings, etc.) . County Plan Reference: See pages 23 through 26 (Documentation 2.4A) of the Weld County Plan and Report on Emergency Medical Services (copies attached) . 2 950298 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 a shared data base system at this time. Although the process has begun to generate a system in conjunction with the communications center, city and county agencies. At this time, medical field reports are hand written for the most part and reviewed as time permits. Tri Area Ambulance Service, Frederick Fire Protection District and Mountain View Fire Protection District work through North Suburban Medical Center for their COI program. Call review is done on an individual basis with call review by the EMS Coordinator with direction of the physician advisor. Incident reports/ concerns/issues are addressed through the EMS Coordinator with the direction of the physician advisor. Revised 6/97 23 980298 2.4.B IDENTIFY ANY AREAS NEEDING IMPROVEMENT - DOCUMENTATION Identify the changes or improvements you plan to make within your current documentation system. If none, please state "NONE", and move on to the next component. 1. The report form for the volunteer agencies has changed since the last EMS plan was written. Although the implementation was not 100% due to specific agency concerns. 2. WCAS has implemented a pilot program for the review of computer generated field reports. This review, when completed should supply information concerning the direction of medical reporting. 3. Interagency and intergovernmental links for exchange of data should be explored and researched. 4. Quality assurance programs need to be completely reviewed to allow for more immediate feedback. 5. Computer hardware and software costs should be analyzed with the new programs. 6. Computer capability issues were addressed some time ago, but there is not a clear indication of what program would be best suited to the agencies. 7. There needs to be assurance with any system that is initiated in the county that all information is confidential, yet allows COI to be shared with all agencies that respond to a particular patient. Revised 6/97 24 980295 2.4.0 State your goals and objectives and place them here. DOCUMENTATION GOAL # 1 Goal—Initiate a cost efficient, computer generated trip report for all agencies in Weld County DOCUMENTATION GOAL #2 Goal—To establish COI program that allows for efficient and worthwhile feedback to emergency responses in the county. List the objectives (process by which you intend to accomplish this goal) and state any progress toward attaining this documentation goal. Objective A for Goal #1 Continue pilot program by WCAS for computer generated trip reports. Objective B for Goal #1 Examine other alternatives, (funding and program alternatives) in the meantime, to address needs of specific agencies, if it is discovered, that the program will be cost prohibitive to the majority of agencies. Objective C for Goal #1 Establish consensus for the program chosen and begin implementation at the earliest possible date. Objective A for Goal #2 Establish parameters and generate fields that would obtain information needed by the EMS Division and the county. Objective B for Goal #2 Establish patterns of treatment to serve as a template for training issues and generate specific data that reflects quality of care. Revised 6/97 25 • 980298 DESCRIPTION OF THE PROJECT AND HOW YOUR PROJECT UPGRADES EMS In the space provided,please outline the project. Include planned expenditures, the time-frame, and any other information that will assist the committee in understanding the nature of the request. Weld County and the surrounding region does not have a shared data base at this time. All patient encounter reports are currently hand-written and archived in a paper (hard- copy) format. EMS dispatch and provider data are not integrated and are duplications of effort. Retrieval of information, Q.A. , and data comparisons are cumbersome, time- consuming, and very inefficient. In 1994, the Paramedic Division of the Denver Department of Health and Hospitals in- vited Weld County Ambulance Service to participate in a study of the Westech comput- erized trip reporting system. The Denver study continued into 1995, but WCAS removed itself from the project due to differences of opinion over the efficacy of the system. In 1996, WCAS initiated its own informal RFI on computerized trip reporting systems and budgeted for the actual project. In June 1997, WCAS proposed a formal RFI to the Weld County EMS Council. The RFI was adopted and expanded. It was included in the 1997 Weld County EMS Plan. The RFI is being converted to an RFP at this writing. In January 1998, the Northeast Colorado ATAC was advised by WCAS that WCAS was proceeding on the computerized trip reporting project, and that the file server could be upgraded to include all ATAC providers agencies. In February 1998, WCAS made the decision that it would purchase the necessary hardware, software, and technical support to: 1. Upgrade its existing LAN PC system. 2. Interface with the Weld County Regional Dispatch Center's computer system. 3. Interface with its own existing billing and reporting system. 4. Develop a network file server system. Total cost of this project is estimated ate $120,000. The File Server component is estimated at approximately $40,000 if it will be used to accept and manage data from all participating ATAC providers in our region. 3 90298 p Epp How will the project provide for a long-term solution to the current problem? Our system will become a model for other providers to study and/or emulate. The file server will act as a repository for county-wide and regional EMS data. This, in turn, will allow for : 1. Comparative analysis (including QA) and 2. EMS research. The LAN part of the system will be maintained by WCAS. The cost of maintaining the File Server would be apportioned according to agency interface requirements and number of agency entries. WCAS would provide host site services (Housing, power, and telephone link capabilities) . If this project is funded,how will the project be sustained in subsequent years? See above. What other remedies to this have you explored to meet your need,and explain why this is the most cost-effective. Individually, some of the providers in our region have explored computerized trip reporting in concert with WCAS. Many have put their projects on hold because of funding and other resource limitations. Ambulance services in our region have utilized the State's Data Collection Program (Dot-to-Dots) to limited success. Provide dollar amounts of other options you have explored. WCAS is in the RFP process. See estimates. 4 980298 EQUIPMENT LIST(Listing brands will not preclude applicant from having to obtain bids for the generic equipment types) In the space provided,please list the EMS equipment,communications,or training equipment for which funding is being requested-Include as much information as aossible. Priority Quantity Description Cost 1 9 Laptop/Penbased Computers $36,000 1 2 Tabletop PCs 5,000 1 1 Laptop PC 3,000 1 9 Portable Printers 2,000 1 1 , Server 30,000 1 1 Server Software/Tech Assistance 10,000 1 12 Software licences/Tech Assistance 24,000 1 1 Telephone interface/Radio Interface 10,000 Other TOTAL $120,000 5 980298 PROJECT FUNDING A) EMS Fund Request $ 40,000 B) Local Government Share-Cash - $ 0 (List source) C)Other Cash $ 80,000 D)Total Cash Proj. Cost(A+B+C) $ 120,000 E)Dollar Estimate of In-kind match $ 0 F)Total Program Cost(D+E) $ 120,000 Describe the in-kind match you can provide: 9 980298 APPLICANT'S FINANCIAL INFORMATION Cash Flow Projection for Next Full Fiscal Year Year: 1998.to 199_ See copy of Budget Unit Request Summary EMS Portion of Agency Projection Agency Projection Cash Balance at the start of year $ 83,868 $ Anticipated Revenues Local Government $ 0 Private Contributions $ 0 $ Investment Income $ 0 Other Fees $ 3,363,893 Anticipated Expenditures Salaries $ 1,601,400 $ Operating $ 1,009,774 Capital Improvement $ 0 $ Loans $ 0 Other Bad Debt $ 752,719 $ Anticipated Cash Balance For the end of next FY $ 0 $ Additional Information: Explain the purpose of your cash balance(i.e., reserve, building fund,etc.) Operating reserves Explain any loan payments you are currently making(i.e., $ per month on a fire vehicle) None Explain any capital improvement purchases you intend to make None 10 980298 BUDGET UNIT REQUEST SUMMARY AGENCY/DEPARTMENT NAME: AMBULANCE ENTERPRISE FUND BUDGET UNIT TITLE AND NUMBER: Ambulance -- 5000-23100 DEPARTMENT DESCRIPTION: The Ambulance Service responds to both routine and emergency calls for the county. It is an advanced life support (paramedic) provider. Personnel and vehicles are stationed in Greeley, Evans, and Fort Lupton. ACTUAL, BUDGETED REQUESTED RECOMMEND RESOURCES LAST FY CURRENT FY NEXT FY NEXT FY Personnel Services $ 1,267,912 $ 1,531,296 $ 1,601,400 S 1,601,400 Supplies 121,988 125,000 139,000 139,000 Purchased Services 281,083 270,300 377,557 377,557 Fixed Charges 326,013 1,128,789 493,217 493,217 Debt Service 569,973 25,000 752,719 752,719 Gross County Cost $ 2,566,969 S 3,080,385 S 3,363,893 S 3,363,893 Revenue 3,165,591 3,080,385 3,363,893 3,363,893 Net County Cost $ -598,622 $ 0 $ 0 S 0 Budget Positions 29 29 32 32 SUMMARY OF CHANGES: Continue four-year reduction in medics' scheduled workweek (52 to 48 hours) with parity change in pay and additional personnel. Professional Services includes 3 additional dispatchers for emergency medical dispatch (S96,957). Overall supply and service accounts are up to reflect activity of the Ambulance Services call volume and usage. No vehicles are requested for purchase in 1998; however, the department has requested permission to order two ambulances and appurtenant equipment in October 1998 for delivery in January 1999. Fees are recommended to be adjusted by 4.3% to fund the operation in 1998, which is well within the inflationary range of medical services. OBJECTIVES: 1) To keep the Ambulance Service on a self-supporting (zero subsidy) basis; 2) To maintain maximum possible collection ratios; and 3) To develop appropriate, additional revenue sources. - 356 98029S COMPREHENSIVE ANNUAL INANCIAL REPORT YEAR ENDED DECEMBER 31, 1996 COUNTY OF wELF OLO Accounting DepartmentST Ef 980298 ENTERPRISE FUND Enterprise Funds are used to account for operations that are financed and operated in a manner similar to private business enterprises -where the intent of the governing body is that the costs of providing goods or services to the general public on a continuing basis be financed or recovered primarily through user charges. 980298 COUNTY OF WELD STATE OF COLORADO ENTERPRISE FUND EXPLANATION OF INDIVIDUAL FUND December 31, 1996 Ambulance Fund: This fund accounts for the ambulance services provided to Weld County. J'. Ili 89 980298 COUNTY OF WELD STATE OF COLORADO Enterprise Fund Ambulance Fund Comparative Balance Sheets December 31. 1996 and 1995 1996 1995 ASSETS Current Assets: Cash and short•term investments $ 83.868 $ 0 Receivables (net of allowance for uncollectibles): Accounts . ambulance services 790.138 407,893 Due from other County funds 0 588 Other assets 0 174 Total Current Assets 874.006 408.655 Fixed Assets: Land 48,496 48.496 • Improvements other than buildings 21.461 21.461 Buildings 648.234 648,234 Machinery and equipment 809.187 719.975 Accumulated depreciation (401.382) (378.847) Total Fixed Assets 1.125.996 1,059.319 Total Assets $ 2.000.002 $ 1.467.974 LIABILITIES AND FUND EQUITY Current Liabilities: Accounts payable $ 10.513 $ 20.954 Due to other County funds 10.588 40,952 Accrued liabilities 123.397 137,993 Total Current Liabilities 144.498 199.899 Fund Equity: Contributed capital 107,523 118.716 Retained earnings 1.747.981 1.149.359 Total Fund Equity 1.855,504 1,268,075 Total Liabilities and Fund Equity $ 2,000.002 $ 1.467.974 • 90 980298 • COUNTY OF WELD STATE OF COLORADO Enterprise Fund Ambulance Fund Statement of Revenues, Expenses and Changes in Fund Balances - Budget and Actual For the fiscal year ended December 31, 1996 (With Comparative actual for the fiscal year ended December 31. 1995) 1996 1996 1996 1995 Budget Actual Variance Actual Operating Revenues: Rescue unit fees S 2,921,300 . $ 3,079,363 $ 158,063 $ 3.091,130 Total Operating Revenues 2.921.300 3.079.363 158.063 3.091.130 Operating Expenses: Bad debt expense 510,214 569.848 (59,634) 1.062,863 Personnel services 1,472,400 1.267.912 204,488 1.295,608 Supplies 145.407 121.988 23.419 185,677 Purchased services 270,300 281,083 (10,783) 247,005 Depreciation 160,000 159.227 773 153.826 Other 220.786 166,911 53.875 215.552 Capital outlay 0 0 0 7,320 Total Operating Expenses 2.779,107 2.566.969 212.138 3.167.851 Operating Income (Loss) 142.193 512,394 370,201 (76,721) Nonoperating Revenues: State grants 12.400 76,439 64.039 12.391 Earnings on deposits 0 0 0 22.008 Donations 0 1,008 1,008 7,320 Other 0 7,820 7.820 42.744 Sale of assets 0 961 961 14.000 Total Nonoperating Revenues 12.400 86.228 73.828 98.463 Net Income (Loss) 154,593 598,622 444,029 21,742 Retained Earnings at Beginning of Year 1.149.359 1,149,359 0 1.127.617 Retained Earnings at End of Year $ 1,303.952 $ 1.747.981 $ 444,029 $ 1.149.359 >F 91 980299 EMS PROVIDER INFORMATION All of the information in this section is mandatory for your application to be considered complete. Please list only the personnel that are trained or certified. Persons currently in training should not be listed in this section. If the number of persons currently in training is pertinent to your application, list them in the project description narrative. Years in Operation 22 TYPE OF SERVICE: X ALS(EMT-P& EMT-I) BLS Combination Fire/Rescue service X Transport DI._Non-transport _Other(i.e.,Air,etc.) Jim Campain, MD Name of physician advisor(if agency has one) PERSONNEL BY TRAINING LEVEL(number of each): Level of Training Number of Full Time Paid Number of Part Time Paid Number of Volunteers EMT-B 5 10 0 EMT-I 5 1 0 EMT-P 19 12 0 First Responder Cert. 0 0 0 CPR,Other,etc. ADMIN 5 PRIMARY Hospital transported to: North Colorado Medical Center 0 to 80 Miles Distance to PRIMARY Hospital: Average number of EMS Runs Annually: 6,675 Average number of Runs Annually: 8, 150 II 980298 EMS Provider Information (cont'd) EMS Service Area and Geographic Description: (See Instructions) Weld County Ambulance Service is responsible for all of Weld County by County Charter. TriArea Ambulance Service covers a small area in southwest Weld. Mutual Aid Agreements are in effect with ambulance services on Weld's continguous borders. 12 980298 • EMS PROVIDER INFORMATION CONTINUED • EMS VEHICLES OWNED BY YOUR AGENCY Write in the number of vehicles owned of each type in the age group. If your agency does not own vehicles please check here N/A Type of Vehicle Ito 3 yrs old 4 to 7 yrs old 8 to I I yrs old II years or>Number& Number& Mileage Number& Number& Mileage • Mileage Mileage Typel 0 / 0 / 0 / 0 / Type II 0 / 0 / 0 / / 0 Type III 5 / 4 / 0 / 0 / Rescue Vehicle 0 / • 0 / 0 / 0 / First Response 0 / 0 / 0 / 0 Extrication Equipment Age #of RS 10 Kits 4 Spreaders +#Cutters # Rams # Air Bags I to 5.yrs 0 0 0 0 0 6 yrs-older 0 0 0 0 0 EMERGENCY MEDICAL EQUIPMENT OWNED BY YOUR AGENCY Defibrillators: Manual 1-3 years old 8 4 years or older Semi-automatic or automatic L. 1-2 years old _ 3 years or older Suction(electric/battery): • 1 I-2 years old 8 3 years or older • Back Boards(number owned): 250 (system wide) Stjcjchers: Scoop _ Wire • 13 • 980298 ; \ u 7 p \ . ( :ci \ 4,1 d § ) � a 6-1 \ � I j } ) ) Q \ � ' ` c \ ÷ ~ § /J / / 2 \, 3 V j/ FR _ c v w ( 2�VI o- r ® ) u ` / © / ; ( V) 2\/ C \} / ( �/ 0- j % ) / d J I ( z 2 M :::3, / / v) * Q Ax . 5§ ! \_\ es \) / � c �^ / � a / � � � � � �k CO V) • @ T « / — 7 /CA 2d » © a 2 q2 R /� � � � � � � � � Q � \ § ; } < a 2 2 ; § - $ k 7 $ § ■ 2 a a $ a a a a 980298 COMMUNICATIONS EQUIPMENT Mobile Radios(VHF): Please check all agencies who use this equipment: _Fire x EMS _Police List the number of mobile radios(VHF)equipment you have in the correct age group: 4 0-5 years old 12 6-10 years old II years or older Mobile Radios(UHF): Please check all agencies who use this equipment: Fire x EMS _Police List the number of mobile radios(UHF)equipment you have in the correct age group: 4 0-5 years old 12 6-10 years old II years or older Portables: Please check all agencies which use this equipment: Fire x EMS Police List the number of Portables you have in the correct age group: 4 12 _0-5 years old _6-10 years old _ I I years or older Pagers: Please check all agencies this equipment is used by: Fire xEMS Police List the number of pagers you have in the correct age group: 600-5 years old _6-I0 years old _11 years or older TRAINING EQUIPMENT OWNED BY YOUR AGENCY Please list the equipment on the following lines: None. Done by AIMS Community College FEE STRUCTURE INFORMATION Does your agency charge for services? Yesx_ No_ Please List Base Rates: Attached Do you charge for service when you provide treatment but do not transport? Yeses No_ If the answer is yes, list basic charge see attached • 14 980298 EXHIBIT "B" 1998 WELD COUNTY AMBULANCE SERVICE FEES CODE AMBULANCES SERVICES: Charges are per person AMOUNT 51, 52, PRIMARY SERVICES SERVICES (TRANSPORT) $420 171, 172 54, 174 RETURN TRIP (TRANSPORT) 230 57, 177 AIR/GROUND AMBULANCE ASSIST (NO TRANSPORT) 420 57/177 PARAMEDIC ASSIST (TREATMENT, NO TRANSPORT) 230 56 PATIENT EVALUATION (NO TREATMENT OR 78 TRANSPORT) WHEELCHAIR TRANSPORT (SCHEDULED IN 39 DISTRICT, ONE WAY, NO EVALUATION OR TREATMENT) STANDBYS: Charges are per hour (One hour minimum) 55 ALS AMBULANCE (FULLY STAFFED; NO TRANSPORT) $78 53 ONE PERSON (NO TRANSPORT) 39 MILEAGE: Charges are per mile (Two mile minimum) one way 58 ONE PATIENT $10 58 MULTIPLE (N) PATIENTS 10/N ADDITIONAL ALS SERVICES: Charges are per procedure, item, or dose 69 ADVANCED AIRWAY CONTROL $140 60 OXYGEN AND PULSE OXIMETER 45 62 INTRAVENOUS THERAPY 60 65 MEDICATIONS 30 61 CARDIAC MONITORING 60 64 CARDIAC PACING 60 63 CARDIOVERSION 60 63 CARDIAC DEFIBFRILLATION 60 980298 BASIS FOR WCAS CHARGES 1 . Health services are not "free . " Payments for the costs of providing services come from three primary sources : a . Taxes* b. Third-party payers (Insurance, HMOs, Medicare, etc . ) c . Direct payers (patients, relatives, etc . ) * WCAS receives no tax moneys . Revenues come solely from fees charged for services rendered. 2 . Not charging or not paying for services creates an inequitable cost-shift to those who do pay. 3 . Managed care payers continue to scrutinize the "necessity" of ambulance transports . Therefore, it is the responsibility of the paramedic-in-charge to elicit informed or implied consent to evaluate, treat , transport , or release patients . Competent patients have the right to refuse any or all services . 4 . Proper triage and treatment dictates the necessity of meticulous patient evaluations . These evaluations should include, but are not limited to : *a . Scene observations, medical history, and chief complaint . *b. Complete vital signs : Pulse, blood pressure, respirations , Glasgow Coma Scale . c . Orthostatic vital signs, when indicated. d. Auscultation of heart , lungs, bowel sounds, when indicated e . Head-to-toe exam (visualization and/or palpation) , when indicated. f . Assessment of distal extremity color, temperature, and pulse, when indicated. g . Neurological assessment of : pupils , movement , sensation, grip, and gait , when indicated. h. The use of other diagnostic instruments (EKG Monitor, Diascan, Pulse-oximeter, Doppler, etc . ) , when indicated. *i . Assessment conclusions . *j . Recommendation (s) regarding treatment and transport . *k. Documentation of services provided. *Required on every patient . 5 . If a patient does not receive services, no charge is assessed. • 980298 WELD COUNTY AMBULANCE SERVICE PHONE (970) 353-5700, EXT. 3200 ip FAX: (970) 353-5700, EXT. 3215 1121 M STREET C. GREELEY, COLORADO 80631 COLORADO February 11 , 1998 Arleen Way Colorado Department of Public Health and Environment Emergency Medical Services & Prevention Division EMSPD-ADM-A5 4300 Cherry Creek Drive South Denver, CO 80246-1530 Dear Arleen: Enclosed is the Weld County Ambulance Service grant application. It is submitted as a county-wide project, but it has regional applications. If you have any questions, please call me. Thank you for your consideration. Si cerely, Cabe, Director 980298 WELD COUNTY AMBULANCE SERVICE PHONE (970) 353-5700, EXT. 3200 FAX: (970) 353-5700, EXT. 3215 ill P 1121 M STREET C. GREELEY, COLORADO 80631 COLORADO February 11, 1998 To: BOCC From: Gary McCabe, Director of Ambulance Service 6-/VV RE: 1998 EMS Grant Application Enclosed is a copy of the grant application I sent to the State EMS Division. We are requesting state grant money to enhance the WCAS computerized trip reporting project. The additional funding will expand our capabilities to collect and comparatively analyze EMS data throughout our ATAC region. 980298 Hello