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/Recruit ment_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.htmlhttp://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 Our Vision – Healthy Kansans living in safe and sustainable environments. 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

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

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

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

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

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

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

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