lake

lake

Community Health and Welfare Partnerships

Will Propose

Mobile Integrated Community Healthcare

“Community Paramedicine

Possible Partnerships

Hospitals

Health Insurance Providers

Community Health Care Providers

Home Health

Pilot Program with an Alternative Response Unit

Gather and analyze data

Expected Results

Greater response percentage in First Due areas

Capacity to meet increasing demand for service

Right Resource to patient

Cost effective while maintaining high quality service

Mobile Integrated Community Healthcare Concept

Alternative Response Units

Provide Services to the patient to avoid serious illness and costly healthcare

Proactive approach rather than reactive

Frequent Users

Hospital Readmissions

Paramedic and EMT

Respond in an SUV or similar Vehicle

Full Complement of ALS Equipment

Respond to low acuity calls

Graphic on MIHC Integration

Responding to the change

Low Acuity Response – Alternative Response Units

Sending the right resource to the type of call

Mobile Integrated Health Care

“Community Paramedicine”

The right resources for the Patient

Treat and Release

Treat and Refer

Follow up care

Reduce Emergency Department visits

Reduce Hospital Readmissions

Reduce demands on 911 system responses

What Community Paramedic MIHC can Accomplish

Any Other Data?

Will Add Examples

Data on Automatic Aid Received and Given

National Models

Mesa

Chandler

Tempe

Scottsdale

Buckeye

North County (The Fire District formerly known as Sun City West)

Data Showing First Due Calls Missed

Local Models

Will add info

States Allowing Reimbursement for MIHC Services

Data Showing Call Increase

Paramedic/EMT

Paramedic/Paramedic

Paramedic/Nurse

Paramedic/Nurse Practitioner or Physician’s Assistant

MIHC Models

What will Change and Why

Aging Population

Stat on boomer population growth

Growth of the Senior Care housing industry

Independent Living (#in Peoria)

Assisted Living (#in Peoria)

Skilled care Facilities (#in Peoria)

Group Homes (#in Peoria)

What Changed and Why

Ambulance Service

Ageing population

Insurance Coverage

Advances in Dispatch

Advances in data acquisition and data analysis

Greater accuracy in deploying the right resource to the call for service in the most cost effective and efficient way

Peoria Fire-Medical is the first responder, provides medical care and determines level of care needed. (ALS vs. BLS)

Private Ambulance will transport patient with a Peoria Fire-Medical Paramedic if ALS.

Private Ambulance will transport without Peoria Fire-Medical personnel BLS

Current Model

Future Models

A 2 person (paramedic and EMT) low acuity response vehicle,

All hazards response 4 person ALS (2 paramedic) Fire Engine for high acuity calls

Can’t think of any, may want to delete this slide in the future

Advantages of Current Model

History of EMS Models

2 Paramedic Rescue Truck, backing up a 4 person BLS Fire Engine

4 person Engine Company with 2 Paramedics on the Truck

Evolving to a 2 person (paramedic and EMT) low acuity response vehicle, with an all hazards response 4 person ALS (2 paramedic) Fire Engine for high acuity calls

Will add info later

Concerns with Current Model

MICR Demonstration

______ entered into Contract with PMT

______ PMT Sold to Rural Metro, creates only one entity to provide service

______ Rural Metro declared Bankruptcy

______ Rural Metro emerges from bankruptcy, proposes decreasing service levels within the current contract.

Rural Metro sold to AMR, creates only one entity to provide service

History of Current Ambulance Contract

12 Lead Demonstration?

Contract with Rural Metro (PMT) to provide ambulance transportation services

Contract will expire February 2016

Current Status

EMS Equipment Demonstration

Partnerships

Current Status

EMS Premiere Agency

Arizona Department of Health Services

Cardiac Arrest Research

Arizona Department of Health Services and U of A

Traumatic Brain Research

Arizona Department of Health Services and U of A

A number of municipalities are reconsidering their long term approach to ambulance transportation services

Concern is present as to long term stability, and lack of options for service

A number of municipalities have applied for Certificates of Necessity (CON) and some have been granted CON’s

Additional Resources

Certificate of Necessity (CON)

Mass Casualty Response

Civilian Decon Response

The Arizona Department of Health Services (ADHS) requires a specific form of business license to provide and bill for ambulances services. This is known as the Certificate of Necessity

Requires a lengthy application, public hearing, possible administrative hearing and approval by the Director of ADHS

Treatments

The CON Process

On Line vs. Offline Medical Direction

66 of Offline Protocols and Guidelines

Cover Adult, Pediatric and Toxic exposures

Application Submitted

Administrative Review

Substantive Review (Current phase for COP)

“Proper and Fit” approval by DHS

Public Comment Period

Intervener – to Administrative Hearing

No Intervener – To the Director of ADHS

Director of ADHS has final say

Toxicology Drug Box

Public/Private Partnerships

Private sector partner would support a Peoria CON with shared responsibilities

The City would assume transportation of all Advanced Life Support (ALS) transports and bill for same.

Private Sector partner would assume transportation of all basic Life Support transports (BLS)

Both entities would provide backup services to each other.

Exclusive Peoria Fire Medical Ambulance

EMS Equipment

Costs vs. Revenue

Pharmaceuticals

Intubation

IV Therapy including Intraosseous infusion

12 lead EKG with fax capabilities

CPAP

Pulse Oximetry

Carbon Monoxide monitoring

Electronic Documentation

May add more

Need to get Data from Budget

Overview of Medical Services Provided

Possible Build Out Plan

Providing Paramedic Services to the Residents and Visitors since 1984

Overview of Equipment, treatments and capabilities

Demonstration of EMS Equipment

Need to access data on server

August Council Seminar

Next Steps

Continue with CON Application Status

Continue to communicate with the private sector with an eye out for collaborative partnerships

Continue to refine the financial aspects of providing ambulance service and provide regular updates to the Council.

Mass Casualty Response Proceeds Next Slide

Summary