Emergency Medical Services Operating Fund Funding Priorities [36 Pa.B. 2469] Under 28 Pa. Code §§ 1001.22 and 1001.23 (relating to criteria for funding; and allocation of funds), the Department of Health (Department) hereby gives notice of priorities for the distribution by the regional emergency medical services (EMS) councils of funding from the Emergency Medical Services Operating Fund (EMSOF) for the fiscal year beginning July 1, 2006, and ending June 30, 2007.
EMSOF moneys are to be used to provide funding to maintain, improve and develop the quality of the EMS system within this Commonwealth. The Department finds that EMSOF is not sufficient to fully fund the EMS system. Therefore, it gives notice, under 28 Pa. Code § 1001.22(d), that recipients of EMSOF funding from regional EMS councils may be required to contribute funds toward all purchases, acquisitions and projects for which the Department permits the use of EMSOF moneys.
Each regional EMS council shall prioritize the distribution of its EMSOF allocation based upon the Statewide EMS Development Plan and its regional EMS development plan, subject to the funding priorities set forth in this notice. By September 30, 2006, the regional EMS councils shall notify the providers and other appropriate entities of the established funding priorities, the application process, acquisition documentation requirements and processing deadlines. Each regional EMS council must complete all documents required for the distribution of EMSOF funding by June 30, 2007.
The Department may increase the amount of the initial payment or reimbursement from EMSOF based upon the EMS development plans (State and regional) or documented financial hardship of a provider of EMS. A provider of EMS that seeks additional funds due to financial hardship shall be required to submit a financial disclosure statement and other documentation deemed necessary by the Department.
A provider of EMS applying for EMSOF funding must be in full compliance, with all regulations, policies and priorities of the State and regional EMS systems.
Funds for purchases, acquisitions and projects for the fiscal year beginning July 1, 2006, and ending June 30, 2007, must be expended by the regional EMS council by June 30, 2007, unless a written request for an extension of time, not to exceed 90 calendar days, is submitted by the regional EMS council and approved by the Department prior to June 30, 2007.
Funding Priorities
These priorities are not ranked. The priorities must be considered before there is any regional distribution of EMSOF moneys for initiatives that are not listed. All funding must be distributed consistent with the regional and Statewide EMS development plans. Consequently, if the priorities in this notice have been funded and additional funding is available, the request to use EMSOF money towards nonpriority items must still be supported by the Statewide and regional EMS development plans.
* Development or improvement of an organizational risk management program (safety measures, hazard recognition/mitigation and the necessary organizational structure and support processes) proposed by an ambulance service. Proposals for funding must be comprehensive and include safe vehicle operations. Approval by the Department is required prior to funding.
* Recruitment and retention programs, including scholarships/tuition reimbursement for emergency medical technician (EMT) and paramedic training in areas with high prehospital personnel vacancy rates as determined by the regional EMS council and approved by the Department.
* Automatic external defibrillators (AED) and upgrade to current standards for Department recognized quick response services (QRSs) and basic life support (BLS) ambulance services.
* Equipment required to meet BLS and advanced life support (ALS) ambulance service licensure.
* Capnography equipment (especially wave-form end-tidal CO2 monitors).
* An ambulance for ambulance services that is older than 10 years or has more than 200,000 miles on it. Limit to one per fiscal year.
* Software/computer equipment to enable services to collect and transmit EMS patient care reports electronically.
* Communication equipment and capabilities for EMS response in areas with poor to no communication capability between ambulances and medical command facilities or between ambulances and receiving facilities.
* Quality assurance/improvement program.
* EMS personnel protective respiratory equipment approved by the Department to protect the EMS practitioner from communicable diseases transmitted from person to person through airborne mechanisms.
When two or more ambulance companies have consolidated, for the first 5 years after the ambulance companies completed consolidation, the entity may be deemed eligible to receive a grant not to exceed the amount of the combined total for which the individual companies would have been eligible had they not consolidated.
Emergency Preparedness and Response Funding Requests
Emergency preparedness and response funding requests must be based on local and response roles of services, regional needs, and needs identified by threat vulnerability analysis. Purchases must be coordinated with county emergency, fire service, HAZMAT and hospital organizations in the applicant's service area to assure interoperability and to prevent duplication. Funding requests related to response to terrorism and emergency preparedness must have a clear connection to the regional EMS catastrophic plan and the regional EMS development plan. Priority will be given to fund the ambulance services in each region that have committed to participating in the EMS surge capability project and respond to requests for EMS, both interstate and intrastate, as identified in the State and regional catastrophic casualty care plans.
Provider Equipment
Purchases by providers of EMS are not limited to equipment. If an EMS provider requests EMSOF moneys to purchase equipment, the Eligible Provider Equipment List identifies equipment for which EMSOF funds will be made available to purchase. This chart identifies the types of providers of EMS eligible for equipment purchases supported by EMSOF funding and the maximum allowable cost upon which the EMSOF contribution will be calculated.
EMSOF funds will fund 60% of the maximum allowable cost of an equipment item for rural providers and will fund 50% of the maximum allowable cost of an equipment item for nonrural providers. An eligible provider is responsible for the balance of the purchase price. The provider may purchase an item for an amount that exceeds the maximum allowable cost, but the provider will be responsible for any amount exceeding that figure. The last two columns of the chart identify the percentage of EMSOF contribution towards the purchase price, up to the maximum allowable cost of the item, based upon whether the provider operates in a rural or nonrural area.
Funding of a QRS or a BLS ambulance service to upgrade its AED to meet American Heart Association standards may be granted at 100% of the cost of the upgrade up to a maximum allowable cost of $400 per AED.
Funding of an ALS ambulance service for a paramedic student to take the State written examination for paramedic certification may be granted at 100% of the cost of the examination up to a maximum allowable cost of $300 per student, but only for the student's first and second attempts to pass the examination.
Questions regarding the Eligible Provider Equipment List or other matters addressed in this notice should be directed to Joseph W. Schmider, Director, Bureau of Emergency Medical Services, Department of Health, 1032 Health and Welfare Building, Seventh and Forster Streets, Harrisburg, PA 17120, (717) 787-8740. Speech or hearing impaired persons may use VTT: (717) 783-6514 or the Pennsylvania AT&T Relay Service at (800) 654-5984. Persons with a disability who require an alternative format of this notice (for example, large print, audiotape, Braille) should contact Joseph W. Schmider at the address or telephone numbers previously noted.
Eligible Provider Equipment List Equipment Description Life Expectancy Eligible Purchase For: Allowable
Costs1Non
Rural
Rural ALS ALS/SQ BLS QRS (50%) EKG Monitor/Defibrillator with Pacer 5 years Y Y N N 12,000 6,000 7,200 12 Lead EKG 2 5 years Y Y N N 20,000 10,000 12,000 Automated External Defibrillator (AED) 5 years N N Y3 Y3 3,500 1,750 2,100 Oxygen Equipment
(any combination)
Cylinder
Demand Valve w/Hose and Mask
Regulator (combination or constant flow)
Case5 years Y Y Y Y 500 250 300 Capnography Equipment 3 years Y Y N N 3,000 1,500 1,800 CPAP Ventilation Portable Equipment 5 years Y Y N N 900 450 540 Pulse Oximeter 5 years Y Y Y N 700 350 420 Nitrous Oxide Delivery System 5 years Y Y N N 2,000 1,000 1,200 Intravenous Infusion Pumps 5 years Y Y N N 2,000 1,000 1,000 Adult /Pediatric Intubation Kits 5 years Y8 Y8 N N 600 300 360 Transtracheal Jet Insufflators (TTJ) 5 years Y Y N N 200 100 120 Splinting/Immobilization Devices (any combination)
Backboard
Cervical Immobilization Device
Splints (rigid, traction, and the like)3 years Y Y Y Y 500 250 300 Stairchair 5 years Y N Y N 2,650 1,325 1,590 Stretcher--Primary 5 years Y N Y N 11,500 5,750 6,900 Stretcher/Chair Combination 5 years Y N Y N 700 350 420 Suction (portable, battery operated) 3 years Y Y Y Y 900 450 540 Ventilator, Automatic
(per Department of Health guidelines)5 years Y4 Y4 Y5 Y5 3,000 1,500 1,800 Ambulance Y N Y N 15,000 20,000 Squad/Response Vehicle N Y N Y 7,500 9,000 Data Collection Software6 Y Y Y Y 1,700 1,700 1,700 Data Collection Hardware7 3 years Y Y Y Y 1,500 750 900 Radio, Mobile (two per vehicle) 5 years Y9 Y9 Y9 Y9 3,000 1,500 1,800 Radio, Portable (one per vehicle) 5 years Y9 Y9 Y9 Y9 3,000 1,500 1,800 Triage Vest Set 5 years Y Y Y Y 150 75 90 Triage System 5 years Y Y Y Y 500 250 300 Alerting Equipment (5 per service @ $400 each) 5 years Y9 Y9 Y9 Y9 2,000 1,000 1,200 Vehicle Safety Monitoring Systems 5 years Y Y Y Y 3,500 1,750 2,100 Personal Protective Equipment/Turnout Gear: Helmet, Coat, Pants, Boots
(one set)5 years Y Y Y Y 1,200 600 720 Protective Ballistic Vest (over garment style) 5 years Y Y Y Y 1,000 500 600 Traffic Safety Equipment 5 years Y Y Y Y 2,500 1,250 1,500 Large Patient Moving/Carrying Device 10 years Y Y Y Y 3,000 1,500 1,800 Self Contained Breathing Apparatus (2 per licensed vehicle) 10 years Y Y Y Y 3,000 1,500 1,800 EMT-P Testing (Written) Y Y N N 300 300 300 1 All figures are dollar amounts for each item of equipment.
2 Amount includes $1,000 for communications package. Receiving facility must have appropriate communications capabilities.
3 Must be an approved AED service or part of regional planning, and AED medical director required.
4 Completion of approved training program required.
5 Completion of approved training program required and BLS service medical director approval required.
6 Must be a Department-approved software program, version and vendor.
7 Data collection hardware may include computer, modem, printer, backup device and battery system.
8 Must be durable equipment, not disposable equipment.
9 Must be compatible with regional and State EMS communications plan.
CALVIN B. JOHNSON, M. D., M.P.H.,
Secretary[Pa.B. Doc. No. 06-895. Filed for public inspection May 19, 2006, 9:00 a.m.]
