895 Division of Emergency Medical Services Systems; notice of funding priorities

DEPARTMENT OF HEALTH

Division of Emergency Medical Services Systems; Notice of Funding Priorities

[26 Pa.B. 2533]

   Under 28 Pa. Code § 1001.23(b) (relating to 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) which will be distributed by the Department to regional EMS councils for the fiscal year beginning July 1, 1996 and ending June 30, 1997. The priorities are as follows:

   1.  State Priorities

   A.  Training Programs for Prehospital Personnel

   Training programs for all prehospital personnel (for example, first responders, emergency medical technicians and paramedics) who will be responsible for providing EMS to patients outside of the hospital setting. Training institutes shall be accredited to insure that size and number of training programs are adequate to assure that ambulance services have a sufficient number of prehospital personnel to meet public need. Up to 100% in EMSOF funds shall be made available to procure essential equipment for training programs, but EMSOF funds shall not be used to pay the cost of course coordinators and primary and secondary instructors without the approval of the Department.

   B.  Management Support or Equipment for Providing Basic Life Support (BLS) Services To Areas In Need

   Management support or purchase of equipment needed for the establishment of BLS ambulance service operations to serve areas not currently served by BLS ambulances within 10 minutes of dispatch, and identified as feasibly needed by regional planning. EMSOF funds shall be used up to the following amounts for urban and rural areas:

Maximum BLS EMSOF Equipment
Reimbursement*

Items	Urban	Rural
BLS Vehicle/Management Support	15,000	20,000
Essential Equipment (See Table 1)	6,650	7,980
Communications Equipment (See Table 2)	5,500	6,600
Maximum Eligible Reimbursement	27,150	34,580

* Figures are dollar amounts per BLS Service.

   C.  Equipment for the Establishment of New Quick Response Services (QRSs)

   Purchase of equipment needed for the establishment of new QRS services outside the 10 minute response area of current ambulance services and identified as feasibly needed by regional planning. EMSOF funds shall be used up to the following amounts for urban and rural areas:

Maximum QRS EMSOF Equipment
Reimbursement*

Items	Urban	Rural
Essential Equipment (See Table 1)	5,250	10,300
Communications Equipment (See Table 2)	5,500	6,600
Maximum Eligible Reimbursement	10,750	12,900

*Figures are dollar amounts per QRS.

   D.  Management Support or Equipment for Providing Advanced Life Support (ALS) To Areas in Need

   Management support or purchase of equipment needed for the establishment of ALS ambulance service operations to serve areas not currently served by ALS ambulances within 20 minutes of dispatch, and identified as feasibly needed by regional planning. EMSOF funds shall be used up to the following amounts for urban and rural areas:

Maximum ALS EMSOF Equipment
Reimbursement*

Items	Urban	Rural
Mobile Intensive Care Unit (MICU)	15,000	20,000
Essential Equipment (See Table 1)	13,400	16,080
Communications Equipment (See Table 2)	5,500	6,600
Maximum Eligible Reimbursement	33,900	42,680
ALS Non-Transport Unit**	7,500	9,000
Essential Equipment	12,000	14,400
Communications Equipment (See Table 2)	5,500	6,600
Maximum Eligible Reimbursement	25,000	30,000

  * Figures are dollar amounts per service.
** ALS Squad Unit

   II.  Regional Priorities

   The following categories may be funded and may be prioritized by each regional EMS council based on the needs determined within their region:

   A.  Vehicle Replacement--One vehicle per ambulance service may be replaced or rechassied during a 5-year period based on the following criteria and priorities:

   First Priority:

   BLS/ALS ambulances, including ALS non-transport squad vehicles that are 10 years old or older, according to the following priorities:

   a.  Single vehicle service (1st priority)

   b.  Two vehicle service (2nd priority)

   c.  Three vehicle service (3rd priority)

   d.  Greater than three vehicle service (4th priority)

   Second Priority:

   BLS/ALS ambulances, including ALS non-transport squad vehicles that are 5 years old or have at least 80,000 miles, according to the following priorities:

   a.  Single vehicle service (1st priority)

   b.  Two vehicle service (2nd priority)

   c.  Three vehicle service (3rd priority)

   d.  Greater than three vehicle service (4th priority)

   Third Priority:

   Any ALS unit over 3 years old and interfacing with multiple BLS services.

Maximum EMSOF Vehicle Replacement
Reimbursement*

Items	Urban	Rural
BLS/MICU Vehicle	15,000	20,000
ALS Non-Transport Vehicle (ALS Squad Unit)	7,500	9,000

* Figures are dollar amounts per vehicle.

   The Department may increase the amount of reimbursement from EMSOF funds based upon the financial hardship of an ambulance service. An ambulance service that seeks additional EMSOF funds because of financial hardship, to replace or rechassis a vehicle, shall be required to submit a financial disclosure statement and other documentation deemed necessary by the Department.

   B.  Essential Equipment for ALS/BLS/QRS Services--new or replacement. (See Table 1)

   C.  Communications Equipment for ALS/BLS/QRS Services--new or replacement. (See Table 2)

   D.  Regional EMS Council Special Needs--These items are eligible based on individual needs of each regional EMS council and are defined in regional plans.

   E.  Rescue Equipment for ALS and BLS services or for any service providing rescue coverage for an ambulance service:

Maximum EMSOF Regional Rescue Reimbursement*

Items	Life	Maximum	Urban*	Rural*
	Expectancy	allowable
		cost
Air Chisel Set	10 Yrs	1,000	500	600
Toxic Environment Detection Device	10 Yrs	2,000	1,000	1,200
Come-Along, Chain (1 1/2 Ton) (including 4 chains--6' maximum)	10 Yrs	800	400	480
Hydraulic Tool**	5 Yrs	15,000	7,500	9,000
Personal Protection Equipment (boots, pants, coat and helmet--any combination)	5 Yrs	5,000	2,500	3,000
Porta-Power--10 Ton	10 Yrs	1,500	750	900

 * Figures are dollar amounts per service.
** For rescue services along the highway corridors which have been identified with high accident mortality rates. If cost is less than $15,000, the reimbursement will be limited to 25% for urban areas and 35% for rural areas.

   F.  Recruitment/Retention Programs--for ambulance services for their activities in recruiting community volunteers to staff the services. Funding amounts to be set by each regional EMS council.

   G.  Data Collection hard and software--alternate method collection systems which must be approved by the Department with a maximum allowable cost of $4,000 for medical command facilities; $3,000 for receiving facilities, and $2,000 for individual ambulance services or 50%, whichever is less. The facilities must have 10,000 or more emergency patients, and the ambulance services in urban areas must transport 2,000 patients, and those in rural areas must transport 1,000 patients per year.

   III.  Regional Communication System Development Equipment

   Purchase of equipment for the establishment or upgrading of regional communication systems. Any project exceeding $50,000 must be reviewed and approved by the Department of Health.

Table 1
Essential Equipment List
(MICU, ALS Squad, BLS and QRS)

Equipment	Life	MICU	ALS/SQ	BLS	QRS	Maximum	Urban	Rural
Description	Expectancy					Allowable	(50% of	(60% of
						Cost***	MAC)***	MAC)***
						(MAC)
Capnometers (End Tidal CO2 Detectors)	5 Yrs	Y	Y	N	N	1,800	900	1,080
Defibrillators (if replacement greater than 5 years old or for new ALS unit)	5 Yrs	Y	Y	N	N	9,000	4,500	5,400
Including pacer		Y	Y	N	N	10,000	5,000	6,000
++ Including pacer and 12 lead		Y	Y	N	N	16,000	8,000	9,600
External Automatic (AED)		N	N	Y*	Y*	6,000	3,000	3,600
Intubation kit (as per licensure requirement)	5 Yrs	Y	Y	N	N	300	150	180
Medical Anti- shock trousers (Adult/Pediatric)	3 Yrs	Y	Y	Y	Y*	600	300	360
Nitrous Oxide Unit, portable	5 Yrs	Y	Y	N	N	1,400	700	840
Oxygen Equipment (any combination) Cylinder (minimum ''D'' size, maximum 2/unit @$80 each)	5 Yrs	Y	Y	Y	Y	500	250	300
Demand valve w/hose and mask
Regulator combination constant flow Case/soft or hard
Pulse oximeters	5 Yrs	Y	Y	Y	Y+	1,000	500	600
Splinting/Immobili- zation devices (including adult and pediatric)	5 Yrs	Y	Y	Y	Y	500	250	300
Stair Chair	5 Yrs	Y	N	Y	N	500	250	300
Stretchers	5 Yrs	Y	N	Y	N	1,800	900
Primary								1,080
multilevel		Y	N	Y	N	500	250
Stretcher chair    combination								300
Suction Unit, portable (battery operated)	3 Yrs	Y	Y	Y	Y	500	250	300
Ventillator, automatic (per Dept. of Health Guidelines)	5 Yrs	Y**	Y**	Y**	Y***/+	1,400	700	840
Maximum Allowable Cost					26,800	24,000	13,300	10,500
EMSOF Totals 50%					13,400	12,000	6,650	5,250
60%					16,080	14,400	7,980	6,300

Y
Yes
N
No
⁺
EMT personnel required.
*
Regional approval of AED plan and training program required.
**
Regional approval and completion of approved training program required.
***
All figures are dollar amounts for each item of equipment.
⁺⁺
Price includes $1,000 for communications package, and receiving facility must have appropriate communications capabilities.

Table 2
Communications Equipment List
(MICU, ALS Squad, BLS and QRS)

Equipment	Life	MICU	ALS/SQ	BLS	QRS	Maximum	Urban	Rural
Description	Expectancy					Allowable	(50% of	(60% of
						Cost**	MAC)**	MAC)**
						(MAC)
Alerting Equipment	5 Yrs	Y	Y	Y	Y	4,000	2,000	2,400
Radio, Mobile (for dispatch and scene coordination--one per EMS vehicle)	5 Yrs	Y	Y	Y	Y	2,500	1,250	1,500
Radio, Mobile (for medical communications with hospitals--one per EMS vehicle)	5 Yrs	Y	Y	Y	Y*	3,500	1,750	2,100
Radio, Portable (for on scene coordination--one per EMS vehicle/unit)	3 Yrs	Y	Y	Y	Y	1,000	500	600
Maximum Allowable Cost					11,000	11,000	11,000	11,000
EMSOF Totals 50%					5,500	5,500	5,500	5,500
60%					6,600	6,600	6,600	6,600

Y	Yes
N	No
*	Mobile radios eligible if 50% or greater number of calls are EMS related for specific vehicle.
**	Figures are dollar amounts for each item of equipment.

   Persons with a disability who require an alternative format of this notice (for example, large print, audiotape, braille) should contact Kum S. Ham, Ph.D., Director of the Division of Emergency Medical Services Systems, at [phone] or TDD: [phone].

DANIEL F. HOFFMANN, FACHE,   
Acting Secretary

[Pa.B. Doc. No. 96-895. Filed for public inspection May 31, 1996, 9:00 a.m.]