WIXLIB

··-·North Coast Emergency Medical ServicesRegional EMS Plan Update- Section 2- System AssessmentJanuary 15, 20105.14Specialty Planning PublicInputXXX5.15Subsystem Evaluation andData Collection Program:A. Patient Registry - aNorth Coast EMS PCRwill be completed oneach field transportedSTEMI patient andfaxed to North CoastEMS. In Lake County,Coastal Valleys EMSwill help ensure thereturn of outcomeinformation. In DelNorte County, we willwork with Sutter-Coastand the MedfordSTEMI ReceivingCenter to secureoutcome information.In Humboldt County,we will receive & reviewcardiac registryinformation.XXXThe existing LakeCounty EMCC &Humboldt-Del NorteEMCC and MACCommittees providepublic input.See 5.13 above.Ensure addition ofpublic representativeto HCCC and considerestablishing CardiacReview Committee inDel Norte CountyWork with SutterCoast Hospital andOregon STEMICenter to get OutcomeData to Help EvaluatePatient Care andEnhance the CardiacSubsystem. ContinueCardiac Contractposition for OngoingEvaluation of CardiacSubsystem. See 5.13above.

'· North Coast Emergency Medical ServicesRegional EMS Plan Update- Section 2- System AssessmentJanuary 15, 2010Throughout region, wewill assess methods ofacquiring STEMIpatient data from NonSTEMI Centers.B. Identification of Overand Under-triage:Review of data will helpdetermine under andover-triage.C. Develop a Process toIdentify Improvements:The Cardiac Subsystemwill be evaluated withinput from participatingpartners and CardiacSystem enhancementswill be implementedwhen possible.

·- ··North Coast Emergency Medical ServicesRegional EMS Plan Update- Section 2- System AssessmentJanuary 15, 20106.01QA/QI Program6.02Prehospital RecordsXXXReviewed & SummarizedQIP Reports; QIP PlanApproved by EMSA;Participated in andCoordinated State QIPand CEMSIS trainingprograms; InvestigatedCasesDesigned & TestedCEMSIS-compliantNorth Coast EMS EPCISProgram; SecuredAdditional Web Licensesfor Providers; Developed& Generated Reports;Allowed Acquisition ofOther PCR Programsprovided they workthrough EPCIS;Implemented CEMSISCompliant EPCIS 2010PCRProa·-.--·Review & SummarizeQuarterly QIP Reports,Update QIP Plan asNeededInitiate Transfer ofCEMSIS-EMS data toEMSA; Expand EPCIS2010 throughout Region& Transfer to EMSA;Acquire input fromUsers and EnhanceEMS System aspossible; Continue toGenerate Reports andUtilize Data toEvaluate and Enhancethe EMS System.

.· . , North Coast Emergency Medical ServicesRegional EMS Plan Update- Section 2- System AssessmentJanuary 15, 20106.03Prehospital Care AuditsXXXAll ALS Providers andBase Hospitals arerequired to conductaudits on PCRs. Also,see 6.01 & 6.02 above.See 6.01 & 6.02 above6.04Medical DispatchXXXNorth Coast EMSredrafted EMD policiesand a New Contract thatwill Ensure EMD userCompliance & Use ofNorth Coast EMS forMedical ReviewSee 2.04 & 3.09.Review EMD cases formedicalappropriateness andComplete EMD UpdateProcess6.05Data Management SystemXXX6.06System Design EvaluationXXXSee 1.12, 5.08, 5.13,6.01,6.02See 1.07, 1.12, 1.26, 5.13,5.14, 6.01, 6.02, 6.03,6.04, 6.05See 1.12, 5.08, 5.13,6.01, 6.02See 1.12, 1.12, 1.26,5.13, 5.14, 6.01, 6.02,6.03, 6.04, 6.056.07Provider ParticipationXXSee 6.01, 6.02, 6.03, 6.05& 6.06 above; QIP Planssubmitted by allProviders quarterly &summarized by NorthCoast EMSContinue to receive,monitor and summarizeQIP Reports andinitiate DisciplinaryProcess as Needed forCause

·-. .,North Coast Emergency Medical ServicesRegional EMS Plan Update- Section 2- System AssessmentJanuary 15, 20106.10, 6.11Trauma System EvaluationXXXSee Revised TraumaPlan. Trauma 1 Registryrecently installed atNorth Coast EMS andboth designated TraumaCenters have access.7.017.027.037.04Public Information MaterialsInjury ControlDisaster PreparednessFirst Aid & CPRXXXMinimal OngoingParticipation in PIEActivities, mostlyPediatricSee Revised TraumaPlan & initiate Trauma& EMS Data Transferto EMSA. UtilizeTrauma Registry datafor Trauma SubsystemEnhancement.More Funding toMaintain PIE, RuralOutreach, Disaster &First Aid/ CPR Activities

. ,.North Coast Emergency Medical ServicesRegional EMS Plan Update- Section 2- System AssessmentJanuary 15, 2010DisastergHazMat Training, CasualtyDistributionNeeds AssessmentDisaster Communications8.08Inventory of Resources8.11, 8.12CCP Designation &EstablishmentXX. ."""'' . .""''"" . Counties wiMedical DisasterAssessment and H1N1Planning, includingacquisition ofExpanded Scope forMedics to assist givingFlu Vaccinations. See3.01 & 3.02See 8.01, 8.06 aboveNorth Coast EMShelped counties assesscurrent status of CCPsas part of NeedsAssessmentMore Funding forExpansion of DisasterRelated Activities.See 3.01 & 3.02See 8.01, 8.06 above

TABLE 2:SYSTEM RESOURCES AND OPERATIONSSystem Organization and Management)EMS System: North Coast EMSReporting Year: 2008-2009NOTE: Number (1) below is to be completed for each county. The balance of Table 2 refers to eachagency.1.Percentage of population served by each level of care by county:(Identify for the maximum level of service offered; the total of a, b, and c should equal 100%)Counties: Humboldt, Lake, Del Norte and So. TrinityA. Basic Life Support (BLS)B. Limited Advanced Life Support (LALS)C. Advanced Life Support (ALS)2.5-10%5%90-59 %Type of agency:a - Public Health Departmentb - County Health Services Agencyc- Other (non-health) County Departmentm:01!. 0 l e - Private Non-Profit Entityf- Other:)3.The person responsible for day-to-day activities of the EMS agency reports to:a - Public Health Officer4.Indicate the non-required functions which are performed by the agency:Implementation of exclusive operating areas (ambulance franchising)Designation of trauma centers/trauma care system planningDesignation/approval of pediatric facilitiesDesignation of other critical care centersDevelopment of transfer agreementsEnforcement of local ambulance ordinanceEnforcement of ambulance service contractsOperation of ambulance service)XXXX

Table 2- System Organization & Management (cont.)Continuing educationPersonnel trainingOperation of oversight of EMS dispatch centerNon-medical disaster planningAdministration of critical incident stress debriefing team (CISD)Administration of disaster medical assistance team (DMAT)Administration of EMS Fund [Senate Bill (SB) 12/612]Other: See EMSA Manual # 104 and Regional ------------5.EMS agency budget for FY 2008-2009Salaries and benefits(All but contract personnel)Contract Services(e.g. medical director)Operations (e.g. copying, postage, facilities)TravelFixed assetsIndirect expenses (overhead)Ambulance subsidyEMS Fund payments to physicians/hospitalDispatch center operations (non-staff)Training program ------------------Other: 354,804 58,195 58,140 12,500------------------------TOTAL EXPENSES 483,639

Table 2- System Organization & Management (cont.)SOURCES OF REVENUESpecial project grant(s) [from EMSA]Preventive Health and Health Services (PHHS) Block Grant 40,000Office of Traffic Safety (OTS) 205,655State general fundCounty general fundOther local tax funds (e.g., EMS district)County contracts (e.g. multi-county agencies) 65,303Certification fees 8,000Training program approval feesTraining program tuition/Average daily attendance funds (ADA)Job Training Partnership ACT (JTP A) funds/other paymentsBase hospital application feesTrauma center application fees) Trauma center designation feesPediatric facility approval feesPediatric facility designation feesOther critical care center application feesType:Other critical care center designation feesType:Ambulance service/vehicule feesContributions 17,500EMS Fund (SB 12/612) 89,000Other grants:)Other fees: Med Net and Misc. 2,550Other (specify): Fund Balance Carryover 55,631TOTAL REVENUE 483,639TOTAL REVENUE SHOULD EQUAL TOTAL EXPENSES.IF THEY DON'T, PLEASE EXPLAIN BELOW.

Table 2- System Organization & Management (cont.)'jFee structure for FY 2008-2009We do not charge any feesX Our fee structure is:First responder certificationEMS dispatcher certificationEMT-1 certificationEMT-1 recertificationEMT-defibrillation certification NIANIA40/2040/20NIAEMT-defibrillation recertificationEMT-II certificationEMT-II recertificationEMT-P accreditationMobile Intensive Care Nurse/Authorized Registered Nurse (MICN/ARN) certification505010080MICN/ARN recertificationEMT-1 training program approvalNIANIAEMT-II training program approvalN/AEMT-P training program approvalNIAMICN/ARN training program approvalN/ABase hospital applicationN/ABase hospital designationNIATrauma center applicationNATrauma center designation50 2500/5000Pediatric facility approvalNIAPediatric facility designationN/AOther critical care center applicationType:Other critical care center designationType:Ambulance service licenceAmbulance vehicule permitOther:-----------------Other:)Other: ------------------7. Complete the table on the following two pages for the EMS agency staff for the fiscal year of 2008-09.

Table 2- System Organization & Management (cont.)EMS System: North Coast EMS Reporting year: 2008-09EMSAdmin./Coord./DirectorExecutive Director1.07555825841Asst. Admin./Admin.Asst./Admin. Mgr.EMS Coordinator1.05734519612ALS Coord./Field Coord./Training CoordinatorTraining Coordinator1.05062817315Program Coordinator/Field Liaison(Non-clinical)Trauma CoordinatorMedical DirectorMedical Director20000Other MD/Medical Consult/Training Medical DirectorDisaster Medical PlannerInclude an organizational chart of the local EMS agency and a county organization chart(s) indicating how theLEMSA fits within the county/multi-county structure.

Table 2- System Organization & Management (cont.)Dispatch SupervisorMedical PlannerData Evaluator/AnalystQA/QI CoordinatorPublic Info. & EducationCoordinatorExecutive SecretaryAdministrative Assistant1.0287429830Other ClericalProgram Assistant.83603012313Data Entry ClerkOtherInclude an organizational chart of the local EMS agency and a county organization chart(s) indicating how theLEMSA fits within the county/multi-county structure.

· ·"'/Section 3 - System resources and OperationsTable 3: Personnel/ TrainingTABLE 3:EMS System:NOTE:PERSONNEL/TRAININGNorth Coast EMSFY 2008-09Reporting Year:Table 3 is to be reported by 0-0--0--0-0-1.Number of EMS dispatchers trained to EMSA standards:2.Early defibrillation: (Note: At this time, NCEMS no longer certifies AED)a)Number ofEMT-I (defib) certifiedN/Ab)Number of public safety (defib) certified (non-EMT-I)N/A3.Do you have a first responder training program?2010 Update- 1999 EMS System PlanXN/Ayesno

Section 3 -System Resources and OperationsTable 4: CommunicationsTABLE 4:COMMUNICATIONSEMS System:North Coast Emergency Medical ServicesCounty:Del NorteReporting Year:20091. Number of primary Public Service Answering Points (PSAP)12. Number of secondary PSAPs23. Number of dispatch centers directly dispatching ambulances14. Number of designated dispatch centers for EMS Aircraft05. Do you have an operational area disaster communication system?a. Radio primary frequency155.175b. Other methodsCell Phoneyes xmedicalnoc. Can all medical response units communicate on the same disaster communications system?yes Knod. Do you participate in OASIS?yes Knoe. Do you have a plan to utilize RACES as a back-up communication system?yes xno1) Within the operational area?2) Between the operational are and the regions and/or state?6. Who is your primary dispatch agency for day-to-day emergencies?yes xyes xRadio-Sheriffs Office7. Who is your primary dispatch agency for a disaster? Sheriffs Office OES2010 Update -1999 EMS System Plannono

Table 4: CommunicationsSection 3 -System Resources and OperationsEMS System:North Coast Emergency Medical ServicesCounty:HumboldtReporting Year:20091. Number of primary Public Service Answering Points (PSAP)62. Number of secondary PSAPs13. Number of dispatch centers directly dispatching ambulances14. Number of designated dispatch centers for EMS Aircraft5. Do you have an operational area disaster communication system?a. Radio primary frequencyb. Other methodsb. Other methodsyes xnoMedNet Tx 467.950 468.175Rx 462.950 463.175Short wave Tx 146.910Rx 146.310 Calcord Tx 156.075 Rx 156.075Cell Phonec. Can all medical response units communicate on the same disaster communications system?noAmbulances can only communicate on the Med-Net. Hospitalsyes xcan only communicate to the EOC on 2-meters.d. Do you participate in OASIS?yes xnoe. Do you have a plan to utilize RACES as a back-up communication system?yes xno1) Within the operational area?2) Between the operational are and the regions and/or state?yes xyes xnono6. Who is your primary dispatch agency for day-to-day emergencies?For Ambulance:Fortuna/Garberville CDF; Hoopa- Tribal Police; and Arcata/Eureka- City Ambulance7. Who is your primary dispatch agency for a disaster? CDF, Tribal Police & City Ambulance OES2009 Update -1999 EMS System Plan

Table 4: CommunicationsSection 3 -System Resources and OperationsEMS System:North Coast Emergency Medical ServicesCounty:LakeReporting Year:2009Note: Table 4 is to be answered for each county.1. Number of primary Public Service Answering Points (PSAP)12. Number of secondary PSAPs03. Number of dispatch centers directly dispatching ambulances14. Number of designated dispatch centers for EMS Aircraft05. Do you have an operational area disaster communication system?)a. Radio primary frequencyMedNetb. Other methodsRedNet Phoneyes xnoc. Can all medical response units communicate on the same disaster communications system?yes llnod. Do you participate in OASIS?yes llnoe. Do you have a plan to utilize RACES as a back-up communication system?yesno x RACES does not exist in county, but plan to use ARES.1) Within the operational area?2) Between the operational are and the regions and/or state?6. Who is your primary dispatch agency for day-to-day emergencies?Officeyes xyesCentral Dispatch - Sheriffs7. Who is your primary dispatch agency for a disaster? Sheriffs Office OES2009 Update -1999 EMS System Plannono K

Table 5: Response/ TransportationSection 3 -System Resources and Operations )TABLES: RESPONSE/TRANSPORTATIONEMS System: ,N:.!.o rt h C o as::.:;t- E M S::::Reporting Year: - 2:. .: 0'""'0.: . 9NOTE:Table 5 is to be reported by agency.1. Number of exclusive operating areas02. Percentage of population covered by Exclusive Operating Areas (EOA)03. Total number responses20,902a) Number of emergency responses(code 2: expedient, Code 3: lights and siren)b) Number of non-emergency responses(code 1: normal)4. Total number of transports:a) Number of emergency responsesNANA20,407(code 2: expedient, Code 3: lights and siren)NA)b) Number of non-emergency transports(code 1: normal)NAEarly Defibrillation Programs5. Number of public safety defibrillation /EMT-defibrillation programs.a) Automatedb) Manual\!2010 Update -1999 EMS System Plan1010-----'0 --

Section 3 -System Resources and OperationsTable 5: Response/TransportationAir Ambulance Services7. Total number of responses.NAa) Number of emergency responsesNAb) Number of non-emergency responsesNA8. Total number of transportsNAa) Number of emergency (scene) responsesNAb) Number of non-emergency responsesNA2010 Update -1999 EMS System Plan

Section 3 -System Resources and OperationsTable 6: Facilities/Critical CareTABLE 6: FACILITIES/CRITICAL CAREEMS System: ------'N"-'-"'-ort h- C o a st'-"'E M SReporting Year: ,2 0 0 9NOTE:Table 6 is to be reported by agency.1. Trauma Patients:a) Number of patients meeting trauma triage criteria)(Total)1 816b) Number of major trauma victims transported directly to atrauma center by ambulanceNAc) Number of major trauma patients transferred to a traumacenterNAd) Number of patients meeting triage criteria who weren't treatedat a trauma center.NAEmergency Departments:2. Total number of emergency departments7a) Number ofreferral emergency services0b) Number of standby emergency services1c) Number ofbasic emergency services6d) Number of comprehensive emergency services0Receiving Hospitals3. Number of receiving hospitals with written agreements74. Number of base hospitals with written agreements72010 Update -1999 EMS System Plan

TABLE 7: SYSTEM RESOURCES AND OPERATIONS-- Disaster MedicalEMS System:North Coast EMSCounzy:LakeReporting Year:2009NOTE: Table 7 is to be answered for each county.SYSTEM RESOURCES1.Casualty Collections Points (CCP)a. Where are your CCPs located? There are several locations identified in each of thepopulation centers throughout the county. A list is available on request.b. How are they staffed? American Red Cross, DART volunteers, County employees asDSW's, First Responders, depending on circumstances. - - - - - - - - - - - c. Do you have a supply system for supporting them for 72 hours?yes no XElements are in place, but complete sustainability cannot be guaranteed.2.CISDDo you have a CISD provider with 24 hour capability?yes no XWe currently rely on CISD services provided by Solano and Napa Counties.3.Medical Response Team (Lake County does not receive MMRS funds)yes no -Xa. Do you have any team medical response capability?b. For each team, are they incorporated into your localyes no -Xresponse plan?yes no -Xc. Are they available for statewide response?yes no -Xd. Are they part of a formal out-of-state response system?4.Hazardous Materialsa. Do you have any HazMat trained medical response teams?yes X noLocal Haz Mat response teams include paramedics trained specifically in WMD.b. At what HazMat level are they trained? Local teams include operations, technicians, andspecialists.-----------------------c. Do you have the ability to do decontamination in anemergency room?yes X noHospitals have decontamination tents that can be operated outside their emergencydepartments. Contamination that occurs within the ED can be dealt with, depending uponthe nature of the contamination. There are no fixed (permanent) decontamination facilitiesin the hospitals.d. Do you have the abilizy to do decontamination in the field?yes X no

··.'l:)OPERATIONS1.Are you using a Standardized Emergency Management System (SEMS)that incorporates a form of Incident Command System (ICS) structure?2.)What is the maximum number of local jurisdiction EOCs you will need tointeract with in a disaster?yes X no1

3.4.Have you tested your MCI Plan this year in a:a. real event

Sutter-Coast Hospital as Level IV Trauma Center; NCEMS Plans to Participate in State's CEMSIS-Trauma Program & Develop Plan for Designation of Additional Trauma . River Community Hospital to Become a Modified Base See 1.02 & 1.12 Continue Updating As Needed See 1.17 See 1.08 See Revised Trauma Plan EDAP Designation of