Rural EMS In Virginia


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Overview of rural EMS issues in Virginia

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Rural EMS In Virginia

  1. 1. Rural EMS in Virginia
  2. 3. Virginia <ul><li>48 of Virginia’s 95 counties are rural (50.5%) </li></ul><ul><li>The topography is varied - </li></ul><ul><ul><li>Ocean, peninsulas, Piedmont Plateau </li></ul></ul><ul><ul><li>Blue Ridge and Appalachian Ridge mountains </li></ul></ul><ul><li>9.9% of Virginian’s live below the poverty level (’07 data) </li></ul>
  3. 5. Virginia’s EMS is Diverse <ul><li>Large agencies – run over 50,000 calls/yr </li></ul><ul><li>Medium size agencies – 7,500 calls/yr </li></ul><ul><li>Smaller size agencies – 650 calls/yr </li></ul><ul><li>Small rural agencies – may not even run a call/day but often travel over an hour to the hospital! </li></ul>
  4. 7. So What - It’s Rural …. <ul><li>Special EMS challenges in rural areas </li></ul><ul><ul><ul><li>Recruitment and Retention of EMS personnel </li></ul></ul></ul><ul><ul><ul><li>Long Response and Transport time </li></ul></ul></ul><ul><ul><ul><li>EMS skill retention and competency </li></ul></ul></ul><ul><ul><ul><li>Integration with Health Care System </li></ul></ul></ul><ul><ul><ul><li>Training not as convenient and available </li></ul></ul></ul><ul><ul><ul><li>Funding, Compensation and Reimbursement </li></ul></ul></ul><ul><ul><ul><li>Involved and engaged Physician Medical Direction </li></ul></ul></ul>
  5. 8. Rural vs. Urban EMS <ul><li>Longer transport times </li></ul><ul><ul><li>Blue Ridge and Appalachian Mountains </li></ul></ul><ul><ul><li>Peninsulas, rivers, large lakes </li></ul></ul><ul><ul><li>Definitive trauma care usually in cities </li></ul></ul><ul><ul><li>Dangerous terrain </li></ul></ul>
  6. 9. Rural vs Urban EMS <ul><li>Potential for non-emergency calls </li></ul><ul><ul><li>Lack of public transportation to go to doctors office </li></ul></ul><ul><ul><li>Specialized physician care in cities </li></ul></ul><ul><ul><li>Greater economic stress </li></ul></ul><ul><ul><li>Little chance for a paid EMS transport service </li></ul></ul>
  7. 10. When It’s Time for a Change <ul><li>EMS service is not being provided 24-7 </li></ul><ul><li>Lack of funding to stay in “business” </li></ul><ul><li>There is conflict within the EMS agency </li></ul><ul><li>Citizen complaints related to – </li></ul><ul><ul><li>Poor EMS care </li></ul></ul><ul><ul><li>Late or no response </li></ul></ul>
  8. 11. Local Government Involvement in EMS? <ul><li>According to the Code of Virginia 15.2-955 B: </li></ul><ul><li>“ Each locality shall seek to ensure that emergency medical services are maintained throughout the entire locality. ” </li></ul>
  9. 12. Why Get Involved? <ul><li>Local government choose to be involved because there is a desire to provide: </li></ul><ul><ul><li>Prompt, efficient and well managed EMS care to the citizens of the community </li></ul></ul><ul><ul><li>Guarantee of continuity of operations and reliability of service </li></ul></ul><ul><li>An incident may precipitate the change </li></ul><ul><li>Unmet community expectations </li></ul>
  10. 13. Guidance Helps! <ul><li>Local government guidance and direction makes a huge difference! </li></ul><ul><li>EMS Agencies continue to operate - </li></ul><ul><li>with a “guiding hand” </li></ul><ul><li>Provides structure, reliability and accountability </li></ul>
  11. 14. EMS Agency – What is Needed <ul><li>Leadership and management skills </li></ul><ul><ul><li>Provide leadership & management training </li></ul></ul><ul><ul><li>Not everyone has the skills to lead </li></ul></ul><ul><li>Structure – to maintain level of service </li></ul><ul><li>Strategic and operational plan </li></ul><ul><li>Guidance to follow the plan </li></ul>
  12. 15. Benefits of Local Government Involvement <ul><li>Promotes comprehensive county planning and integrates activities of multiple agencies </li></ul><ul><li>Improved coordination and delivery of service </li></ul><ul><li>Greater accountability & quality assurance measures </li></ul><ul><li>Consistent EMS medical direction </li></ul><ul><li>Consistent level & standard of EMS care </li></ul>
  13. 16. Benefits of Local Government Involvement (continued) <ul><li>Interoperability of EMS agencies </li></ul><ul><li>Improved oversight of EMS education and training </li></ul><ul><li>Leadership and management programs for EMS agency heads </li></ul><ul><li>Elimination of duplicated programs and services leading to cost savings </li></ul>
  14. 17. Government Involvement = Positive Impact <ul><li>Accountability </li></ul><ul><li>Financial stability </li></ul><ul><li>Standard Polices/ Procedures/ Protocols </li></ul><ul><li>Large agency buying power </li></ul><ul><li>One person to deal with outside agencies such as OEMS / VDFP/ VDEM </li></ul><ul><li>Central records- Training / PPCR </li></ul><ul><li>One Mutual Aid agreement for surrounding areas </li></ul>
  15. 18. Benefits to Local Government <ul><li>Enhances economic development opportunities </li></ul><ul><ul><li>Advertising county assets </li></ul></ul><ul><ul><ul><li>Beautiful location (mountains, lakes etc.) </li></ul></ul></ul><ul><ul><ul><li>Great schools (high SOL scores) </li></ul></ul></ul><ul><ul><ul><li>Great community health system </li></ul></ul></ul><ul><ul><ul><ul><li>Prompt and efficient EMS care </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Award winning EMS care </li></ul></ul></ul></ul>
  16. 19. Local Government - Commitment Fears? <ul><li>Have always been hands-off! We don’t know anything about EMS </li></ul><ul><li>EMS does OK – they don’t need us… </li></ul><ul><li>Do not want to upset the volunteers </li></ul>
  17. 20. Local Government Fears?... <ul><li>Local government may feel EMS is an unfunded mandate </li></ul><ul><ul><li>Clarification - Locality not required to provide EMS – but is required to seek to ensure that it is provided </li></ul></ul><ul><ul><ul><li>By providing infrastructure, planning and oversight of EMS agencies </li></ul></ul></ul><ul><li>User fees to offset costs </li></ul><ul><ul><li>Cost recovery (Billing for Service) </li></ul></ul><ul><ul><ul><li>EMS is not cheap </li></ul></ul></ul><ul><ul><ul><li>Health insurance billing is available </li></ul></ul></ul><ul><ul><ul><li>Most insured have benefits for emergency transports </li></ul></ul></ul>
  18. 21. Areas of Assistance <ul><li>Assistance is available </li></ul><ul><ul><li>Office of EMS (OEMS) has many resources ( ) </li></ul></ul><ul><ul><ul><li>Technical Assistance Coordinator </li></ul></ul></ul><ul><ul><ul><li>Area OEMS Program Representatives </li></ul></ul></ul><ul><ul><ul><li>EMS Grants Information (RSAF) </li></ul></ul></ul><ul><ul><ul><li>EMS Education and Training Funds </li></ul></ul></ul><ul><ul><li>Regional EMS Councils ( </li></ul></ul><ul><ul><li>Virginia Association of Volunteer Rescue Squads ( </li></ul></ul><ul><ul><li>VA Governmental EMS Administrators ( </li></ul></ul>
  19. 22. Need Information? CAROL S. MORROW OEMS Technical Assistance [email_address] 804 864-7600