Ambulance Fund. FY2013 Service Level Report

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(1)

Ambulance

 

Fund

(2)

Mission

Our

 

mission

 

is

 

to

 

help

 

people.

 

We

 

are

 

dedicated

 

to

 

preserving

 

life

 

and

 

property

 

through

 

prevention

 

and

 

professional,

 

compassionate

 

(3)

Organizational

 

Chart

Fire Chief Assistant Chief Operations/ EMS Assistant Chief Public Safety/ Tech. Services Battalion Chief A-Shift Special Teams Prevention Battalion Chief B-Shift Fire Training Battalion Chief C-Shift EMS training

Public Education Technical Systems

Station 1 Station 2 Station 3 Station 4 Station 5 Capt. D/O FF FF PM PM D/O Capt. D/O FF FF Capt. D/O FF PM PM Capt. Capt. D/O FF FF L-1, A-1 BC-1, E-2, A-2 E-3, A-3 E-4 E-5 Capt. Inspector Capt Dispatch Computer Systems Office Manager Billing Admin. Assist. 2 - Work Study

(4)

Measures

 

of

 

Inputs

Money

People

FY 2009 FY 2010 FY 2011 FY 2012 FY3013 FY 2014 ACTUAL ACTUAL ACTUAL ACTUAL ACTUAL BUDGET AMBULANCE (less SS refund impact)

Labor 1,670,307 1,826,761 1,806,512 1,896,494 2,425,722 2,502,482 Operating 237,121 269,117 339,316 390,100 430,481 486,906 Capital 8,982 6,250 23,775 42,070 Total 1,916,410 2,102,128 2,145,828 2,310,369 2,898,273 2,989,388 CPI 216.177 218.711 226.421 231.317 233.546 Real FY09 $ 1,916,410 2,077,773 2,048,744 2,159,152 2,682,726 % Change in Real FY09 $, FY09-FY13 39.99%

(100% funded by program revenue = Bannock County contract)

Ambulance FY09 FY10 FY11 FY12 FY13 FY14

FY09-FY14 Change

Full Time 15 15 15 15 21 21 6

(5)

ACTUAL ACTUAL ACTUAL ACTUAL ACTUAL FY 2009 FY 2010 FY 2011 FY 2012 FY3013 Total 1,916,410 2,102,128 2,145,828 2,310,369 2,898,273 CPI 216.177 218.711 226.421 231.317 233.546 Real FY09 $ 1,916,410 2,077,773 2,048,744 2,159,152 2,682,726 1,916,410 2,077,773 2,048,744 2,159,152 2,682,726 1,500,000 1,700,000 1,900,000 2,100,000 2,300,000 2,500,000 2,700,000 2,900,000 3,100,000

Ambulance Fund (less Social Security refund impact) Nominal & Real FY09- FY13

(6)

Descriptors

Provides

 

24/7

 

Advanced

 

Life

 

Support

 

Level

 

Emergency

 

Medical

 

Service

 

Response

 

to

 

Bannock

 

County;

Covering

 

Bannock

 

Counties

 

1,147

 

Square

 

Miles

 

with;

3

 

– Advance

 

Life

 

Support

 

Ambulances

 

(Career

 

Staffing)

– Fire Station #1 – Ambulance #1

– Fire Station #2 – Ambulance #2

– Fire Station #3 – Ambulance #3

3

 

– Basic

 

Life

 

Support

 

Ambulances

 

(Volunteer

 

Staffing)

– Inkom Ambulance

– Lava Ambulance

– Downey Ambulance

(7)

Measures

 

of

 

Workload

 

/

 

Output

7

Measure 2009 2010 2011 2012 2013 %∆

Total Responses 5134 5182 5748 5572 5979 16%

ALS Response/1000 Pop 16.7 22.9 24.1 21.9 17.3 4%

BLS Response/1000 Pop 21.5 15.9 18.8 18.5 27.5 28%

Public Service/1000 Pop 22.9 22.2 25.0 24.9 26.0 14%

Out of Town TXFR 127 129 109 122 50 61%

Training Hours 2,690 2,438 793 1,898 3,218 20%

Total Response/1000 Pop 62.6 62.6 69.3 66.7 71.3 14%

Total

 

Response

 

up

 

16%

 

from

 

2009

ALS

 

Response/1000

 

Pop.

 

up

 

4%

from

 

2009

BLS

 

Response/1000Pop.

 

up

 

28%

 

from

 

2009

Public

 

Service

 

Response

 

up

 

14%

 

from

 

2009

Training

 

Hours

 up

 

20%

 

from

 

2009

(8)

Measures

 

of

 

Workload

 

/

 

Output

0 1000 2000 3000 4000 5000 6000 7000 2009 2010 2011 2012 2013

EMS

 

Response

 

by

 

Level

 

of

 

Care

 

Code

(9)

Measures

 

of

 

Workload

 

/

 

Output

ALS Response,  1449 BLS Response,  2301 Public Service,  2179 Out of Town  TXFR, 50

(10)

Measures

 

of

 

Workload

 

/

 

Output

Station 1, 1800 Station 2, 1242 Station 3, 1307 Station 5, 112 Chubbuck, 863 Downey, 94 Inkom, 112 Lava, 138 North  Bannock, 151 South 

(11)

Measures

 

of

 

Workload

 

/

 

Output

Above

 

Total

 

EMS

 

Response/1000

 

Pop.

Below

 

ICMA

 

Avg ALS

 

Response/1000

 

Pop.

 

Below

 

ICMA

 

Avg BLS

 

Reponses/1000

 

Pop.

 

71.3 62.3 68 55 60 65 70 75 Total EMS/1000 Pop. PFD IFFD ICMA 17.3 35 0 10 20 30 40

ALS Response/1000 Pop

PFD ICMA 27.5 61 0 20 40 60 80 BLS Response/1000 Pop PFD ICMA

(12)

Measures

 

of

 

Efficiency

Expenses

 

and

 

Staffing

 

up

as

 

a

 

result

 

of

 

the

 

addition

 

of

 

the

 

3

rd

ALS

 

and

 

Inkom

 

Ambulance

Square

 

Mile/Ambulance

 

down

for

 

the

 

same

 

reason

 

Measure 2009 2010 2011 2012 2013 %∆ Total Expense/Capita $23.4 $25.4 $25.9 $27.7 $34.6 48% Operating Expense/Capita $2.9 $3.2 $4.1 $4.7 $5.1 78% Staffing/1000 Pop. 0.18 0.18 0.18 0.25 0.25 37% Square Mile/Ambulance 286.8 286.8 286.8 286.8 191.2 ‐33%

(13)

Measures

 

of

 

Efficiency

13  $‐  $10.0  $20.0  $30.0  $40.0 $$/Capita PFD IFFD 0 0.1 0.2 0.3 Staff/Pop. PFD IFFD 0 100 200 300 400 SQ. Mi/Amb PFD IFFD

IFFD

 

only

 

Staff

 

5

 ‐

ALS/Career

 

Ambulances

IFFD’s

 

5

 

Ambulance

 

all

 

reside

 

(14)

Measures

 

of

 

Effectiveness,

 

Outcomes

 

and

 

Results

Baseline

 

Turnout

 

Time

 

<1:30

 

@

 

90%

Baseline

 

Travel

 

Time

 

< 5:12

 

@

 

90%

National

 

V

Fib/V

Tach ROSC

 ≈ 

41.9%

1 Turnout Time – Time of Dispatch to Enroute

Measure 2009 2010 2011 2012 2013 %∆

% Ambulance Turnout Time1 < 1:30 Min N/A N/A 61% 66% 62% 1% % Ambulance Travel Time2 < 5:12Min. N/A N/A 68% 68% 68% 1%

Total ROSC3 @ ED N/A N/A 33% 29% 24% ‐27%

ROSC @ ED w/ V‐Fib/V‐Tach N/A N/A 64% 56% 83% 30% Return of Normal Function @ Discharge N/A N/A N/A N/A 7%

(15)

Measures

 

of

 

Effectiveness,

 

Outcomes

 

and

 

Results

0.0% 50.0% 100.0% Total V‐Fib

2013

 

ROSC

PFD National 0.0% 10.0%

2013

 

Normal

 

Function

PFD National

(16)

Explanatory

 

Factors

Increasing

 

life

 

expectancy

 

and

 

aging

 

“Baby

 

Boomers”

 

continue

 

to

 

increase

 

demands

 

on

 

the

 

EMS

 

system.

EMS

 

Medicare

 

reimbursement

 

policy

 

changed

 

in

  

2011

 

resulting

 

in

 

a

 

decline

 

in

 

ALS

 

and

 

an

 

increase

 

in

 

BLS

 

charges.

Ambulance

 

cross

 

district

 

response

 

correlates

 

with

 

Travel

 

Time

 

Compliance

 

%

Turnout

 

Times

 

compliance

 

are

 

poor

 

and

 

the

 

cause

 

is

 

under

 

investigation.

The

 

reason

 

for

 

the

 

high

 

and

 

increasing

 

number

 

of

 

(17)

Issues

 

&

 

Concerns

“Baby

 

Boomer”

 

will

 

continue

 

to

 

drive

 

up

 

EMS

 

demand.

Call

 

volume

 

is

 

increasingly

 

interfering

 

with

 

training

 

required

 

to

 

maintain

 

proficiency.

 

The

 

increase

 

in

 

large

 

patients

 

continue

 

to

 

place

 

significant

 

strain

 

on

 

responders.

The

 

high

 

and

 

increasing

 

number

 

of

 

“Public

 

Service”

 

Response.

(18)

Thank

 

You!

David

 

G.

 

Gates

Fire

 

Chief

Office: 234‐6202

dgates@pocatello.us

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