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HomeMy WebLinkAboutC03-175 Authorization for Central Mountains RETAC
Acknowledgements:
Funding for this Plan is wholly provided by financial support
from the Colorado Department of Public Health and Environment (CDPHE). The
CDPHE is not responsible for the content of this document.
Approved:
March, 2003
Central Mountains RETAC
P.O. Box 5055
Frisco, CO 80443
(970) 668-4240
John Woodiand. MD, RETAC Chairman
Central Mountains RETAC Chairperson - 2003
Authorizations:
X
Print Name:
of Cou~y Commissioners Cty~irperson -Chaffee County 2003
X / ////V~ /Y 1/ l/~~ / ( Print Name:
rd of County Commissioyf~rs Chairperson -Eagle County 2003
X Print Name:
Board of County Commissioners Chairperson -Lake County 2003
X
Print Name:
Board of County Commissioners Chairperson -Park County 2003
X
Print Name:
Board of County Commissioners Chairperson - Pitkin County 2003
X Print Name:
Board of County Commissioners Chairperson -Summit County 2003
Acceptance:
x
Print Name:
Colorado Department of Public Health and Environment - 2003
OFFICE OF THE
COUNTY ATTORNEY
(970)328-8685
FAX (970) 328-8699
Ms. Lorraine Caposole
c/o CM ]ZETAC
5554 CR 30
Silverthorne, CO 80498
June 25, 2003
Subject: Authorizations for Central Mountains 1ZETAC
Dear Ms. Caposole:
Eagle County Building
P.O. Box 850
500 Broadway
Eagle, Colorado 81631-0850
Per your request, enclosed are the originals signed by the Chairman of the Eagle County Board of
Commissioners. Please return a fully executed document to our office at the above address.
Please call our office at the above number if you have any questions.
Thank you.
Sincerely,
Lucy Grewe
Administrative Assistant
Enc.
e~: D. Mauriello, County Attorney
•
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r.
2.Trauma designations - on track.
3.Transfer protocols - in progress.
4.Continuing education plan - in progress.
S.Injury prevention and prevention education plan - come a long ways with increasing
number of seminars and programs.
A concern is that there is no formal link between committees and It>/TAC so knowledge
of what committees are doing isn't fully shared.
Goals for next year:
1. Develop a progress report form.
2. Setup minutes so that the goals are addressed after each meeting by check-off system.
3. Prepare awell-defined Data Managemerrt Plan.
At this point in the discussion there was a suggestion that it might be, better if we broke
into committee groups first and determine goals -come back to. the group with goals.
Then it was suggested that we talk first about process of how we want our committees to
work. A discussion of that process ensued.
Committee process expectations:
i. Monthly meetings focus on projects
2: Structure committee meeting to address stated goals per state statutes
and regulations::
3. Focus on fewer things.
4. Prioritize within the group. .
5. Limit unfounded mandates.
6. Success depends on °champions" for each project.-personal
responsibility for the task at hand -who is going to do it and when wilt it be done.
7. Language from RETAC about expectations for partiapants and their
commitment level -especially chairs of committees and "champions."
Suggestion that thank you letters to administrators for whom committee members
work be written to further the educational process reganiing the need for
participation.
8. Subcommittees with particular focus -less is more.
9. RETAC staffing/funding issues - RETAC responsibility.
10. MCI and prehospital committees shouldn't meet at the sarrsr time.
11. Ten to fifteen minute announcement time at end of meeting to promote:
networking, education opportunities, prevention activities and to disseminate
general information.
12. Standing agenda items:
New programs, updates, acknowledging participates.
(Page 3 of 6 - CM RETAC 09-02)
•
Calendar for the year to assure meeting mandated goals.
Ideas for individual committees:
1. Prehospital and facilities only work on data collection -critical now to drive
everything else.
2. MCI plan should be a priority for all committees.
3. Do we agree that the three subcommittees of the Council are the essentials for this
year. The consensus was yes.
The goals for working on our MCI plan in the next year were discussed. A list of matters
which needed to be addressed was made:
1. Mutual Aid Agreements
2. MCI-Field Guide Completion
3. Regiona1911 Dispatch Coordination
4. EMS Agency Bioterrorism Plans
5. Training Standards & Calendar
6. ICS and Decontamination
7. Planning the Full Functional Exercise
i __ .
There is frustration in connection with reaching the above goals. Our MCI plan is
akeady outdated. Our RETAC is in different regions for Preparedness and Bioterrorism
Planning. Unfunded mandates keep appearing. We need to give tl~e State feedback about
the problems we face regazding regionalization - a letter to the State from CM-RETAC
was suggested..
It was decided that we should break into committees and discuss goals before continuing
the discussion with the entire group.
REPORTS OF CONIlVIITTEE MEETINGS -GOALS
Prehospital Committee Report:
Goals for the Eaters:
Refocus and simplify
Concentrate on data collection
KeepChris
Create manual
Decide what we want to get from the data
Adjust data based on findings
Accomplishments:
- everyone online inputting data
(Page 4 of 6 - CM RETAC 09-02)
•
•
~~~ ~ ~ - finished EMS assessment
- half of the services are using Healthware Solutions as their main- Quality
improvement tool.
Facilities Committee Report:
Goals for the futar~e:
MCI -improve how we work together
Data Managemenx
Two proposals for handling data management in the future.
Independent Contractor or CDM
Decision to go with Independent Contractor
Day long retreat -first week in December
Education
Shared educational opportunities with the group.
BREAK FOR EXECUTIVE SESSION'
~: Motion: Allow Summit County Government to take the State contract allowable charges
,`_. for overhead/expenses from RETAC beginning July 2003. Vote -unanimous in
approval. Swerdlinger, Caffrey abstained.
3. Discussion re forming 50143.
Coordinator report:
- There are three in the state. They were forced to do so because they had no
fiscal agent similar to Summit County.. Mile High RETAC is a Govemrr~nt
Instrumentality Group instead of anon-profit.
- Problem with using Summit County -submitting entire budget to apply for
grants. .
- Lindstrom believes that BOCCs would not have to approve the. formation
- Proposes incorporation effective October 15, 2002. Get tax exempt status
by March, 2003.
- Two options:
Summit County Gov't to fund the 50143 -shift money from RETAC budget.
Seek other funds.
Discussion points re advantages and disadvantages:
What have we missed in the past because we aren't 50143. Hard to assess. Advantage
of showing regional significance.
We will always be at the same funding level if we don't become a non profit.
The value of management services (cost of adminish~ation) from the county will need to
be paid by the non profit.
(Page 5 of 6 - C1V1 RETAC 09-02)
• •
Should analyze the costs before we approve it.
Can we purchase fiscal management services from Summit County
Do we need governmenal partners.
Can we get governmental in kind conlnbution.
Great advantage that we are no longer grant funded - we are now entitlement funded.
Need to consider before final decision:
ProForma financials.
Examples of Grants we can get.
Other RETAC experience getting grants.
Other RETAC work/motivation applying for grairts.
"Getting private foundation funding is about relationship building."
Availability of utilizing other non profits to let us use them as a grant recipient initially.
Dr. Woodland proposed the possibility of using the Vail Valley Association -used
before.
Size of ItETAC and nature of organization may not lend itself to use another non profit.
Choice between non profit and Government Instrumentality Corp. (simpler
Are there restrictions placed upon non-profits for ty~s of activity that can be funded.
Are there lobbying rules for 50143
We should answer the above at October meeting. Advisable to bring Attorney to October
~ _~~ 1 meeting. The Summit County position: It's a mandatory program but, Summit County
wants to get rid of administration
4. Template for upcoming Meetings - the. process. We will follow this for the
October meeting and meetings in the firture. For October:
October l0a' at Summit County 9:30-3
Intro
Approval of Agenda
Approval of Minutes
Establish Quorum
General Issues
Coordinatorreport -include non profit
Treasurer's report
MCI
Two Breakouts for Committees
AnnouncemeirtsJSummary
Injury Prevention
Educational Opportunities
Set Agenda for next meeting
No networking if we are behind schedule
AdjournmeHt
ATTACl3~NT: 9/12 Sammary Notes by Jack Taylor (Page 6 of 6 - CM RETAC 09-02 ~.
•
~``~ ` Central Mountain RETAC Meeting
Buena Vista
September 12, 2002
Summar~r Notes
The group agreed to identify expectations they have for inter-committee interaction as
well as interaction among committee members. The following suggestions were made
during the discussions:
- A project champion -someone who accepts responsibility for expediting
goal/objective completion - needs to be identified for any project the group takes on.
- Monthly meetings need to focus on project work. There is not enough time devoted
to committee work during the monthly meetings.
- Structure the committee meetings to address specific goals.
- Focus on "fewer things" - narrow the focus of the work to be done.
- Prioritize goals and objectives within each group.
- Pre-hospital and Facilities should focus only on datacollection at-this time.
- Thank you letters should be written to administrators to express appreciation for
allowing staffparticipation in the work of the group.
- Consider forming sub-committees of the larger committees. These sub-committees
would have a particular project focus.
- The RETAC should identify participants and who is responsible for funding their
involvement.
- MCI and'Hospital committees should not meet at the same time.
- There should be 10-15 minutes set aside at the end of each meeting to promote
networking and shared information.
- There should be standing agenda items that may include:
- New programs
- Updates on existing programs
- Acknowledging participatrts
The Pre-Hospital, Facilities, and Executive committees met separately to discuss their
goals and objectives for the coming year. After those individual discussions, the fiill
group re-convened to report back to the group.
Pre-Hospital
Concentrate on data collection. Part of this task wdl include manual development,
including defining what it is that is wanted from the data.
Data. collection goals will be adjusted based on findings from the original efi`orts.
Keep Chris!
Facilities
MCI focus -the work here depends on tasks identif ed by the MCI Conunittee
• •
Engage an independent contractor for data collection
Attend a daylong planning retreat in December 2002.
xecutive
Discussed primarily the 501(c)(3) proposal that was presented later in the meeting
MCI
The agenda for the upcoming meeting on September 13, 2002 was presented to the group.
The following items were on that draft agenda:
- Mutual aid agreements
- MCI Field Guide completion
- Regiona1911 dispatch coordination
- EMS agency bioterrorism plans
- Training standards and calendaz =ICS and Decoirtamination
- Planning the full, functional exercise
It was suggested evacuation plan details be included in the mutual aid discussion. It was
also suggested that federal funding be discussed. Another suggested addition was
discussion about finalizing the MCI Plan Revisions.
~ There was discussion about draftitlg a letter to the State regazding the regionalization
challenges the group has identified with the new Bioterrorism and the Prepazedness
Regions.
There was discussion about giving the State direction about the expectations of the
RETAC.
A proposal for consideration about organizing the Central Mountain RETAC as a
501(c)(3) nonprofit organization was discussed. Advantages and disadvantages of
changing to a nonprofit organization were presented and discussed. After a spirited
discussion, the group identified additional information needed to make a decision about
forming a nonprofit as follows:
- Cost of Administration - an estimated annual expense budget
- Examples aze needed of grants the RETAC could get
- Experience of RETAC's that organized as nonprofit organizations including
fundraising
- Abetter understanding of lobbying rules for 501(c)(3) organizations
- Determine if there are rules about funding pass-thmughs from current funding
sources
• •
(`~ ~'°~ Answers to questions and. additional information will be a topic in the October meeting.
There was a request that an attorney familiar with nonprofit organizations be asked to
attend the October meeting.
A template for firture meeting agendas was discussed. Those present agreed upon the
following:
v One hour-for general issues to include, but not limited to:
/ Introductory remarks
/ Approval of past meeting minutes
/ Approval of the agenda for the current meeting
/ Coordinator reports
/ Treasurer report
o One hour for MCI
o One hour for committee breakout sessions
o One half horn for announcements .
/ Summaries of committee efforts
/ Educational opportunities
/ program updates .
It was decided that the meetings would be monthly from 9:30 am unti13:00 pm with a
half hour for lunch. Participants will bring their own lunches.
The next meeting is scheduled for October 10, 2002 in Summit County at a location to be
announced.
Attachment D -Central Mountains RETAC Biemual Plan
S»m~r~ed below are the RETACs comments to the CDPHE's 15 components for a
regional EMS and Trauma. System
Component 1-Integration of Health Services
As part of its' mission, the RETAC provides technical assistance to counties, to help every county in the
region have a local EMS/Trauma/Emergency Services-type Council. This objective accomplishes the above
two goals, which calls for the integration of health services.
The Short Term Objective is to annually give RETAC fiords to all of the counties to help support
development of the Councils' tasks, as they work together to better the local EMTS system. RETAC
members from a county also typically come from the Local Councils and act as two-way
communicators between ffie groups. This work includes setting parameters within ffie RETAC policies
regarding the spending of county funds and monitoring the spending by the counties on behalf of the
above mentioned Councils. The Long Term Objective is to share Policies and Procedures and Standard
Operating Procedures among the Healffic~re Facilities and Prehospital Agencies.
Component 2 - EMTS Research
The RETAC gathers EMS and Trauma data in order to determine which injuries should be addressed with
prevention efforts. The Short Term Objective is to continue to collect EMS and Trauma Data. and utilize
Independent Contractors for collecting regional data. The Long Term Objective is to write data collection
policies that are in compliance with the Federal HIPPA regulations.
Anoffier Long Term Objective is to write policies for the public dissemination of data that are in
compliance wiffi the Federal HIPPA regulations.
Component 3 -Legislation and Regulation
In order to identify needs around the regulation of the EMTS system, the RETAC will study the regional
EMS and trauma data to determine if there are any serious trends necessitating the need for new legislation.
The RETAC would make such recommendations to the CDPHE. The Short Term Objective is to compile
the regional data into a useable format and generate regional reports and bring them to the RETAC for
analysis. The Long term Objective is to perform Quality Monitoring of the system via data. That effort
may point to the need to suggest new state regulations.
Comomponent 4 -System Finance
Annually, the CM RETAC receives $165,000.00 in dedicated funding from the State. Seventy five
thousand dollars covers administration. Twenty eight ffiousand currently covers the costs of two data
specialists, one for EMS and one for Trauma regional data collection. The balance of the fiords is disbursed
to the counties on behalf of local Councils doing systems development. Approximately $200,000.00 is
spent annually, by the healthcare system in the region to conduct the business of these local and regional
Councils. This money is an in-kind match made by the providers of emergency and trauma care. Recently,
the RETAC has determined that changing the organization structure to a 501 c3, non-profit status would be
advantageous in order to raise additional funds for prevention efforts, education, training and equipment
needs. The RETACs Short Term Objective is to forma 501 c3 prior to the next fiscal year, which begins
July 1, 2003.
•
~J
Component S -Human Resources
The RETAC's Short Term Goal is to hire a Coordinator for the 501 c3. Due to personnel issues, a
Coordinator is not currently in place. The Short Term Objective will be to write a new job description
and standards of performance for the coordinator and conduct the hiring.
The Long Term Objective is to strive for appropriate staiFing throughout the 12ETAC/EMTS System.
Component 6 -Education Systems
The IZETAC objective is to increase the availability of educational opportunities for providers.
The Short Term Objective is to define the educational needs of the providers and determine regional
availability by analyzing the education-related reports from the CM RETAC 02 Assessment. The Long
Term Objective is to coordinate regional educational offerings and distribute educational information via a
web site.
Component 7 -Public Access
The RETAC intends that all dispatch centers in the region have Emergency Medical Dispatch (EMD).
The Short Term Objective is to offer assistance to the counties that do not have this capability.
The Long Term Objective is to rectify the problems of "dead spats" in accessing the 911 system.
Component 8 -Communications Systems
The RETAC will strive for excellence in communications. The Short Term Objective is to finalize the
regional Mutual Aid Field Guide, which includes county radio frequencies. The Long Term Objective is to
identify communication problems through the Full Scale MCI exercises and prioritize the issuesJproblems.
Component 9 -Medical Direction
The ]tETAC would like to improve medical control. The Short Term Objective is to create a regional
medical control resource document. The Long Term Objective is to coordmate CME opportunities for
Medical Control and provide a networking forum for the physicians.
Component 10 -Clinical Care
The RETAC is committed to improving clinical care through encourage the appropriate facilities to
participate in the trauma system. The Short Term objective it to continue the work of the Facilities
Committee as they address facility issues. The Long Term Objective is to encourage culture appropriate
resources such as encouraging the use of Spanish speaking interpreters for assistance with clinical care.
Component 11-Mass Casualty Systems
The ItETAC strives to coordinate emergency medical response to MCI's and Terrorism
Incidents. The ItETAC plans to meet State requirements in this area. One Short Term Objective is to
publish the MCI Plan and integrate the Plan into each county's emergency Plans. Another Short Term goal
• a
includes publishing the MCI Plan and resource lists ~ a RETAC Web site. The Long Term Objective is
to create a Regional "Type II" Medical Response Team to respond to large medical incidents and acquire
frequencies for regional medical use.
Component 12 -Public Education
The RETAC is not addressing this component at this time.
Component 13 -Prevention
The RETAC intends to support regional prevention programs. The Short Term Objective is to assist the
ThinkFirst and SafeKids non-pmfit Programs, which were started in the regim- in the past few years by
RETAC members. The RETAC intends to provide monetary support for the programs via RETAC fiends
The Long Term Objective is to expand the ThinkFirst and SafeKids Programs to all of the counties.
Component 14 -Information Systems
The RETAC endeavors to use the EMS and tra~a data collection systems as a means to preventing injury
and improving the effectiveness and integration of the healthcare delivery system.
The Short Term and Long Term Objectives are to.gaffier and study the data.
Component 1 S -Evaluation
The RETAC is interested in fulfilling the state goals established for RETACs. The Short Term Objective is
to seek county approval of the 2003-2005 Biennial Plan. The Long Term Objective is to evaluate the
progress made on the Biennial Plan by creating as Evaluation tool to assess the progress on the Plan.
March 2003
•
The Central Mountains
Regional EMS and Trauma Advisory Council
(CM RETAC~
Serving Chaffee, Eagle, Lake,
Park, Pitkin and Summit Counties
to optimize
the care of sick
and injured patients
through
the integration and coordination
of Emergency Resources,
utilizing communications,
data, protocols,
training and system development.
1St Biennial
Regional EMS and Trauma ;=services Plan
7/1/2003 - 7/1/2005
~ •
Acknowledgements:
Funding for this Plan is wholly provided by financial support
from the Colorado Department of Public Health and Environment (CDPHE). The
CDPHE is not responsible for the content of this document.
Approved:
March, 2003
Central Mountains RETAC
P.O. Box 5055
Frisco, CO 80443
(970) 668-4240
John Woodland, MD, RETAC Chairman
Central Mountains RETAC Chairperson - 2003
Authorizations:
X
Print Name:
Board of County Commissioners Chairperson -Chaffee County 2003
X Print Name:
Board of County Commissioners Chairperson -Eagle County 2003
X
Print Name:
Board of County Commissioners Chairperson -Lake County 2003
X
Print Name:
Board of County Commissioners Chairperson -Park County 2003
X
Print Name:
Board of County Commissioners Chairperson - Pitkin County 2003
X Print Name:
Board of County Commissioners Chairperson -Summit County 2003
Acceptance:
X
Print Name:
Colorado Department of Public Health and Environment - 2003
2
• •
Table of Contents
Acknowledgements
Approval
Authorizations
Acceptance
Section 1: Mission Statement Pg.4.
Section 2: Purpose and Background Pg.4.
Section 3: RETAC description Pg.8.
Section 4: Needs Assessment Process Pg.9.
Section 5: Prioritization Process Pg.10.
Section 6: Summary RETAC Goals and Objectives Pg.10.
Section 7: Stakeholder List Pg.12.
Attachment A: Master roster of regional EMS agencies and Trauma Facilities
Section 8: Supporting Documentation Pg.12.
Attachment B: March 2003 RETAC members' list
Attachment C: September 200~RETAC meeting minutes
Attachment D: RETAC comments on the State's 15 components of an EMS and
Trauma System
3
Section 1:
Central Mountains RETAC Mission Statement- 2003
The Central Mountain's Regional Emergency Medical and Trauma Services
Advisory Council (CM RETAC) was created to develop a comprehensive and regional,
emergency medical and trauma. care system Its Mission is: "To optimize the care of
sick and injured patients thra-agh the integration and coordination of Emergency
Resources, utilizing Comm®nications, data, protocols, training and system
development."
Section 2:
Purpose and Backarround
The Central Mountains RETAC was formed July 1, 2000, via an
Intergovernmental Agreement (IGA) by and among the l3oazd of County Commissioners
of the Counties of Chaffee, Eagle, Lake, Pazk, Pitkin, and Summit, Colorado.
Per Provisions of Section 18 of Article XIV of the Colorado Constitution and
Section 29-1-203, C.RS., as amended, Chaffee, Eagle, Lake, Park, Pitkin, and Summit
may cooperate or contract with one another to provide any function, service or facility
lawfully authorized to each County.
The RETAC was formed after the General Assembly of the State of Colorado
revised the Colorado Trauma Care System Act, Section 25-3.5-701, et seq., C.RS.
(hereinafter "Act"). The Act revisions mandate,"... that the boazd of county
commissioners of each county, replace existing ATACs with multicounty Regional
Emergency Medical and Trawna Advisory Councils (hereinafter "RETAC"s) which aze
to be comprised of no fewer than four counties, or with the goven3ing body of a city and
county..."
The purpose of the RETAC is "... to provide recommendations concerning
regional azea emergency medical and trauma service plans in compliance with the
requirements of the Act; and ... that Counties recognize that appropriate care for those
persons experiencing a medical emergency or traumatic injury is immediately necessary.
And, that much of the infrastructure and cooperative spirit needed to create such a
multicounty organization including shared re~urces, equipment, and facilities that
provide trauma service already exists. And, support the legislative directive and
...extend their best efforts to implement the legislative directive consistent with the
funding appropriated by the State of Colorado, or other sources designated for this
P~~•„
The Counties agreed, "... to jointly establish a RETAC to recommend a regional
emergency medical and trauma system plan for the Counties and satisfy any other
regulatory of stahrtory requirements and obligations of the Counties pursuant to the
4
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Emergency Medical Services Act, § 25-3.5-101 et seq., C.RS. and the Statewide Trauma
Care System Act, 25-3.5-701 et seq., C.RS., or as expressly delegated by the Counties."
In accordance with 25-3.5-701, et seq., C.RS. and the desires of the pazticipating
Counties, the CM RETAC membership is comprised of eighteen (18) voting members:
three (3) per County, approximately configured according to the choices, as follows:
• 6 Emergency Medical Technicians - (paid or volunteer) -one from each Coutby's
emergency medical services boazd or council
• 1 Trauma Surgeon
• 1 Emergency Department Physician
• 1 Healthcaze Facility Administrator
• 3 Trauma Nurse Coordinators
• 1 Local Government Representative
• 1 Emergency Medical Service Physician Advisor
• 1 Ski Patroller
• 1 Open Seat
• 1 First Responder
• 1 Primary Caze Provider
The CM RETAC also invites professionals from key resource healthcaze facilities
to participate as non voting members. Key resources facilities offer the highest level of
~- trauma care, called Level I. Such trauma facilities aze designated by the CDPHE as
levels I through V. Again, the highest levels of resources are in Level I facilities, and the
least in Level V. Level V was largely created for ski clinics to obtain a designation.
Yearly, local countywide EMS and Emergency Councils have obtained input
from health care facilities and EMS providers in order to provide nominations for the
RETAC to the BOCC. The BOCC in turn has appointed the members. This slate of
approved candidates was sent to the RETAC office, completing the process. Recently,
however,. the RETAC voted to recommend amending the IGA whereby appointments will
be made for t3Ko-yeaz terms.
The founding RETAC members established their Bylaws in October 2000,
following several months of reseazch and debate. Issues of attendance, frequency of
meetings and the establishment of an executive boazd were among the items studied for
inclusion. The Bylaws are reviewed every yeaz during the RETAC annual meetings,
traditionally held the second Thursday in September.
Yearly, the RETAC elects a Chairperson, Vice Can, and Secretary-
Treasurer from its members. These officers serve one-yeaz terms.
The RETAC attempts to employ a fiill-time coordinator. The coordinator is
medically trained as either a nurse or EMT. In addition, a master's degree is preferred.
Several master's level discipline: are acceptable. This distinction is made due to the high
level of education held by RETAC members.
The coordinator focuses on organizational and administrative duties for the
RETAC. Planning and follow through are important aspects of the job. Problem solving
through analyzing relevant issues and making appropriate recommendations allows the
coordinator to operate effectively.
The coordinator is the RETAC liaison to the CDPHE and provider of technical
assistance to the counties. Currently, the CM RETAC is functioning with an interim
coordinator. A new coordinator will ~ hired in the summer of 2003. In the case ofthe
CM RETAC, the coordinator is but one of a team of hired professionals. In addition, two
consultants aze working for the RETAC, one with EMS data collection and the second
with healthcare facility trauma data. This strategy of utilizing several professionals helps
maxim;~e the number of skill sets available to the region
All meetings of the CM RETAC and any subcommittee meetings where business
is discussed. or at which formal action may be taken is a public meeting and subject to the
Colorado Open Meetings Law § 24-6-401, et seq., C.RS. Therefore, Notices and
agendas of all regular and special meetings aze faxed as "postings" for county
administrative bulletin boards at leasttwenty-four (24) hours in advance of the
commencemeirt of the meeting. The RETAC meets no less than every two months.
Educational opporhmity sharing is a regular part of the RETAC monthly meeting agenda.
Meetings are held at central locations during most of the year but rotate among the
counties during the summer. Minutes and records of the CM RETAC shall be open to the
public and .subject to the Colorado Open Records Act, § 2472-101 et seq., C.RS.
The CM RETAC receives $165,000.00 per yeaz, as part of the distribution of the
State EMS and Trauma Fund. This money is intended to help develop and maintain the
regional EMS and Trawna system The State fiord is capitalized via a $1.00 surcharge on
Colorado vehicle registrations. The amount the CM RETAC receives includes a fixed
amount of $75,000 per RETAC and $15,000.00 per county. The administrative portion
has been used to cover operating costs, employ the regional coordinator and contract with
the data specialists. In 2003, the counties were each given $8,800.00 for local EMS and
trauma system projects. The balance between the $15,000.00 consideration for the
counties and the $8,800.00 disbursement to them was used to help purchase the work of
the two RETAC data specialists.
The CM RETAC is limited in its spending authority to the annual total budget
approved by the RETAC. Annual expenditures shall not exceed revenues, including any
reserve fiends, as approved by the RETAC. The RETAC adheres to generally accepted
accounting principles and Colorado law.
Summit County Government has been the fiscal administrator for the State fiords
on behalf of the RETAC for the past two, initial yeazs of the RETAC. Recently, the
RETAC voted to seek 501(c) 3, non profit organizational status for fiscal administration
The new structure allows the RETAC to operate with it's own IRS designation The
501(c) 3 also allows the RETAC to be separate from the politics of the counties and state.
~ ~
The RETAC has a history of writing grants for resource and educational needs. The new
IRS designation broadens fund-raising possibilities.
The RETAC has four committees: the Prehospital(EMS), the Healthcaze Facility,
the Executive and the Mass Casualty Incident (MCI) for all hazards. Each committee has
a chairperson and secretary who aze Council members. The Committees make
recommendations to the full Council for approval No votes take place in committee
meetings.
Each committee has a major focus. The Prehospital committee's top project is
standazdizing and collecting regional EMS data. L~lcewise, the Facility committee
concentrates on Trauma Data collection. The Executive Committee focuses on
administrative issues. The Mass Casualty Incident Committee ha$ a written regional plan
and tests regional responses through Tabletop exercises and Evaluations.
The CM RETAC conducts regional planning by conducting meetings and
activities that bring the six counties together. These forums provide for information
sharing, innovating, networking and making regional choices, thereby optimizing care of
the sick and injured patient. Regional projects include the standardizing EMS data
collection by 11 out of the 12 licensed EMS agencies in the region. Trauma data is
collected by nine out of nine healthcaze facilities and is used to plan prevention activities.
The RETAC has a Regional MCUAll Hazazds Plan and Field Guide, which was created
over the past two years. Plans continue for a Weapons of Mass Destruction Tabletop
exercise in October 2003 and afull-scale exercise in May 2004. A Department of Justice
(DOJ) Grant will fund nth of these exercises.
Following inception, the RETAC was awarded a State Provider Grant for EMS
regional data collection soflwaze and hardware. A Rural AED (Automatic External
Defibrillator) Grant, obtained by the RETAC, via federal funds in 2002, facilitated 12
Automatic External Defibrillator (AED's) units being distributed regionally in January
2003.
Expectations for the firture include resolving issues on the discoverability of
collected data and the writing of state and regional policies for statistical dissemination of
this information and conducting quality of care assessments. The RETAC acknowledges
the need to raise additional money for further infrastructure development and allocation
of better resources. For the past year and a half, the RETAC has been attempting to
secure funds for portable decontaminationunits, but to date, remain without these
Items vital for terrorism response. Region wide disaster planning now involves two new
types of regions in Colorado 1) Bioterrorism, which is anchored by Public Health and 2)
Prepazedness regions, which address law enforcement.
Continuing integration between the RETAC, the counties, local Councils, the
CDPHE, the facilities and the prehospital agencies is the essence of the regional
systemization. Identifying common needs drives the RETAC to seek further fimding for
solutions.
~ ~
The Central Mountains RETAC has been instrumental in helping to form and
support new local EMS and Trauma. Councils in Lake, Pazk and Chaffee counties, using
organizational models from Eagle, Summit and Pitkin counties. The later three counties
have recognized these local advisory boazds via county resolutions. The former three
counties aze on track to accomplish this same type of formal relating to the BOCC. The
CM RETAC works using a local, regional and state, three-way communications model
Secti®n 3:
Central Mountains RETAC Description
The Central Mountain's Regional Emergency Medical and Trauma Services
Advisory Council (CM RETAC). was created to develop a comprehensive and regional,
emergency medical and trauma care system for hospital and prehospital response in the
6,898 squaze mile region. The squaze miles per county aze as follows: Chaffee - 1,015;
Eagle - 1,701;Lake - 383; Park - 2,210; Pitkin - 970; and Summit - 619.
Populations in the counties are as follows: Chaffee -16,300; Eagle - 31,721,
Lake - 8,220; Pazk -12,451; Pitkin -14,500; Summit -18,557. All Counties aze
experiencing a 10% to 25% annual growth in their base populations in both populated
and rural azeas. Some azeas aze forecasted to double their populations in the next 10
years. Seasonal and Tourist populations are also increasing. Populations can swell by
over 400% in some azeas, from 15,000 to 93,000 and this now occurs neazly yeaz-round.
The region is mountainous and interwoven with,high narrow roads winding over
peaks 11,000 feet and higher. Locations aze separated by these mountain passes and can
become landlocked during inclement weather. One major Interstate highway, I-70
intersects the region. Several highly traveled primary and designated scenic highways
include major hazazdous material routes: highways 285, 6, 9, 24, 91, 82, 50 and 131.
Major ski and winter sport azeas draw hundreds of thousands of tourists to the
region during cold months and provide summer venues for concerts and other events.
Lazge azeas of all the counties aze public lands, some 40-80%.
Severe and unusual weather conditions may occur year-round throughout the
region to include: windstorms, heavy snows, sleet, freezing and/or heavy rains.
Avalanches and landslides occur. Flooding can also occur in the rivers, upstream
tributazies basins and downstream from major dams in the region.
Two regional airports and a number of landing strips serve small personal craft
to high speed, multi passenger aircraft. Several industrial plants exist, ranging from fixed
facilities and petroleum fuels storage to light industry.
The region has seven State-Designated Trauma Centers for patient care. These
•
include: The Aspen Valley Hospital, Level III (Pitkin); Breckenridge Medical Center,
Level IV (Summit); Century Summit Medical Center, Level IV (Summit), Heart of the
Rockies Regional Medical Center, Level IV (Chaffee); Keystone Medical Center, Level
IV (Summit); St. Vincent's General Hospital, Level IV (Lake) and Vail Valley Medical
Center, Level III (Eagle). Non designated facilities include Copper Mountain Medical
Center (Summit) and Beaver Creek Medical Center (Eagle). See Appendix A -
Healthcaze Facility Report for facility statistics.
Several regional similarities exist among the healthcare facilities. Inter-facility
transfers aze needed for moderate and high risk patients. These include high incidence
motor vehicle and skier accidents. High altitude problems, hypotherrmia, a significant
incidence of head traumas, without available neurosurgery in the region, and a high
incidence of orthopedic trauma aze seen.
There are ~'9~prehospital agencies in the region. Fully-license Ambulance
agencies include: the Aspen Ambulance District (Pitkin), Basalt Fire Rescue (Pitkin),
Chaffee County EMS, Eagle County Ambulance District, Platte Canyon Rescue (Pazk),
Snowmass Wildcat Fire Protection District (Pitkin), South Pazk Ambulance District, St.
Vincent's Hospital Ambulance (Lake), Summit County Ambulance, High Country EMS
(Pazk) and the Westera Eagle County Ambulance District.. A seasonal Basic Life Support
license is cazried during the ski season by Aspen Emergency Services.
Several regional prehospital challenges include:
• - High response times
• High mountain passes including two of the highest Interstate passes in the country
• High transport times due to large distances between healthcare providers
• High mileage on ambulance vehicles from long distance transports
• Drastically changing weather and road conditions with long winters
• Areas inaccessible to ambulances and accessible only by bicycle, foot or ATV
• Steep mountain seazch and rescue initial response
• Ski azea initial response
• Lazge wilderness areas with hunting activities
• High recreational use and tourist azeas
• Swift water rescue initial response
• Additional Ambulance wear from responding on non-mai~ta;ned dirt roads
• Lazge numbers of volunteers being asked to participate in precarious situations
• A wide range of communications problems among varied technologies
• Multi-language and multi-cultural issues with both residents, visitors sand Interstate
travelers
• High number of aeromedical rescues
• Urban, residential and wildland fires.
See Appendix B Prehospital Report for statistics
Section 4:
•
Needs Assessment Process
In September 2001, the entire RETAC membership worked for the better part of a
day to create three templates for the region's Needs and Resource Assessment project.
Over six different assessment samples were considered. Then, the group drafted three
specific assessment tools, titled the Prehospital, Healthcare Facility and County
assessments. Twelve assessments were distributed to the prehospital agencies and all
were completed with the exception of High Country EMS in Pazk County. All nine
healthcare facility assessments were completed. And, five out of six county assessments
were completed with the exception of Pazk Cou~y: Each assessment
consisted of at least 50 questions. The purpose of the Assessment project was to identify
system needs and resources available for the regional improvement planning.
Beginning in July 2002, completed surveys were entered in an Access database by
staff from the Denver. Health Medical Center, one of the CM RETAC's key resource
facilities. A verification process took place and reports were generated. Identified
problems, trends and issues have helped generate sohrtions, goals and objectives for the
region.
Section 5:
Prioritization Process
At-the September 2002 Annual RETAC meeting, the Council approved its'
priorities for the next two yeazs. In addition, at the December 2002 RETAC meeting, they
decided on short and long term goals according to regions needs and the state's newly
developed 15 components of an EMS and Trauma System
Further data analysis and SWOT (Strengths, Weakness, Opportunity, Threats)
analysis work in February and March 2003, provided the basis for the prioritization of the
goals for the region.
Section 6:
Summary of Goals and Objectives
The Goals for the RETAC during 2003 through 2005 aze prioritized as follows:
O®e: Better finance the system via the development of the 501(c) 3
organization
T®vo: Hire a Coordinator for the RETAC
1®
• •
Three: Further identify regional communications systems problems and
solutions and hire a Communications consultant for corrective action
during the 2003/2004 fiscal year, which begins July 1, 2003
Four. Correlate data collection and the new federal (HIPPA) regulations
governing patient information
Five: Conduct MCI/WNID regional exercises and secure decontamination
equipment for the counties
S.W.O.T. Analysis
The RETAC analysis ofthe regions S.W.O.T. (Strengths, Weaknesses, Opportunities and
Threat) yielded the following information:
STRENGTHS:
• Clearly defined objectives
• Coordination of trauma data
• Information sharing
• Networking
• MCI planning
• Reasonable goals likely to be achieved
• RETAC fosters greater understanding of regional issues
• Competent consultant for EMS data collection
• Strong group of committed individuals
WEAI~TESSES:
• Trauma data not used
• Meetings are too long
• More CDPHE categories for goal achievement than is reasonable to accomplish
• Not enough contact or involvement with the BOCCs
• BOCCs do not discuss the RETAC efforts
• Analysis of State requirements takes too much time
• Too maay RETAC administrative issues vs. coordination of services
• Lack of adequate funding
• Lack of RETAC coordinator at present
'` OPPORTUNITIES: x`
• 501(C)3 for fiscal administration and better funding
• Can accomplish more purchasing of equipment and resources with the 501(c)3
• Better understanding ofinter-regional and state needs and mandates
• To be a model for other regions as was the case initially
11
THREATS:
•
• Increasing demands on RETAC members without adequate work time to accomplish
goals and without reimbursement to the members' employers
• Too many regional jurisdictions in Colorado
• Not enough state grant money
• Paralysis of obtaining grant money
• Uncertainty of the hurdles to progress to the 501(c)3
• Uncertainty of the coordinator component
Section 7:
Stakehold®rs List
Attachment A :Master roster of regional EMS agencies and Trauma Facilities
Section 8:
Supporting Documentation
Attachment B: March 2003 RETAC members' list
Attachment C: September 2003 RETAC meeting minutes
Attachment D: RETAC comments on the State's 15 components of an EMS and Trauma
System
12
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Attachment B:
i
Central Mountains RETAC
Regional Emergency Medical and Trauma Services Advisory Council
P.0 Box 5055, Frisco, CO 80443
Serving Chaffee, Eagle, Lake, Parr Pitkin and Summit Counties
Appointed Members and Alternates
3 votes per county per meeting/18 total votes
Judy 1, 2002 -June 30, 2003
Chaffee Countw.
Diane Brooks, RN Phone: 719-539-6661
Trauma Nurse Coordinator a-mail: dianeb@hrrmc.net
Heart of the Rockies Regional Medical Center
PO Box 429
Salida, CO 81201
Pat Barnett, RN Phone: 719-395-8493
Chaffee County Public Health Nurse a-mail: salidagat(c~hotmail.com
PO Box 37
Buena Vista, CO 81211
Jackie Berndt', EMT-P Phone: 719-539-2212
Chaffee County EMS a-mail: ccems@amigonet
PO Box 699
Salida, CO 81201
Pete DeChant, Director Phone: 719-539-2212
Salida Fire a-mail: salidafd@chaffee.net
Carl Hasselbrink Phone: 719-539-7442
Emergency Manager Chaffee County a-mail: Cazlh@amigo.net
PO Box 669
Salida, CO 81201
Adam Petro, EMT-P Phone: 719-539-2212
Chaffee County EMS a-mail: salidafd@chaffee.net
PO Box 699
Salida, CO 81201
Randy Rodak, DO Phone: 719-530-8221
Heart of the Rockies Regional Medical Center a-mail: drriner@hotma~7.com
PO Box 429
Salida, CO 81201
J.W.W~7der Phone: 719-5531654
Colorado State Pazk a-mail: jw@ahra.salida.co.us
307 West Sackett Ave
Salida, CO 81201-1654
•
Eagle County:
Chris Dick, EMT Phone: 970- 318-1130
Western Eagle County Ambulance a-mail: chrisdick@hotmaiLcom
PO Box 1809
Edwards, CO 81631
Anne Fassel, RN Phone: 970- 479-7185
Trauma Nurse Coordinator a-mail: traumaservices@VVMC.com
Vail Valley Medical Center
181 West Meadow Dr.
Vail, CO 81657
Reg Franciose, MD Phone: 970- 479-5039
Vail Valley Medical Center a-mail: Franciose@vvmc.com
181 West Meadow Dr.
Vail, CO 81657
Tom Kelley, EMT-P Phone: 970-328-1130
Western Eagle County Ambulance Director a-mail: wecad@fgn.net
PO Box 1809
Eagle, CO 81631
Sarah Moody, RN Phone: 970- 479-7230
Vail Valley Medical Center a-mail: m~dy@VVMC.com
181 West Meadow Dr., Suite 100
Vail, CO 81657
~ --~~ Lyn Morgan, EMT-P Phone: 970-926-5270
Eagle County Ambulance Director a-mail: lmorgan@ecad-ems.com
PO Box 990
Edwards, CO 81632
John (Chip) Woodland, MD, Chairman Phone: 97076-8065
Medical Director a-mail: woodland@vaiLnet
Vail Valley Medical Center
181 West Meadow Dr.
Vail, CO 81657
Lake County:
Joan Fretz, RN Phone: 719- 486- 0230
St. Vincent's General Hospital a-mail: jfretz@SVGHD.org
822 W. 4s` St.
Leadville, CO 80461
Mike Osborn, Fire Chief Phone: 719-486-2900
Leadville/Lake County Fire a-mail: mosborn@leadvillefQe.org
816 Harrison Ave.
Leadville, CO 80461
Lfsa Zwerdlinger, MD Phone: 719- 486- 0230
St. Vincent's General Hospital e-mail: DrLisa@amigo.net
822 W. 4s' St.
Leadville, CO 80461
Park County:
Jndi Andreson, Fire Chief
Jefferson Como Fire Department
PO Box 380
Como, CO 80432
Pahl Mattson, EMT-P
South Park Ambulance District
PO Box 417
Fairplay, CO 80440
Marti Wooton, RN
Pazk County Public Health
PO Box 846
Fairplay, CO 80440
Fitkin County:
Flint Smith, EMT-P
Basalt Fire Rescue
1089 J.W. Drive
Carbondale, CO 81623
William Rodman, MD
Aspen Valley Medical Center
0401 Castle Creek Rd.
Aspen, CO 81611
Mary Shelton, RN
Trauma Nurse Coordinator
Aspen Valley Medical Center
0401 Castle Creek Rd.
Aspen, CO 81611
Rich Walker, EMT-P
Aspen Ambulance District Director
0401 Castle Creek Road
Aspen, CO 81611
Summit County:
Shelly Almroth, RN
Trauma Nurse Coordinator
Summit Medical Center
PO Box 738
Frisco, CO 80443
Kevin Ahern
Breckenridge Ski Patrol Director
PO Box 1058
Phone: 719-836-3244
e-mail: jcfpd@direcway.com
Phone: 719-836-4149
e-mail: pmattson@theparknet.com
Phone: 719-836-4147
e-mail: pcphns@thepazknet.com
Phone: 970- 704- 0675
e-mail: fsmith@basaltfire.org
Phone: 970- 920- 7024
e-mail: wjrod@ro~net
Phone: 970- 544-1571
e-mail: mes@avhaspen.org
Phone: 970- 544-1580
e-mail: rwalker137@aol.com
Phone: 970- 668-3300
e-mail: ShellyAlmroth@centura.org
Phone: 970- 496- 7229
e-mail: KevinA@Vailresorts.com
C
Breckenridge, CO 80424
Sean Caffrey, EMT-P, Secretary/Treasurer
Summit County Ambulance Director
PO Box 4910
Frisco, CO 80443
Kelley Laa, RN
Trauma Nurse Coordinator
Breckenridge Medical Center
PO Box 930
Breckenridge, CO 80424
Ed Noordewier, MD
Emergency Room Physician
Summit Medical Center
PO Box 738
Frisco, CO 80443
Mike Stern, EMT-P
Summit County Ambulance
PO Box 4099
Frisco, CO 80443
i
Phone: 970- 668- 5777
e-mail: SeanC@co.summit.co.us
Phone: 970- 453- 1010
e-mail: Lau@WMC.com
Phone: 970-668-3300
e-mail: enoordewier@compuserve.com
Phone: 970-668-4121
e-mail: Mikes@co.summit.co.us
~ ~
fFT°(AC ISM 6~`I-C ;
~_1 ~` Central Mountains Regional Emergency Medical and Trauma Services Advisory
Council
(CM - RETAC)
Serving Chaffee, Eagle, Lake, Parr P#kin acid Summit cournies
Mission: `To optianize the care of sick and injured patients through the intimation
and coordination of emergency-resources and injtuy prevc~ztion."
9/2001
DRAFT Minutes from the September 12, 2002 meeting,
Held at the Buena Vista Community Center 0930-1500
VOTING Members Present
Chaffee Comty (Votes 3):
Diane Brooks, RN
Jackie Benndt, EMT-P
Pat Barnett, RN, Chtaffee PH
Esgle Cotmty (Votes 3):
Chip Woodland, MD. VVMC, Chairman.
Reg Franciose, MD, VVMC
Lake County (Votes 3):
Roger Colt, EMT P, SVGH
Lisa Zwerdlinger, MD, SVGH
Anne Wardrop, RN
Joan Fretz, RN, SVGH
Park County (Votes 2):
Chris Montera, EMT P, S. Park AmbJRETAC Pre-Hospital Data
Ed Noordewier, MD, Summit Med Ctr.
Pltkin County (Votes 3):
Mich Walker, EMT-P, Aspen Ambulance Rhonda J. Cole, EMTP
Mary Shelton, RN, AVH Flint Smith, EMT P, Basalt Fire
William Rodman, MD
Summit County (Votes 3):
Shelly Ahnroth, RN, Summit Med. Ctr
Sean Caffrey, EMT-P, SCAS, Treas/Sec.
Kevin Ahern, Breck Ski Patrol
Others Present
Lorraine Caposole, CM RETAC Coordinates Kathleen Patterson, RN, Denver Health
Chris Dick, Western Eagle County Amb. District Perri Walborn, Chaffee Fire
Claudia York,EMT Ed Parry, EMT-P
Diane Knecht, RN, Copper Mt. Clinic Marti Wooton, RN, Fark PH
Phyllis Uribe, RN, H~lthOne Swedish Kelley Lau, RN, Brackenridge
Carl Smith, Carbondale Fire
(Page 1 of 6 - CM RETAC 09-02)
~ ~
9:30 General Meeting
Dr. Woodland, CM-RETAC Chair called the meeting to order. A roll call of voting
members of the Council was called. A Quorum was present. All attendees introduced
themselves. Dr. Woodland proposed a revised agenda The revised agenda was
approved Sean Caffrey, TreaslSec. Requested an executive session per the open
meetings law regarding budget issues. An executive session to be held over the lunch
hour was approved. Motion by Sean; second.
Vote -approved
Lorraine Caposole introduced Jack Taylor who was employed to facilitate the meeting.
1. Regional EMS and Trauma Plan Timeline Discussion.
The Coordinator provided the group with a worksheet for formailating a contract with the
state. This contract will take the place of the 6 individual county subsidy plans. A major
difference will be the use of a Quarterly Payment Disbursement Plan,
Our Biennial Plan draft is due March 1, 2003. The final plan is due by July, 2003. After
the final plan is sent there is an approval process through. SEMTAC. Plans will be
evaluated by Semtac. Submission of a revised plan is allowed if the original plan is
found to be inadequate.
Our Coordinator is looking for direction in creating a plan. The Coordinator provided a
rough draft of a Biennial Plan Template which listed the components the plan should
contain. The information obtained from our self-assessment and from an evaluation of
our current needs can ~ used to formulate the' plan Data collected from data collection
sources -facilities and EMS agencies -can also be used We will, not use facilitators or
consultants to formulate our plan Rather, we will rely on our existing committees.
The regional plan will be what we use in the next 2 - 5 years. We cad't effectively do
strategic planning for long and short term due to our need to come up with a regional plan
within the same time period.
Lorraine wants committees to come up with data for the regional plan.
2. Review of previous year Committee goals -set new goals and
priorities.
Our facilitator asked the question -How well did we reach goals set last year and what
are our goals for this year?
a. Facilities Committee -goals and objectives and progress reaching same.
1.Trauma data .plan - in process- with improvement in collection by non hospital
faacilities• (Page 2 of 6 - CM RETAC 09-02)