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PA Bulletin, Doc. No. 17-1088

NOTICES

DEPARTMENT OF HEALTH

Emergency Medical Services Operating Fund Funding Priorities for Fiscal Year 2017-2018

[47 Pa.B. 3653]
[Saturday, July 1, 2017]

 Under 28 Pa. Code §§ 1021.24 and 1021.25 (relating to use of EMSOF funding by a regional EMS council; and allocation of EMSOF funds to regional EMS councils), the Department of Health (Department) 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) for the fiscal year beginning July 1, 2017, and ending June 30, 2018.

 EMSOF moneys are to be used to provide funding to maintain, improve and develop the quality of the EMS system within this Commonwealth. The Department finds that the EMSOF is not sufficient to fully fund the EMS system. Therefore, it gives notice, under 28 Pa. Code § 1021.24(e), that recipients of EMSOF funding from regional EMS councils may be required to provide matching funds toward all purchases, acquisitions and projects for which the Department permits the use of EMSOF moneys.

 Each regional EMS council shall prioritize the distribution of its EMSOF allocation based upon the Statewide EMS Development Plan and its regional EMS development plan, subject to the funding priorities in this notice. By October 30, 2017, regional EMS councils shall notify the providers and other appropriate entities of the established funding priorities, the application process, acquisition documentation requirements and processing deadlines. Each regional EMS council must complete all documents required for the distribution of EMSOF funding by June 30, 2018.

 The Department may increase the amount of the initial payment or reimbursement from the EMSOF based upon the EMS development plans (State and regional) or documented financial hardship of a provider of EMS. A provider of EMS that seeks additional funds due to financial hardship shall be required to submit a financial disclosure statement and other documentation deemed necessary by the Department. A provider of EMS applying for EMSOF funding must be in full compliance with all regulations, policies and priorities of the State and regional EMS systems.

 Funds for purchases, acquisitions and projects for the fiscal year beginning July 1, 2017, and ending June 30, 2018, must have been expended or encumbered by the regional EMS council by June 30, 2018.

Funding Priorities

 The following funding priorities listed are listed in order of current State priority. These priorities must be considered before there is any regional distribution of EMSOF money for initiatives that are not listed. All funding must be distributed in a manner consistent with the regional and Statewide EMS development plans. Consequently, if the priorities in this notice have been met and additional funding is available, the request to use EMSOF money towards lower priority items must still be supported by the Statewide and regional EMS development plans.

 1. Recruitment and retention programs, including scholarships or tuition reimbursement for emergency medical responder (EMR), emergency medical technician (EMT), advanced emergency medical technician (AEMT) and paramedic (P) education in areas with higher than average prehospital personnel vacancy rates or other challenges associated with the provision of EMS primary education, or both, as determined by the regional EMS council and approved by the Department.

 2. Costs associated with investigating a potential merger or consolidation of services. These costs include consulting fees, studies, legal fees and statistical analysis.

 3. Costs associated with the actual merger or consolidation of services.

 4. Development or improvement of an organizational risk management program (safety measures, hazard recognition or mitigation and the necessary organizational structure and support processes) proposed by an ambulance service. Proposals for funding must be comprehensive and include safe vehicle operations. Approval by the Department is required prior to funding. Equipment that is required to meet basic life support (BLS), intermediate advanced life support (IALS) and advanced life support (ALS) ambulance service licensure.

 5. Capnography equipment (especially wave-form end-tidal CO2 monitors).

 6. Software or computer equipment to enable services to collect and transmit EMS patient care reports electronically.

 7. Bariatric equipment for ambulances.

 8. Replacement of an ambulance, for ambulance services, that is older than 10 years or has more than 200,000 miles on it. This allowance is limited to one per fiscal year.

 When two or more ambulance companies have consolidated to create one entity, for the first 5 years after the ambulance companies completed consolidation, the entity may be deemed eligible to receive funding not to exceed the amount of the combined total for which the individual companies would have been eligible had they not consolidated.

Emergency Preparedness and Response Funding Requests

 Emergency preparedness and response funding requests must be based on local and response roles of services, regional needs and needs identified by threat vulnerability analysis. Purchases must be coordinated with county emergency, fire service, hazmat and hospital organizations in the applicant's service area to assure interoperability and to prevent duplication. Funding requests related to responding to all hazard and emergency preparedness must have a clear connection to the regional EMS catastrophic plan and the regional EMS development plan. Priority will be given to fund the ambulance services in each region that have committed to participating in the EMS strike team capability project and responding to requests for EMS, both interstate and intrastate, as identified in the State and regional mass casualty plans.

Provider Equipment

 Purchases by providers of EMS are not limited to equipment. If a provider of EMS requests EMSOF moneys to purchase equipment, the following Eligible Provider Equipment List identifies equipment for which EMSOF funds will be made available to purchase. This list provides the types of providers of EMS eligible for equipment purchases supported by EMSOF funding and the maximum allowable cost upon which the EMSOF contribution will be calculated.

 EMSOF funds will fund 60% of the maximum allowable cost of an equipment item for rural providers and will fund 50% of the maximum allowable cost of an equipment item for nonrural providers. Providers of EMS that receive funding are responsible for the balance of the purchase price. The provider may purchase an item for an amount that exceeds the maximum allowable cost, but the provider will be responsible for any amount exceeding that figure. The last two columns of the Eligible Provider Equipment List identify the percentage of EMSOF contribution towards the purchase price, up to the maximum allowable cost of the item, based upon whether the provider operates in a rural or nonrural area.

Examinations

 Funding may be provided to EMS agencies to cover the cost of the State written test for P, prehospital physician extender (PHPE), prehospital registered nurse (PHRN), AEMT, EMT and EMR certification taken by their personnel at 100% of the cost of two examination attempts up to a maximum allowable cost of $220 for Ps, PHPEs and PHRNs, $200 for AEMTs, $140 for EMTs and $130 for EMRs per person.

Medical Director

 The maximum allowable cost for an EMS agency to contract for medical director oversight is $10,000 for Fiscal Year 2017-2018.

Eligible Provider Equipment List

LifeEligible Purchase for AllowableNonruralRural
Equipment Description Expectancy ALS ALS/SQ IALS IALS/SQ BLS BLS/SQ QRS Costs1
(50%)
(60%)
EKG Monitor/Defibrillator
 with Pacer
5 years Y Y N N N N N 12,000 6,000 7,200
12 Lead EKG 2 5 years Y Y Y Y N N N 20,000 10,000 12,000
Automated External  Defibrillator (AED) 5 years N N N N Y3 Y3 Y3 1,500 750 900
Automated External  Defibrillator Trainer 5 years N N N N Y Y Y 400 200 240
Oxygen Equipment (any  combination)
 Cylinder
 Demand Valve w/Hose and   Mask
 Regulator (combination or   constant flow—25 lpm   capable)
 Case
5 years Y Y Y Y Y Y Y 500 250 300
Capnography Equipment 3 years Y Y Y Y N N N 3,000 1,500 1,800
CPAP Ventilation Portable  Equipment 5 years Y Y Y Y Y Y Y 1,500 750 900
Pulse Oximeter 5 years Y Y Y Y Y Y Y 700 350 420
Nitrous Oxide Delivery  System 5 years Y Y N N N N N 2,000 1,000 1,200
Intravenous Infusion Pumps 5 years Y Y N N N N N 2,000 1,000 1,200
Adult/Pediatric Intubation  Kits 5 years Y4 Y4 N N N N N 600 300 360
Transtracheal Jet Insufflators  (TTJ) 5 years Y Y N N N N N 200 100 120
Splinting/Immobilization  Devices (any combination)
 Backboard
 Cervical Immobilization  Device
 Splints (rigid, traction, and   the like)
3 years Y Y Y Y Y Y Y 500 250 300
Stairchair 5 years Y N Y N Y N N Up to 5,000 1,325 1,590
Stretcher 5 years Y N Y N Y N N Up to 10,000 5,000 6,400
Stair Stretcher 500 lb.  Capacity 5 years Y N Y Y Y N N 2,700 1,350 1,620
Suction (Portable) 3 years Y Y Y Y Y Y Y 900 450 540
Ventilator, Automatic
 (per Department of Health  Guidelines)
5 years Y5 Y5 Y6 Y6 Y6 Y6 Y6 3,000 1,500 1,800
Ambulance with Chevron  Marking on Back of Unit - Y N Y N Y N N - 15,000 20,000
Chevron - Y Y Y Y Y Y Y 1,500 750 900
Squad/Response Vehicle with  Chevron Marking on Back  of Unit - N Y N Y N Y Y - 7,500 9,000
Data Collection  Software/Technology7 - Y Y Y Y Y Y Y 1,700 850 1,020
Data Collection Hardware8 3 years Y Y Y Y Y Y Y 2,000 1,000 1,200
Radio, Mobile (two per vehicle) 5 years Y9 Y9 Y9 Y9 Y9 Y9 Y9 5,000 2,500 3,000
Radio, Portable (two per  vehicle per year) 5 years Y9 Y9 Y9 Y9 Y9 Y9 Y9 5,000 2,500 3,000
Triage Vest with Reflection  Stripes Meeting ANSI  National Standards 5 years Y Y Y Y Y Y Y 150 75 90
Triage System 5 years Y Y Y Y Y Y Y 750 375 450
Alerting Equipment
 (five per service at $400  each)
5 years Y9 Y9 Y9 Y9 Y9 Y9 Y9 2,000 1,000 1,200
Vehicle Safety Monitoring  Systems 5 years Y Y Y Y Y Y Y 3,500 1,750 2,100
Personal Protective  Equipment/Turnout Gear:   Helmet, Coat, Pants,   Boots Protection   Respiratory Protection   from Communicable   Diseases 5 years Y Y Y Y Y Y Y 1,200 600 720
Protective Ballistic Vest 5 years Y Y Y Y Y Y Y 1,000 500 600
Global Positioning System  Receiver one per licensed   Ambulance or Recognized   QRS Vehicle 5 years Y Y Y Y Y Y Y 500 250 275
Traffic Safety Equipment 5 years Y Y Y Y Y Y Y 2,500 1,250 1,500
Large Patient Moving/
 Carrying Device
10 years Y Y Y Y Y Y Y 3,000 1,500 1,800
Self-Contained Breathing  Apparatus (two per licensed  vehicle) 10 years Y Y Y Y Y Y Y 3,000 1,500 1,800
P/PHPE/PHRN Testing  (Written) 220 220 220
AEMT—Testing (Written) 200 200 200
EMT Testing (Written) 140 140 140
EMR Testing (Written) 130 130 130
CO Detectors (Monitors) 5 Years Y Y Y Y Y Y Y 200 100 120
12 Lead EKG Transmitter  System 5 Years Y Y Y Y N N N 1,000 500 600
IO Drills or Bone Injection  Systems 5 Years Y Y Y Y N N N 300 150 180
Narcotics Security Systems 5 Years Y Y Y Y N N N 900 450 540
Refrigerators (mini) 10 Years Y Y Y Y N N N 1,200 600 720
Pediatric Safe Transport Device 10 Years Y N Y N Y N N Up to 400 200 240
Tourniquet (tactical) 5 Years Y Y Y Y Y Y Y 25 12.50 10
Bariatric equipment 5 Years Y Y Y Y Y Y Y 27,000 13,500 10,800

 ALS—Advanced Life Support ambulance service; ALS/SQ—Advanced Life Support Squad service; IALS—Intermediate Advanced Life Support ambulance service; IALS/SQ—Intermediate Advanced Life Support Squad service; BLS—Basic Life Support ambulance service; BLS/SQ—Basic Life Support Squad service; QRS—Quick Response Service

1 All figures are dollar amounts for each item of equipment.

2 Amount includes $1,000 for communications package. Receiving facility must have appropriate communications capabilities.

3 Must be an approved AED service or part of regional planning, and AED medical director required.

4 Must be durable equipment, not disposable equipment.

5 Completion of approved training program required.

6 Completion of approved training program required and BLS service medical director approval required.

7 Must be a Department-approved software program, version and vendor.

8 Data collection hardware may include computer, modem, printer, backup device and battery system.

9 Must be compatible with regional and State EMS communications plan.

 Questions regarding this notice should be directed to Aaron Rhone, EMS Program Manager, Bureau of Emergency Medical Services, Department of Health, Room 606, Health and Welfare Building, 625 Forster Street, Harrisburg, PA 17120-0701, (717) 787-8740.

 Persons with a disability who require an alternative format of this notice (for example, large print, audiotape, Braille) should contact Aaron Rhone at the previously listed address or telephone number or for speech or hearing impaired persons may use VTT (717) 783-6514 or the Pennsylvania AT&T Relay Service at (800) 654-5984.

KAREN M. MURPHY, PhD, RN, 
Secretary

[Pa.B. Doc. No. 17-1088. Filed for public inspection June 30, 2017, 9:00 a.m.]



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