Emergency Medical Services Structure and Financing of Ambulance Services– IS 11 -062 Mark Newman Oklahoma State Department of Health
House Bill 1888 Summary Title 19 -1201 -1221 HB 1888 amended existing statutes. The act, cited as the Ambulance Service Districts Act allows for the creation of an EMS District that is not based on the Emergency Medical Service Districts found in Article X Section 9 C of the Constitution. (This section allows for the formation of an district that is funded by a ad volorem of up to 3 mills)
House Bill 1888 Summary Title 19 -1201 -1221 Also amended another statute: 63 O. S. § 1 -2504. 1 A. There is a required duty to act within the licensed area upon the acceptance of an ambulance service license. All licensed ambulance services shall respond appropriately, consistent with the level of licensure, when called for emergency service regardless of the patient’s ability to pay. This eliminated the requirement for an ambulance service to respond when they are the closest agency.
House Bill 1888 affects ✱ Altered the existing statute regarding how an EMS District is formed under Title 19. ✱ County Commissions are required to submit a plan to OSDH. ✱ Should have started a positive dialogue between cities, agencies, and county officials
House Bill 1888 affects O. A. C. 310: 641 -3 -120 (c) The current standard is: 63 O. S. § 1 -2504. 1 There is a required duty to act within the licensed area upon the acceptance of an ambulance service license. All licensed ambulance services shall respond appropriately, consistent with the level of licensure, when called for emergency service regardless of the patient’s ability to pay.
House Bill 1888 affects O. A. C. 310: 641 -3 -120 (c) The current standard allows services to: ✱ Alter their current licensed service area ✱ Allows the service to refrain from responding to requests for service beyond their licensed service area, even when miles closer.
House Bill 1888 affects O. A. C. 310: 641 -3 -120 (c) ✱ One agency has formally altered its Licensed Service Area- City of Coweta-Wagoner County ✱ One agency has made the decision to adhere to its licensed service area-Okmulgee Co. EMS ✱ Other Cities and Agencies continue to discuss altering their service areas
HB 1888 By April 1, 2011 each county with a population <500, 000 shall present to OSDH an EMS Plan that Shall: Address funding issues; Ensure countywide EMS coverage; Address county boundaries related to 9 -1 -1 response
Counties that have submitted plans Adair Alfalfa Beckham Cleveland Comanche Creek Garfield Grady Harper Haskell Jefferson Johnston Mayes Mc. Clain Mc. Curtain Mc. Intosh Murray Noble Okmulgee Osage Ottawa Seminole Sequoyah Stephens Washington 26 of the 75 plans have been submitted Washita
Funding for EMS Funding Options Resources
Statewide Funding Districts
Trauma Care Assistance Revolving Fund Annual Collections - 5 Year Average Cigarette Tax (39. 2%) $10, 208, 891 Tobacco Products (4. 2%) $1, 104, 342 All Tribal Tobacco (10. 1%) $2, 622, 262 Vehicle Collections (13. 3%) $3, 459, 716 County Fine & Fees (33. 2%) $8, 657, 889 Annual Average Total $26, 053, 100 Annual Distributions – 5 Year Average OSDH EMS Agencies Hospitals Physicians $2, 605, 310 $1, 641, 345 $19, 461, 666 $2, 344, 779 (10. 0%) (6. 3%) (74. 7%) (9. 0%) Cumulative Distribution Totals to date. EMS distribution Hospital distribution Physician Distribution Total Distribution $10, 726, 312. 92 $132, 248, 962. 93 $14, 921, 087. 30 $157, 896, 363. 15
5 Year Annual Average – 10% Expenses
EMT Death Benefit Revolving Fund Annual Collections State FY 2009 State FY 2010 State FY 2011 State FY 2012 $38, 190 $41, 215 $26, 091 $4, 834 (thru SFY 2012 Q 1 - 09 -30 -2011) Fund Balance $90, 330 Annual Distributions State FY 2009 State FY 2010 State FY 2011 State FY 2012 Claims Paid to Date $10, 000 $5, 000 $- 0 $5, 000 $20, 000
Why is EMS Coverage So Important in Oklahoma? Some reasons. . Oklahoma Data Rural State Large uninsured population. Time/distance = Life
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