EMSC Program Update

CAPT Dan Kavanaugh, MSW, LCSW-C

Federal EMSC Program

EMSC Program

HRSA / MCHB / EMSC

Mary Wakefield, BSN, MSN PHdHRSA Administrator

PETER VAN DYCK, MDAssociate Administrator

Maternal and Child Health BureauDAVID HEPPEL, MDChief

Division of Child, Adolescent & Family Health

PETER CONWAYDeputy

Division of Child, Adolescent & Family Health

DAN KAVANAUGH, MSW, LSCW-CSenior Program Manager, EMSC Program

TINA TURGEL, BSN, RN, BCNurse Consultant, EMSC Program

EMSC Program

New Leadership at HRSA

Dr. Mary Wakefield

• New HRSA Administrator

• Came from the Center for Rural Health at the University of North Dakota

where she was the Director and the Associate Dean at the University of

North Dakota School of Medicine

• Received her MSN and her PhD from the University of Texas at Austin

• Received her BS in nursing from the University of Mary at Bismarck, North

Dakota

• Served as the Chief of Staff for United States Senator Kent Conrad (D-ND)

• Served as a Legislative Assistant and Chief of Staff to Senator Quentin

Burdick (D-ND).

EMSC Program

The Wakefield Act

• Passed in House

– Vote: 390-6

– March 30, 2009

• Reintroduced into the Senate (S 408) by Sen.

Daniel Inouye of Hawaii and Sen. Orrin

Hatch of Utah.

– No vote scheduled

• If passed would reauthorize the EMSC

program for 5 more years beginning

October 2009

EMSC Program

FY 2010 Budget:

– President: $20,000,000

– House: TBD

– Senate: TBD

FY 2009 Budget:

– Omnibus legislation contains an increase of $546,000.00 for the

remainder of this year for a total budget of $20,000,000

EMSC Funding

EMSC Program

FY 09 Partnership Grants

• 54 State Partnership Grants (45 new awards and 9 continuation awards)

- $115,000 per year for 9 continuation

- $130,000 per year for 45 new

- Start date March 1, 2009

- 9 competing continuation applications expected in Fall 2009 at

$130,000 each for FY 10.

● Responsible for working on program performance measures

EMSC Program

FY09 Targeted Issue Grants

- 13 Continuing Targeted Issue Grants

- FY 08- REUNITE: A Novel Imaging System for Children Separated

During Disaster. Original PI: Michael Shannon, MD. Current PI: Sarita Chung, MD, Children’s Hospital Boston

- Family Presence During Pediatric Trauma Team Activation: Measuring the Effects of a Multidisciplinary Approach to Patient-Family-Centered Care. PI: Karen O’Connell, MD, Children’s Research Institute, CNMC

- Michigan Pediatric Error and Excellence Discovery Study. PI: Richard Lammers, MD, Michigan State University Kalamazoo Center for Medical Studies

- Efficacy of Driving Simulator Training for Novice Teen Drivers.PI: Brendan Campbell, MD. Connecticut Children’s Medical Center

EMSC Program

FY09 Targeted Issue Grants- 13 Continuing Targeted Issue Grants – FY 2007

- Development and Evaluation of Targeted ATV Safety Educational Strategies for Rural Children. PI: Mary Aitken, MD, Arkansas Children’s Hospital Research Institute

- Evaluation of the Pediatric Assessment Triangle as an Assessment Tool for Children in the Prehospital Setting (PAT Evaluation Study). PI: Marianne Gausche-Hill, MD, Harbor-UCLA Medical Center

- Pediatric Quality Improvement Modules: Head Trauma, Seizures and Diabetic Ketoacidosis. Co-PIs: Evelyn Lyons, MD, and Mark Chicon, MD, Loyola University Chicago

- Impact of Pre-hospital Factors on Function Independence of Injured Children. PI: Gary Smith, MD, DrPH, The Ohio State University Research Foundation

EMSC Program

FY09 Targeted Issue Grants

Continued- Defining Quality Performance Measures for Pediatric Emergency Care.

PI: Evaline Alessandrini, MD, The Children’s Hospital of Philadelphia (original)/Cincinnati Children’s Hospital Medical Center (current)

- Pediatric Emergency Department (ED) Use of an Asthma Educational Intervention to Improve Health Care Utilization. PI: Charles Macias, MD, Baylor College of Medicine

- Diagnostic Signatures in Febrile Infants. PI: Octavio Ramilo, MD, U of T Southwestern Medical Center at Dallas

- Enhancing Coordination Between EMS Systems and Primary Care for Injured Adolescents with Alcohol Problems and Post Traumatic Stress Disorder (PTSD). PI: Douglas Zatzick, MD, University of Washington

- A Multicenter Study to Evaluate the Effect of an Education Pediatric Pain Management Program on Prehospital Providers’ Knowledge and Practice.PI: Halim Hennes, MD, Medical College of Wisconsin (original)/UT Southwestern Medical Center at Dallas (current)

EMSC Program

Network Development

Demonstration Project Pediatric Emergency Care Applied

Research Network (PECARN)

• Four NDDP cooperative agreements

- $ 890,000 per year

• Project Period: 9/30/2008 to 9/29/2011

• One Central Data Management Coordinating Center (CDMCC) is

being re-competed this year. Applications were due March 23, 2009.

• www.pecarn.org

EMSC Program

PECARN Studies• Application of Transcriptional Signatures for Diagnosis of Febrile Infants within

the PECARN Network: goal is to incorporate a new RNA-based diagnostic technology, called transcriptional signatures, to distinguish between bacterial and non-bacterial infections in febrile infants who present to the ER.

• Clinical Decision Rules for Identifying Children at Low and High Risk for Traumatic Brain Injuries after Mild Blunt Head Trauma: This is a prospective study of children with minor-to-moderate blunt head trauma with a goal of identifying high-risk and low-risk indicators of traumatic brain injury (TBI). This study is co-funded by HRSA/EMSC and MCHB Research Division. Completion 2006. Numerous presentations at PAS & SAEM. Manuscript has been submitted.

• Development of Research Partnerships with EMS Agencies and Descriptive Study of EMS Pediatric Population within PECARN: The objective of this protocol is to study pediatric emergency medical services (EMS) within the PECARN network and establish the network’s capability to collect pre-hospital data. This would be a descriptive study that will initiate date collection from EMS agencies.

• Pediatric Seizure Study: Randomized, Double-blinded trial of Lorazepam and Diazepam. 9 of 11 participating sites are enrolling, so far 22% of projected enrolled.

EMSC Program

PECARN Studies• PECARN Core Data Project (PCDP): provides important epidemiological

information regarding pediatric emergency department visits in the PECARN network

• Pediatric Patient Safety in Emergency Departments: focuses on pediatric patient safety in the emergency departments. First phase involved survey of pediatric ED’s. A Manuscript was submitted. Second phase involves transmitting incident reports to the data center and classifying and quantifying ED events using a consensus process.

• Therapeutic Hypothermia After Cardiac Arrest in Children (THAPCA): a prospective cohort study of children experiencing cardiopulmonary arrest to determine whether children have higher survival rates and improved neurological outcomes if treated with mild hypothermia after cardiac arrest. Funding from NHLBI as a U01.

• Intra-abdominal Fat and Appendix Visualization: currently in study development; finalizing protocol for submission to IRB for approval. Protocol hopeful for mid-March. Training/enrollment to begin by summer.

• Performance Measures: initial pool of 333 measures which have been reduced to 104. Further reduction to be completed then remaining measures will be sent to EMSC Stakeholders for further feedback.

• Clinical Decision Rule to Identify Children with Intra-abdominal Injuries: prospective study of children with blunt torso trauma with a goal of identifying high-risk and low-risk indicators of intra-abdominal injury (IAI). The study is funded by the Centers for Disease Control and Prevention.

EMSC Program

National EMSC Data Analysis

Resource Center (NEDARC)• Project Period: 7/1/08 – 6/30/11

• Objective: To help EMSC grantees and State EMS offices develop their own

capabilities to collect, analyze, and utilize EMS and other healthcare data to

improve the quality of care in state EMS and trauma systems

• Principal Investigator: J. Michael Dean, MD

• Director: Michael Ely

(801) 585-9761 or michael.ely@hsc.utah.edu

• www.nedarc.org

EMSC Program

EMSC National Resource Center

• Project Period: 7/01/2008 - 6/30/2011

• Objectives:

– Identify and organize resources needed to implement national EMSC activities;

– Provide guidance to grantees on securing funds, developing strategic plans, implementing EMSC performance measures, and fulfilling grant expectations;

– Provide support to the EMSC federal program managers

• PI & Executive Director: Tasmeen Weik, DrPH NREMTP

tsingh@cnmc.org

• Medical Director: Joseph Wright, M.D.

• www.childrensnational.org/emsc

EMSC Program

Interagency Agreements

Betty Hastings, MSW

Indian Health Services EMSC Coordinator

Indian Health Services

NHTSA’s Office of EMS

Drew Dawson

Director

EMSC Program

Other Happenings

• HRSA Office of OPR: OPR is evaluating progress of 7 Targeted Issue grants to make sure they are meeting their stated goals and objectives

• NIH Roundtables on Emergency Care: NIH roundtables on neuro-pysch, med-surg, and trauma.

• HHS/ASPR Emergency Care Coordinating Center: is located within the Office of Assistant Secretary for Preparedness and Response in the DHHS. EMSC is represented on the Council for Emergency Medical Care.

• FICEMS: HRSA continues to be represented on FICEMS by Peter van Dyck. Susan McHenry (NHTSA) and Dan Kavanaugh co-chair the data and research technical working group.

EMSC Program

Grant Reviewers Needed

EXPERTISE IN:

Emergency care issues

Rural health

Health professions training

For more information go to:

http://www.hrsa.gov/grants/reviewers.htm

EMSC Program

EMSC Program Contacts

• Dan Kavanaugh, MSW, LCSW-C, CAPT. USPHS, Senior Program Manager

(301) 443-1321 or Dan.Kavanaugh@hrsa.hhs.gov

– NRC

– NEDARC

– Targeted Issues

– PECARN

• Tina Turgel, BSN, BC, Nurse Consultant

(301) 443-5599 or Christina.Turgel@hrsa.hhs.gov

• State Partnership