WECAD 2008 Annual Report

ANNUAL REPORT

YEAR 2008

WESTERN EAGLE COUNTY AMBULANCE DISTRICT


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OUR MISSION:

Provide professional, compassionate health care to the

community in a safe and efficient manner. We achieve this by

timely response, providing advanced life support, prevention

programs, continuous staffing and community education.

WWhhaatt iiss EEMMSS??

Emergency Medical Services, more commonly

known as EMS, is an essential public service. You

can easily recognize EMS when you see

ambulances and medical helicopters responding to

incidents in our community, but EMS is much

more than emergency medical response and

transport. EMS is part of an intricate system of

agencies and organizations; communications and

transportation networks; trauma systems, as well

as hospitals, trauma centers, and specialty care

centers; rehabilitation facilities; and highly trained

professionals —including volunteer and career

prehospital personnel, physicians, nurses,

therapists, administrators, government officials

and an informed public that knows what to do in a

medical emergency. Each player in the EMS

system has an essential job to perform as part of

a coordinated system of care.

-Adapted from NHTSA

Service Area:

WECAD covers approximately 1100 square miles including the western portions of Eagle County and the eastern portion of Garfield County, Colorado. The response area is shared with 2 fire districts and 1 Airport Fire Department that provide medical first response services. The District does not have a licensed hospital within its borders and average transport mileage of 35 miles

one way.


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Chief Report 4

History 6

Budget 6

System Analysis 10

Community Outreach 16

Training Division 17


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I am pleased to present you with this annual report from Western Eagle County Ambulance District (WECAD). This is the first report of its kind ever produced for our community by WECAD. It is my priority that we are a transparent organization, and we provide you with information you can use about our services and practices. I am very proud of this organization and all that we have accomplished. I hope that you will agree with me that we provide

the very best service.

WECAD just completed its 20th year of service to the community, and I am glad to say that today we are providing high quality Emergency Medical Services (EMS). I have been in EMS nearly 20 years and have worked for and consulted with many EMS agencies. Western Eagle County Ambulance District is the first organization that I have come into where there were no problems. Personnel, financial health, pay, benefits, and community service are all strong within this organization. Over the past 2 years it has been my job to maintain this and look

toward the future.

The Board of Directors for the District is elected to represent you, the community. The Board ensures that your tax dollars are well spent in the provision of EMS. During the past 20 years the board has focused on ensuring that employees are the first priority. Our staff of 30 full and part time employees is the cornerstone of WECAD. As you will read later in this report nearly 72% of our income comes from property tax and 68% of our expenses are for personnel. The Board and I agree that our number one asset to providing medical care that

fulfills our mission is by taking care of our employees.

The District is looking for new and better ways to integrate into the healthcare system in the community. It is my goal that WECAD will be a community health organization that is partnered with Public Health, local medical clinics and hospitals to provide healthcare in the home. There is a desperate need in our community for healthcare. WECAD hopes to be part of the system by filling in the gap of care. Soon it is my hope that you will see an ambulance and not think Emergency but think healthcare, wellness and prevention.

CHIEF REPORT


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Last year our employees responded to 1131 calls for service at all hours of the day and night in all weather conditions including Interstate 70 and Wilderness Areas of the National Forest. They are the first line of healthcare that most patients receive in a time of need. The management of WECAD is very careful in our selection process for employees to ensure that they are a good fit for the organization and the community. We look for people that will be with our organization for many years to come and want to be invested in our community.

If you ever have questions or concerns about the care we provide, please feel free to contact me personally. Our contact information is

at the bottom of this page.

Christopher A. Montera

Chief

Our Values

Clinical Excellence

Demonstrate total commitment to the

provision of the highest standard of patient

care. Our services and activities will be ethical,

kind, compassionate, considerate and

appropriate to the patients’ needs.

Respect and Courtesy

Value diversity and will treat everyone as they

would wish to be treated, with respect and

courtesy.

Integrity

Observe high standards of behavior and

conduct, making sure we are honest, open

and genuine at all times and ready to stand up

for what is right.

Teamwork

Promote teamwork by taking the views of

others into account. We will take a genuine

interest in those who we work with, offering

support, guidance and encouragement when

it is needed.

Innovation and flexibility

Continuously look for better ways of doing

things, encourage initiative, learn from

mistakes, monitor how things are going and

be prepared to change when we need to.

Communication

Make ourselves available to those who need

to speak to us and communicate face to face

whenever we can, listening carefully to what

is said to us and making sure that those we

work with are kept up to date and understand

what is going on.

Leadership and Direction

Demonstrate energy, drive and determination

especially when things get difficult, and

always lead by example.

Contact: PO Box 1809, Eagle, CO 81631 (970)328.1130

Email: [email protected]


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The Western Eagle County Ambulance District (WECAD) is a full-service Emergency Medical Services (EMS) agency that provides 9-1-1 emergency response, occasional inter-facility (hospital to hospital) patient transportation and

medical support of special events and specialized response teams. The District was formed by a vote of area residents and property owners in 1988 in order to provide full-time ambulance service to the area. Since that time the total calls for service has increased from 208 in 1988 to 1131* in 2008 which represents a six fold increase. During the same time period, the budget has increased from $149,000

the first year to $2,939,915 in 2008.

Property tax as shown in *Fig.1 does not cover the entire costs for operations for the District according to our service plan. Fees for Service are then charged for patients that are transported by the ambulance to

hospitals.

Property Tax:

The District currently has a mil levy of 5 which equates to total revenue of $2,123,273. Another .136 mils was approved by voters in 1994 to pay for a bond issue to construct the Eagle Station located at 360 Eby Creek Rd. This .136 is set to sunset once the bond is paid off in 2010. 5 mils equals $40 per $100,000 of value on a house. The average assessed value of a home in 2008 in the District was $500,000 thus

BUDGET

HISTORY


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most property owners pay only $200 per year or $.54 per day for ambulance service.

Taxes do not pay for the entire service the district provides. This was created intentionally by the service plan in 1988. The service plan stated that the District would charge fees to ―reflect increases in costs of operation of the District and its

facilities.‖

In 2008 the fees were as follows:

In May of 2008 the District implemented a new electronic billing system that interfaces with our field electronic patient care reporting system and gives us a better picture of billing. All of the billing statistics are from May 1, 2008 – December 31, 2008. This does allow

us to look at percentages and our effectiveness at collections.

INCOME Property Tax $ 2,123,273.00 Specific Owner Tax $ 105,109.00 Investment Income $ 54,250.00 Fees for Service $ 372,033.00 Impact Fees/Lease Purchase $ 284,723.00 Other Income $ 527.00

Total Operating Income $ 2,939,915.00

Basic Life Support Base Rate $850.00

Advanced Life Support Base $950.00

Advanced Life Support II Base $1100.00

Mileage Fee $16.00/mile

District Resident Discount ($200.00)

The Board of Directors recognizes

that taxes are paid to ensure

ambulance readiness and feel it is

important to provide a discount to

residents of the district that have a

need to use ambulance services.

The resident discount is figured by

the following formula: average

assessed value for all houses in the

district = $500,000 and the district

receives $200 in taxes per year

from this $500,000 house, thus the

discount is equal to the average

amount of tax paid to the district.


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Commercial Insurance

36%

Medicaid0%

Medicare7%

Private Pay10%

Contract1%

Auto Insurance

1%

Write-offs/Bad

Debt45%

Credits by Payer 2008

The fees charged in 2008 *Fig.2 show what was charged by the type of payer. It should come as no surprise however that insurance, Medicare and Medicaid do

not pay 100% of charges for ambulance service. The Credits by Payer chart below shows that we write off or send 45% of our accounts to collections. Thus our collection rate without write-offs and bad debt is 43% of what is charged.

May 2008 – Dec. 2008 Charges Payments

Commercial Insurance $ 197,611.00 $ 127,035.00

Medicaid $ 13,072.00 $ 1,704.00

Medicare $ 56,856.00 $ 24,079.00

Private Pay $ 176,530.00 $ 33,824.00

Contract $ 4,950.00 $ 3,991.00

Auto Insurance $ 1,330.00 $ 2,394.00

Write-offs/Bad Debt $ - $ 161,121.00

Total $ 450,349.00 $ 354,148.00


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STAFFING:

In 1988 the District had

one full-time employee,

today the District has 18

full-time personnel and

12 part-time personnel

who help provide

24/7/365 ambulance

service to the Western

portion of Eagle County.

The District currently

staffs 2 ambulances at

the Paramedic level 24/7.

One is located in Gypsum

and the other is located

in Eagle. Additionally,

we have added a full-

time paramedic

supervisor that can cover

a 3rd ambulance as

needed. All of these

efforts have helped to

increase our level of

service and commitment

to the community.

Expenditures:

Expenditures for the District show that nearly all of the property tax revenue is utilized for Staffing where 72% of revenue is from taxes and 68% of expenditures is for

personnel.

The Capital line item includes a payment of $184,784 for

our Gypsum Station and new Ambulance.

Personnel 68%

Operation12%

Admin6%

Capital 14%

2008 Expenditures

Expenditures Personnel (Includes Salary and Benefits for all Personnel) $ 1,877,481.98

Operations (Includes Equipment and Supplies) $ 330,925.00 Administration $ 184,677.00 Capital (Any purchase over $5,000 with life expectancy of 5 years or more) $ 379,969.00

Total $ 2,773,052.98


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Western Eagle County Ambulance District responded to 1131 calls for service in 2008. The average emergent response time to calls was 9 minutes 11 seconds and there was an ambulance on-scene in 15 minutes 53 seconds 90% of the time. Our response times to calls in Eagle and Gypsum average 8 minutes 12 seconds and there is an ambulance on-scene in 12 minutes 25 seconds 90% of the time. This statistic is well above the standard as described by the State of Colorado in 6 CCR 1015-4 Statewide Emergency Medical and Trauma Care System Chapter 2. This standard states that Rural areas with a population from 12,000 – 100,000 should have a response time of 20 minutes or less 90% of the time. The time for these statistics starts when the 9-1-1 call is placed to our dispatch to when an ambulance arrives on-

scene.

Our crews spent 874 hours on calls last year and the average time on a call was 75.5

minutes.

SYSTEM ANALYSIS

Average Emergent Response in

Towns 6 Minutes 24 Seconds

Ambulance On-Scene in Town 90%

11 Minutes

*Measured from Ambulance Dispatched to On-

Scene


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Eagle Main Station58%

Gypsum Station42%

Responses by Station


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Patient Demographics:

Most of our patients in 2008 reported their home state as Colorado. Texas and California had the next highest amount of patients who were treated by District

personnel.

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Patient Home StateColorado #1 at 588 total patients

Patient Home States 2008


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Female44%Male

56%

Patient Gender

Female44%Male

56%

Patient Gender

The average age of all patients last year was 35 years old with a range of Newborn (minutes old) to 93

years of age.

56% of all patients were male and 32% of patients had an injury due to Trauma. 10% complained of Chest Pain or a Cardiac related

issue.

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Patient Ages 2008


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For patients that complained of an injury 75% of the Mechanism was reported as

blunt force trauma.

01020304050607080

Primary Patient Problem Top 10

Total

Blunt75%

Burn1%

Other11%

Penetrating4%

Twisting6% Unknown

3%

Mechanism of InjuryFor Trauma Patients


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Patients that were transported by District personnel last year were taken to 2 primary facilities. Patients are transported to these hospitals as determined by medical condition and severity of condition, patient/family choice, and physician choice. All patients are allowed to choose the medical facility of their choosing as long as their condition is not of a critical nature. If the condition of the patient is critical then the closest facility is chosen. Our Paramedics strive to communicate openly about medical issues and where they feel it is most appropriate to take you or

your family.

Vail Valley Medical Center55%

Valley View

Medical Center 45%

Patient Destination


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One of the many priorities that the District and Board of Directors has is to be a resource in our community. WECAD has a tradition of community training and

outreach. We offer the following services at no charge to the community:

CPR Classes

First Aid Classes

Blood Pressure Screenings

Standby Coverage for Community Events

Car Seat Safety checks

Camp 9-1-1 (Summer only)

Public Access AED program

Classroom/In-school talks

COMMUNITY OUTREACH

CPR 2008

WECAD Personnel trained 125

people in the community for

free last year in CPR. The 4

hour class is interactive and fun.

Ages for people taught last year

ranged from 9 years old to 70+.

The class teaches how to

recognize a heart attack, how to

perform CPR, use an AED and

how to help the ambulance crew

once they arrive.


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2008 was the first year that WECAD had a training division with a full-time training Captain. Our training division is responsible to provide medical training to 3 fire departments and all of the WECAD personnel. This includes over 90 fire personnel and 30 Emergency Medical Technicians (EMT) and Paramedics at WECAD. Training is provided monthly for each entity and special trainings are provided such as Advanced Cardiac Life Support, Pediatric Advanced Life Support, Advanced Medical Life Support and many other courses. Paramedics and EMTs get 36 hours of continuing education per year and are required to maintain other certifications as well. Monthly Continuing Education is provided by well-known speakers from the state and region. Additional education is provided by our Medical Director Benji Kitagawa, MD.

Last year our training division provided over 200 hours of continuing education opportunities for WECAD personnel and Fire

personnel.

TRAINING DIVISION

WECAD 2008 Annual Report

Documents

Transcript of WECAD 2008 Annual Report