Emergency Medical Services

Structure and Financing of Ambulance Services– IS 11-062

Mark NewmanOklahoma State Department of

Health

House Bill 1888 SummaryTitle 19 -1201-1221HB 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 SummaryTitle 19 -1201-1221Also amended another statute: 63 O.S. § 1-2504.1A.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 affectsO.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.

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 affectsO.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

House Bill 1888 affectsO.A.C. 310:641-3-120 (c)

HB 1888By 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 McClain McCurtain

McIntosh Murray Noble Okmulgee Osage

Ottawa Seminole Sequoyah Stephens Washington

Washita26 of the 75 plans have been submitted

Funding for EMS

Funding Options

Resources

Statewide Funding Districts

Cigarette Tax (39.2%) $10,208,891Tobacco Products (4.2%) $1,104,342All Tribal Tobacco (10.1%) $2,622,262Vehicle Collections (13.3%) $3,459,716County Fine & Fees (33.2%)$8,657,889

Annual Average Total $26,053,100

Annual Collections - 5 Year Average

Annual Distributions – 5 Year Average

OSDH $2,605,310 (10.0%)EMS Agencies $1,641,345 (6.3%)

Hospitals $19,461,666 (74.7%)Physicians $2,344,779 (9.0%)

Cumulative Distribution Totals to date.

EMS distribution $10,726,312.92

Hospital distribution $132,248,962.93

Physician Distribution $14,921,087.30

Total Distribution $157,896,363.15

Trauma Care Assistance Revolving Fund

5 Year Annual Average – 10% Expenses

State FY 2009 $38,190State FY 2010 $41,215State FY 2011 $26,091State FY 2012 $4,834

(thru SFY 2012 Q1 - 09-30-2011)

Fund Balance $90,330

Annual Collections Annual Distributions

State FY 2009 $10,000 State FY 2010 $5,000State FY 2011 $- 0 -

State FY 2012 $5,000

Claims Paid to Date $20,000

EMT Death Benefit Revolving Fund

Why is EMS Coverage So Important in Oklahoma? Some reasons. . . .

Oklahoma DataRural State

Large uninsured population.Time/distance = Life

Questions