Adopted Budget Personnel Services $ 909,745 $ 1,279,673 $ 1,479,830 Materials & Services 287, , ,120.

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Emergency Medical Services Program Description Fund 10 Directorate 05 Division 63 Department 205 The Emergency Medical Services (EMS) program is responsible to ensure the highest quality medical care

1 Emergency Medical Services Program Description Fund 10 Directorate 05 Division 63 Department 205 The Emergency Medical Services (EMS) program is responsible to ensure the highest quality medical care is delivered to patients on emergency scenes by District responders, and now includes a second program, mobile integrated health. Summary Expenditures Revised Personnel Services $ 909,745 $ 1,279,673 $ 1,479,830 Materials & Services 287, , ,120 Total Expenditure $ 1,197,472 $ 1,732,289 $ 1,771,950 Personnel Summary 1 Position Significant Changes Division Chief Medical Services Chief Battalion Chief EMS Officer EMS Assistant OHS Business Manager Total Full-Time Equivalents (FTE) A new Division Chief position was added with the addition of the mobile integrated health program and the Newberg contract brings the Medical Services Chief position. Materials and Services expenses for 5320 EMS Supplies are budgeted in cost center. Medical supervision is provided for in Account 5413 ($110,000) and $44,000 in other consultant services is budgeted for mobile healthcare and regional data depository projects. In addition, the District must recertify its Paramedics every two years and accordingly, the certification fees in account 5502 were increased as this is a recertification year. Billing agent fees are reduced in account 5418 as the District is planning to bring transport billing in-house. 417

2 Emergency Medical Services, continued Status of Service Measures Maintain cardiac arrest survival rate. Goal(s)/Call(s) for Action: Service Type(s): Measured By: Status or Outcome: I/D Essential Sustained or improved percentage of survival of cardiac arrest patients (Vfib and overall). Influenced by Hands-Only CPR training, Public Access to Defibrillators program, Pit Crew CPR and PulsePoint implementation. Due to small numbers per year, staff must look at long-term trending. Awaiting tabulation of 2015 data for accurate numbers. Status of Change Strategies Transition from EMS Officer to Medical Services Officer as the base staffing model for the EMS Division and to support District Operations. Goal(s)/Call(s) for Action: I/D Impact: Increase required Duration: Year 1 of 1 Description: Move to a Medical Services Officer as the staffing model within the EMS Division. Additional staffing is required to support the expansion of District Operations. Partner(s): Integrated Operations, Human Resources, Finance. Status or Outcome: Completed. New job description written and approved by Civil Service. Testing process completed with successful hiring of three MSOs, bringing EMS Division to strength of four MSOs. Each MSO has specific assignments to support the District s operational needs and monitor EMS performance. Develop innovative healthcare partnerships that benefit both District goals and Oregon s Triple Aim. Goal(s)/Call(s) for Action: I/D; VI/A and 1 Impact: Increase required Duration: Year 2 of 4 Description: Explore healthcare partnerships based upon information gained from research pilots performed during the first two years. Associated costs will be staff FTE, training cost, and mobile healthcare equipment. Partner(s): EMS, Integrated Operations, Information Technology, Training, hospital partners Status or Outcome: First Mobile Integrated Healthcare (MIH) contract signed with Legacy following evaluation of pilot data. MIH metrics are being jointly developed with Health Share of Oregon, Family Care and EMS agency partners. MIH proposals were presented/being considered by several potential partners. Phase II of Clackamas County frequent caller pilot program underway. 418

3 Status of Change Strategies Complete performance metrics for Stroke, Trauma System Entry, and STEMI. Emergency Medical Services, continued Goal(s)/Call(s) for Action: I/D and 2; VI/A and 1 Impact: neutral Duration: Year 2 of 3 Description: Develop best practice metrics to measure system performance in management of Stroke, TSE and STEMI. Metrics will help quantify patient outcome and value-based performance. Partner(s): EMS, Integrated Operations, Information Technology, Training, external healthcare partners Status or Outcome: Draft Key Performance Indicators (KPIs) were written for Cardiac Arrest, STEMI, Stroke, Sepsis, Pediatrics, Airway and Trauma. Metrics include established system indicators that affect patient outcome. National KPIs from the EMS Compass Project are included as they evolve. Medical Services Officers are assigned management of specific KPIs. January ALS In-service delivered expectations and education on District KPIs to our paramedics. Create a quality improvement process to communicate EMS performance metrics to the Training Division. Goal(s)/Call(s) for Action: I/D Impact: neutral. Transfer EMS training funds to Training Division. Duration: Year 1 of 1 Description: Infuse EMS performance metrics into a structured training/evaluation process to target training needs. Supports outcome-driven, value-based patient care objective. Partner(s): EMS, Training, Integrated Operations, Information Technology Status or Outcome: A process was implemented to communicate EMS KPIs to the Training Division. These metrics were used to develop Training KPIs used during cardiac arrest and airway simulations. The process will continue during pediatric simulations being planned for ALS In-service material reinforced the KPIs developed during the process. Additional Accomplishments Completed first year of Clackamas County transport subcontract Completed EMS equipment upgrade; Trauma/active threat kit, Airway kit, addition of IV pumps, electronic thermometers and laryngoscopes Added an Assistant Medical Director Activities Summary EMS Service Measures (Calendar year) Projected Estimated Patient Care Reports Written 16,379 19,699 21,027 22,234 Number of EMS Responses 29,829 32,067 34,472 37,057 Cardiac Arrest Survival % V-Fib / Overall 36%/15.4% 29%/10.4% 40%/16% 42%/18% 419

4 Emergency Medical Services, continued Tactics Define key performance indicators (KPI) for EMS services at the individual, unit, division, and system levels. Goal/Strategy: Goal 2 Strategy 2.5 Tactic 2.5.2, Timeframe: 12 months Partner(s): Information Technology, Patient Records, Hospital QI, Regional STEMI Impact: None Measured By: Completed KPI that meet national standards, and generate meaningful outcome/feedback data to Operations and individual crews. Develop and expand innovative healthcare partnerships that benefit District goals and Oregon s Triple Aim initiatives. Goal/Strategy: Goal 3 Strategy 3.6 Tactic Timeframe: 18 months Partner(s): Integrated Operations, MIH, Finance, Fire Chief s Office, Coordinated Care Organizations (CCOs), Other Healthcare Systems Impact: Increase required Measured By: Additional Mobile Integrated Healthcare (MIH) contracts and community partners. Reduced patient hospital readmission rate. Increased revenue. Create processes and policy to manage vulnerable populations and high 911 utilization groups. Goal/Strategy: Goal 2; Goal 3 Strategy 3.6 Tactic Timeframe: 12 months Partner(s): Partner counties, neighboring response agencies, private ambulance, primary care providers, licensed clinical social workers, TC911 Impact: Increase required Measured By: Lowered number of 911 calls placed by frequent callers, lower number of ED visits. Completed written policy. Enhance and diversify EMS and ambulance transport services, and provide for the requisite scope of practice, tools, training and system integration. Goal/Strategy: Goal 3 Strategy 3.6 Tactic Timeframe: 24 months Partner(s): Operations, Fire Chief s Office, County EMS Offices, Private Ambulance Impact: Increase required Measured By: Increased service types with requisite scope of practice, tools and training in place. Improved relationships, service delivery, data sharing and billing processes. 420

5 Emergency Medical Services, continued Revised Proposed Approved General Fund 5001 Salaries & Wages Union $ 233,720 $ 524,507 $ 394,715 $ 394,715 $ 394, Salaries & Wages Nonunion 197, , , , , Vacation Taken Union 30,329 36,390 25,059 25,059 25, Vacation Taken Nonunion 13,965 14,534 29,358 29,358 29, Sick Leave Taken Union (3,555) 10,400 6,659 6,659 6, Sick Taken Nonunion 1,593 2,907 7,800 7,800 7, Personal Leave Taken Union 4,464 5,200 3,527 3,527 3, Personal Leave Taken Nonunion 3,657 1,247 4,129 4,129 4, Comp Taken Nonunion Vacation Sold 10,338 13,990 11,026 11,026 11, PEHP Vac Sold at Retirement 11,294 11,294 11, Deferred Comp Match Union 12,056 23,397 19,578 19,578 19, Deferred Comp Match Nonunion 16,316 16,871 37,211 37,211 37, Overtime Union 106,378 12,608 2,000 2,000 2, Overtime Nonunion 600 1,500 1,500 1,500 1, PERS Taxes 123, , , , , FICA/MEDI 40,650 62,579 72,026 72,026 72, Worker's Comp 16,375 26,847 19,582 19,582 19, TriMet/Wilsonville Tax 4,243 6,215 8,228 8,228 8, OR Worker's Benefit Fund Tax Medical Ins Union 40,856 88,550 82,668 82,668 82, Medical Ins Nonunion 35,502 38,381 64,406 85,875 85, Post Retire Ins Union 1,400 3,000 2,400 2,400 2, Post Retire Ins Nonunion 1,800 1,800 3,600 3,600 3, Dental Ins Nonunion 4,200 3,688 4,588 4,588 4, Life/Disability Insurance 1,793 2,811 2,923 2,923 2, Uniform Allowance 2,194 1,500 2,450 2,450 2, Employee Tuition Reimburse 2,637 11,280 6,075 6,075 6, Vehicle/Cell Allowance 5,760 5,760 5,760 5,760 5,760 Total Personnel Services 909,745 1,279,673 1,458,360 1,479,830 1,479, Office Supplies Special Department Supplies Training Supplies 72 3,800 1,000 1,000 1, EMS Supplies 57, ,810 1,000 1,000 1, Fire Fighting Supplies Protective Clothing ,250 1,250 1, Noncapital Furniture & Equip 3,400 2,300 2,300 2, Apparatus Fuel/Lubricants 2,465 7,500 7,500 7,500 7, M&R EMS Equip 13,132 66, M&R Office Equip 1, Insurance Premium 360 1,000 1,000 1, Consultant Fees 93, , , , , Other Professional Services 8,325 24,530 24,530 24,

6 Emergency Medical Services, continued 5415 Printing 38 Revised Proposed Approved 5417 Temporary Services 7, Trustee/Administrative Fees 41,125 31, External Training 7,117 5,910 7,030 7,030 7, Travel and Per Diem 7,258 13,400 15,636 15,636 15, Citizen Awards Employee Recog & Awards 2,609 1,900 1,900 1,900 1, Postage UPS & Shipping Dues & Subscriptions 1,623 1,983 7,590 7,590 7, Certifications & Licensing 49,023 6,075 64,024 64,024 64, Misc Business Exp Planning Retreat Expense Total Materials & Services 287, , , , ,120 Total General Fund $ 1,197,472 $ 1,732,289 $ 1,750,480 $ 1,771,950 $ 1,771,

7 EMS / Occupational Health / Wellness Program Description Fund 10 Directorate 05 Division 47 Department 421 The combined EMS, Behavioral Health, and Occupational Health/Wellness programs were reorganized in, with the prior year personnel and program budgets moved to the Fire Chief s Office (Behavioral Health), new EMS, and the new Occupational Health/Wellness program. Occupational Health/Wellness was moved to the Business Operations Directorate, effective July 1, Summary Expenditures Personnel Services $ 1,426,047 Materials & Services 376,664 Total Expenditure $ 1,802,711 Personnel Summary Position Division Chief 1.00 Battalion Chief 1.00 EMS Officer Paramedic 1.00 Program Manager 1.00 Wellness Coordinator 1.00 Program Assistant 1.00 EMS Specialist 1.00 Nurse 1.00 Behavioral Health Specialist 0.50 Total Full-Time Equivalents (FTE) 8.50 Significant Changes All former department costs, Service Measures, and Change Strategies were previously moved to departments 150, 470, and

8 EMS / Occupational Health / Wellness, continued Revised Proposed Approved General Fund 5001 Salaries & Wages Union $ 85, Salaries & Wages Nonunion 640, Vacation Taken Union 16, Vacation Taken Nonunion 52, Sick Taken Nonunion 12, Personal Leave Taken Union 2, Personal Leave Taken Nonunion 2, Comp Taken Nonunion 1, Vacation Sold 24, Vacation Sold at Retirement 7, Deferred Comp Match Union 4, Deferred Comp Match Nonunion 29, Overtime Union 132, Overtime Nonunion 4, PERS Taxes 175, FICA/MEDI 69, Worker's Comp 15, TriMet/Wilsonville Tax 6, OR Worker's Benefit Fund Tax Medical Ins Union 19, Medical Ins Nonunion 91, Post Retire Ins Union Post Retire Ins Nonunion 5, Dental Ins Nonunion 11, Life/Disability Insurance 5, Uniform Allowance 1, Vehicle/Cell Allowance 7,225 Total Personnel Services 1,426, Office Supplies 1, Special Department Supplies 8, Training Supplies Physical Fitness 9, EMS Supplies 42, Protective Clothing Noncapital Furniture & Equip Apparatus Fuel/Lubricants 6, M&R EMS Equip 12, M&R Office Equip 1, Consultant Fees 104, Other Professional Services 107, Printing Temporary Services 54, Rent/Lease of Building 2,

9 EMS / Occupational Health / Wellness, continued 5461 External Training 6,435 Revised Proposed Approved 5462 Travel and Per Diem 13, Citizen Awards Employee Recog & Awards Postage UPS & Shipping Dues & Subscriptions 1, Certifications & Licensing 3, Misc Business Exp 1, Planning Retreat Expense Inventory Over/Short/Obsolete (417) 5462 Travel and Per Diem 13, Citizen Awards Employee Recog & Awards Postage UPS & Shipping Dues & Subscriptions 1, Certifications & Licensing 3, Misc Business Exp 1, Planning Retreat Expense Inventory Over/Short/Obsolete (417) Total Materials & Services 376,664 Total General Fund $ 1,802,

10 426

Adopted Budget Personnel Services $ 1,177,593 $ 1,123,525 $ 1,254,815 $ 1,339,194 Materials & Services 405, , , ,089

Adopted Budget Personnel Services $ 1,177,593 $ 1,123,525 $ 1,254,815 $ 1,339,194 Materials & Services 405, , , ,089 Finance Program Description Fund 10 Directorate 03 Division 20 Department 210 The Finance Department provides financial accounting, budgeting, and reporting services; treasury and investment management;