You asked for background information on (1) reports submitted by public safety answering points (PSAPs) under CGS § 28-25b(f) and (2) the $250,000 per year the Department of Public Health (DPH) receives for collecting, maintaining, and reporting emergency medical services data.

SUMMARY

A 1999 Program Review and Investigations Committee study of the emergency medical services (EMS) cited the lack of EMS data in spite of a 1975 law requiring data collection. According to the committee, data collection was necessary for identifying problems; monitoring, evaluating, and determining the effectiveness of the EMS system; and justifying the allocation of resources. The report indicated that Connecticut was among the minority of states that did not require some type of EMS performance study.

Among other things, the report recommended that (1) PSAPs submit information quarterly to the Office of State-Wide Emergency Telecommunications (OSET) on EMS calls they receive for medical emergencies; (2) OSET submit this information quarterly to DPH; (3) DPH collect EMS data from licensed and certified ambulance services and other EMS-related entities quarterly and prepare annual reports based on the data; and (4) DPH assume responsible for data collection because it has overall regulatory responsibility for the state's EMS system and an

existing statutory mandate to develop a uniform data system. The committee also recommended a maximum of $250,000 per year from the surcharge on E 9-1-1 calls to pay DPH for its role. The recommendations became part of PA 00-151.

The data collection project is still in the design and implementation stage, according to DPS. DPS has determined that the current data collection software needs to be upgraded to allow the data to be collected electronically.

PROGRAM REVIEW REPORT

According to a 1999 Program Review Committee report on the emergency medical services:

One of the biggest gaps in the EMS system in Connecticut is the lack of a data collection system to measure how the system is performing. There are no comprehensive data on the system, including key performance indicators like types of calls, passed calls (i.e., where the responder cannot take the call), response times, or patient outcomes. Even basic information like the number of emergency and non-emergency calls and the services that respond are not routinely collected or reported (Regulation of Emergency Medical Services: Phase 2, December 1999, p. 25).

The committee said data collection was needed to:

1. get basic descriptive information, such as the number and type of 9-1-1 calls for EMS services, what towns they were in, or what treatment was required;

2. allow towns to adequately monitor EMS service providers;

3. allow measurement and evaluation of provider services, thereby improving accountability;

4. allow providers to examine their own performance and work towards improving it;

5. evaluate the system and determine how well it works; and

6. justify the allocation of resources to EMS (p. 28).

Recommendations

The legislature adopted the committee's recommendations as part of PA 00-151, and they are codified at CGS §§ 28-25b(f) and 19a-177.

PSAP Reporting. Under CGS § 28-25b(f), PSAPs must submit to OSET quarterly reports of EMS calls they receive for medical emergencies. (A PSAP is a facility operated 24 hours a day to receive 9-1-1 calls and, as appropriate, directly dispatch emergency response services or transfer or relay E 9-1-1 calls to other public safety agencies.) For each call, the report must show the time that elapsed between when (1) the call was received and answered and (2) the call was answered and emergency response services were dispatched or the call was transferred or relayed to another public or private safety agency. Quarterly, OSET must give this information to DPH, make it available to the public, and post it on the Internet.

Ambulance Reporting. Under CGS § 19a-177, DPH must develop an EMS data collection system and track patients from initial EMS entry through emergency room arrival. Each licensed or certified ambulance service providing EMS must submit to DPH every quarter:

1. the total number of calls for EMS received during the reporting period;

2. the level of EMS required for each call;

3. the response time for each ambulance service given during that period;

4. the number of passed, cancelled, and mutual aid calls (a “mutual aid call” is a call for EMS that, according to a written agreement, a secondary or alternate EMS provider responds to because the primary or designated provider cannot because it is responding to another call or the vehicle is out of service); and

5. prehospital data for unscheduled patient transportation.

DPH may audit the service as necessary to verify that the information is accurate.

Beginning October 1, 2006, DPH must also collect this information from each licensed or certified EMS person or organization and include it in its annual reports.

DPH Annual Reports

Under CGS § 19a-177, DPH must prepare annual reports showing the:

1. total number of EMS calls each licensed or certified ambulance service receives;

2. level of EMS required for each call;

3. provider of each level of EMS given;

4. response time for each provider, using a common definition of response time; and

5. number of passed, cancelled, and mutual aid calls.

The reports must categorize the information for each town in which EMS was provided, grouped according to urban, suburban, and rural categories. Annually, DPH must submit these reports to the Public Health Committee, make them publicly available, and post them on the Internet.

Funding

The law gives DPH get up to $250,000 each fiscal year from the E 9-1-1 program funds to collect, maintain, and report the required data (CGS 28-24(7)(c)).

DPH DATA USE

As far as we were able to determine, the data project is still in the design and implementation stage. According to DPH, its only policy decision was to determine the need for modifications to the new data collection software, which was done in an attempt to collect the information electronically and “relieve the dispatch centers.” DPH describes the situation as follows:

Based on the fact that DPH receives [the] reports in paper format, it is impossible to tie the [two sets] of data together at this point. We have 17 EMS and Fire Services who have both the software and the hardware and [are] using the system to track EMS patient data. In addition, we have been working with each hospital in the state to install printers to allow this electronically collected data to be printed out and turned over to the hospital staff at time of patient delivery. It will be several more years before the hospitals will be ready to receive the data electronically. This is due in large part to the variety of hospital data collection systems now in use statewide. Once the data system is up and functioning DPH will be able to identify system weaknesses, response issues, system strengths and weaknesses and validate patient care treatment procedures. In the current fragmented paper system, the state cannot make such a review. We are still working with Department of Information Technology to build the intake system so the information can be sent electronically to the DPH data base.

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