F-M Ambulance Service Inc

NORTH DAKOTA FM AMBULANCE RURAL EMS PROGRAM - EMERGENCY MEDICAL SERVICE (EMS) PROVIDERS ACROSS THE US CONTINUE TO FACE MULTIPLE CHALLENGES AS THEY STRIVE TO 'ANSWER THE CALL' IN 911 MEDICAL EMERGENCIES. THE OVERALL PURPOSE OF THE SAMHSA FY 2024 RURAL EMS TRAINING PROGRAM AS PROPOSED IS TO RECRUIT, TRAIN AND MAINTAIN EMS PERSONNEL ACROSS THE RURAL AND FRONTIER PROJECT AREA THAT WILL COMPETENTLY AND COMPASSIONATELY SERVE RURAL POPULATIONS. THESE PROVIDERS WILL BE COGNIZANT AND PROACTIVE IN THEIR ABILITY TO ADDRESS PATIENTS WITH SUBSTANCE ABUSE DISORDERS, PARTICULARLY AS THEY CO-OCCUR WITH BEHAVIORAL HEALTH AND/OR MENTAL HEALTH CONDITIONS AND PRIOR TRAUMA AND WILL BE KNOWLEDGEABLE OF RELEVANT RECOVERY CARE OPTIONS. AS A RECIPIENT OF CONSECUTIVE SAMHSA RURAL EMERGENCY MEDICAL SERVICES TRAINING GRANTS, SANFORD HEALTH’S EMS EDUCATION (SHEMSE) TRAINING CENTER HAS BEEN WORKING DILIGENTLY TO ADDRESS THESE CHALLENGES ACROSS THE EXISTING PROJECT’S ELEVEN RURAL AND/OR FRONTIER PARTNERS IN THE NORTHERN MIDWEST. WE WILL USE THIS EXPERIENCE TO ADD A REMOTE, RURAL AREA IN IDAHO TO ENHANCE THEIR EMS RESPONSES, AVAILABILITY TO TECHNOLOGY, AND MENTAL HEALTH/SUBSTANCE ABUSE TRAINING. IN ADDITION, A PROPOSED PARTNERSHIP WITH THE WHITE EARTH RESERVATION AND ITS AMBULANCE SERVICE IS PROPOSED. THIS COLLABORATION WILL ENABLE TRAINING WHICH WILL INCLUDE SUBOXONE TREATMENT IN EMS/CP INTERACTIONS, POST-TRAUMATIC GROWTH, AND HARM REDUCTION SERVICE DELIVERY FOR THE SERVICES THAT RESPOND TO THE RESIDENTS OF THE RESERVATION AND ITS NEIGHBORING COMMUNITIES. OVER THE 2-YEAR PROJECT TIMEFRAME, SANFORD HEALTH EMS EDUCATION (SHEMSE) AND ITS PARTNERS WILL MEET THESE CHALLENGES IN PART THROUGH THE TRAINING AND CERTIFICATION OF 40 UNDUPLICATED EMTS, 4 PARAMEDICS, AND UP TO 4 COMMUNITY PARAMEDICS (CP). THIS WILL INCORPORATE TARGETED TRAINING ON SUBSTANCE USE DISORDERS, CO-EXISTING SUD AND BEHAVIORAL CHALLENGES, AND INCLUDE AN AWARENESS OF TRAUMA-INFORMED, RECOVERY-BASED CARE FOR PEOPLE WITH SUCH DISORDERS IN EMERGENCY SITUATIONS. ONGOING TRAINING WILL ALSO TARGET EXISTING EMS PROVIDERS, TO ENABLE THEM TO MAINTAIN LICENSES AND CERTIFICATIONS RELEVANT TO SERVE IN THEIR RESPECTIVE EMS AGENCIES. THIS ONGOING CERTIFICATION TRAINING WILL BE AUGMENTED WITH FOCUSED COVERAGE OF MENTAL AND SUBSTANCE USE DISORDERS, TOGETHER WITH OPTIONS FOR TRAUMA-INFORMED RECOVERY-BASED TREATMENT OPTIONS. THE FY 2024-2026 EMS TRAINING PROJECT WILL IMPLEMENT A STRUCTURED, ITERATIVE MONITORING AND DATA COLLECTION PROCESS TO DRIVE ONGOING PROJECT MANAGEMENT AND TO STRENGTHEN SHORT- AND LONG- TERM OUTCOMES. THE PROJECT DIRECTOR AND PROJECT GUIDANCE TEAM WILL OVERSEE AN ADAPTIVE MANAGEMENT APPROACH THAT UTILIZES REQUIRED DATA COLLECTION AND REPORTING.

FM AMBULANCE EMS EDUCATION RURAL EMERGENCY MEDICAL SERVICES - EMERGENCY MEDICAL SERVICE (EMS) PROVIDERS IN THE RURAL AND FRONTIER REGIONS OF THE UPPER MIDWEST CONTINUE TO FACE MULTIPLE CHALLENGES AS THEY STRIVE TO ‘ANSWER THE CALL’ IN 911 MEDICAL EMERGENCIES. SANFORD HEALTH EMS EDUCATION (SHEMSE) WILL ADDRESS THE CRITICAL NEED TO RECRUIT, TRAIN, AND MAINTAIN EMS PROVIDERS ACROSS THE PROJECT AREA OF RURAL AND FRONTIER NORTH DAKOTA AND MINNESOTA THROUGH THE TRAINING AND CERTIFICATION OF 50 UNDUPLICATED EMTS AND UP TO 4 PARAMEDICS. IN ADDITION, SPECIALIZED RECERTIFICATION TRAINING WILL ENABLE EXISTING EMTS AND PARAMEDICS ACROSS THE PARTNERING RURAL SERVICES TO MAINTAIN THEIR LICENSES AND CERTIFICATIONS. SPECIALIZED COURSES SUCH AS ADVANCED STOKE LIFE SUPPORT AND PREHOSPITAL TRAUMA LIFE SUPPORT WILL BE PROVIDED AS REQUESTED. THIS TRAINING WILL ALSO ENCOMPASSES MENTAL AND SUBSTANCE ABUSE DISORDERS, AND INCLUDE A FEASIBILITY ASSESSMENT TO ESTABLISH PEER ASSISTED CRISIS TEAMS (PACT) AND PROVIDE CRISIS INCIDENT STRESS MANAGEMENT (CISM) TRAINING. AS A RECIPIENT OF A SAMHSA FY 2021 RURAL EMERGENCY MEDICAL SERVICES TRAINING GRANT, SANFORD HEALTH’S EMS EDUCATION (SHEMSE) TRAINING CENTER HAS BEEN WORKING DILIGENTLY TO ADDRESS THESE CHALLENGES ACROSS THE EXISTING PROJECT’S ELEVEN RURAL AND/OR FRONTIER PARTNERS IN THE NORTHERN MIDWEST. BUILDING UPON THE SUCCESSES AND LESSONS LEARNED TO DATE, THE HIGHEST PRIORITY IN FY 2022 WILL BE TO INCREASE THE NUMBER OF EMS PROVIDERS THAT ARE TRAINED, RETAINED, AND/OR SUSTAINED ACROSS AN EXPANDED RURAL AND FRONTIER FOOTPRINT. COLLABORATION WITH LOCAL AND REGIONAL FIRE AND EMS ORGANIZATIONS WILL BE IMPLEMENTED TO STRENGTHEN RECRUITMENT AND TRAINING INITIATIVES. . THE PROJECT WILL BE IMPLEMENTED IN TWO PARALLEL AND INTEGRATED TRACKS. EIGHTY STUDENTS WILL BE RECRUITED AND TRAINED TO THE EMT CERTIFICATION LEVEL, WITH FORTY IN EACH CLASS IN TWO SUCCESSIVE SEMESTERS. 2-4 PARAMEDIC STUDENTS WILL BE SUPPORTED DURING THEIR 2ND YEAR OF TRAINING. INNOVATIVE RECERTIFICATION TRAINING WILL BE PROVIDED TO A MINIMUM OF 100 CURRENT EMT AND PARAMEDICS, TO ENABLE THESE RURAL PROJECT PARTNER PROVIDERS TO MAINTAIN THEIR LICENSURE, AS WELL AS THEIR ENTHUSIASM FOR EMERGENCY MEDICINE. THIS WILL BE INTEGRATED WITH MENTAL HEALTH TRAINING THAT INCORPORATES A DUAL FOCUS ON EMS PATIENTS AND PROVIDERS. IT WILL INCLUDE THE MENTAL HEALTH EMERGENCIES THAT EMS PROVIDERS MAY ENCOUNTER, RECOGNIZE, ASSESS AND TREAT WITH THEIR PATIENTS, TOGETHER WITH THE MENTAL HEALTH AND/OR SUBSTANCE USE CHALLENGES THAT EMS PERSONNEL MUST MANAGE TO MAINTAIN THEIR OWN MENTAL STABILITY AND RESILIENCE. THIS IS INCLUDED WITHIN THE FIRST FEW WEEKS OF TRAINING AT THE EMT LEVEL. SPECIFIC TRAINING ON THE USE OF NALOXONE WILL BE INCLUDED IN BOTH EMT CERTIFICATION AND EMT/PARAMEDIC RECERTIFICATION TRAINING. THE FY 2022 EMS TRAINING PROJECT WILL IMPLEMENT ASTRUCTURED, ITERATIVE MONITORING AND DATA COLLECTION PROCESS TO DRIVE ONGOING PROJECT MANAGEMENT AND TO STRENGTHEN SHORT- AND LONG-TERM OUTCOMES. THE PROJECT DIRECTOR AND PROJECT GUIDANCE TEAM WILL OVERSEE AN ADAPTIVE MANAGEMENT APPROACH THAT UTILIZES REQUIRED DATA COLLECTION AND REPORTING.

FM AMBULANCE RURAL EMERGENCY MEDICAL SERVICES - THE GOAL OF FY 2021 FM AMBULANCE PROJECT IS TO SUBSTANTIVELY EXPAND THE REACH OF RURAL EMS TRAINING TO HELP ACHIEVE A FULLY STAFFED AND WELL- TRAINED CADRE OF EMERGENCY MEDICAL SERVICES PERSONNEL THAT PROACTIVELY SUPPORT SANFORD’S RURAL HEALTH SERVICES AND CLIENTELE ACROSS THE NORTHERN MIDWEST. THEPROPOSED PROJECT IS COMPRISED OFTHE SHEMSE TRAINING CENTER AND ELEVEN RURAL EMS PARTNERS IN RURAL AND FRONTIER AREAS OF ND, SD, AND MN. THE CHALLENGES FACED BY EMERGENCY MEDICAL SERVICE (EMS) PROVIDERS IN THE RURAL AND FRONTIER AREAS OF THE UPPER MIDWEST HAVE BEEN SIGNIFICANTLY EXACERBATED BY THE ONGOING COVID-19 PANDEMIC. IT HAS REEMPHASIZED THE CRITICAL NEED FOR COVID-19-READY EMS PROVIDERS TO BE RECRUITED, TRAINED, AND ‘MAINTAINED’. AS A RECIPIENT OF A SAMHSA FY 2020 RURAL EMERGENCY MEDICAL SERVICES TRAINING GRANT, SANFORD HEALTH’S EMS EDUCATION TRAINING CENTER HAS BEEN WORKING DILIGENTLY TO ADDRESS THESE CHALLENGES ACROSS THE EXISTING PROJECT’S NINE RURAL AND/OR FRONTIER PARTNERS IN THE NORTHERN MIDWEST. THE STRONG RESPONSE SHEMSE HAS RECEIVED IN FY2020 IS THE PRIMARY DRIVER BEHIND THE FY2021 EMS TRAINING PROJECT PROPOSED HEREIN. THE PROJECT WILL BE IMPLEMENTED IN TWO PARALLEL AND INTEGRATED TRACKS. EIGHTY STUDENTS WILL BE RECRUITED AND TRAINED TO THE EMT CERTIFICATION LEVEL, WITH FORTY IN EACH CLASS IN TWO SUCCESSIVE SEMESTERS. INNOVATIVE RECERTIFICATION TRAINING WILL BE PROVIDED TO A MINIMUM OF 100 CURRENT EMT AND PARAMEDICS, TO ENABLE THESE RURAL PROJECT PARTNER PROVIDERS TO MAINTAIN THEIR LICENSURE, AS WELL AS THEIR EXCITEMENT FOR EMERGENCY MEDICINE. THIS WILL BE INTEGRATED WITH MENTAL HEALTH TRAINING THAT INCORPORATES A DUAL FOCUS ON EMS PATIENTS AND PROVIDERS. IT WILL INCLUDE THE MENTAL HEALTH EMERGENCIES THAT EMS PROVIDERS MAY ENCOUNTER, RECOGNIZE, ASSESS AND TREAT WITH THEIR PATIENTS, TOGETHER WITH THE MENTAL HEALTH AND/OR SUBSTANCE USE CHALLENGES THAT EMS PERSONNEL MUST MANAGE TO MAINTAIN THEIR OWN MENTAL STABILITY AND RESILIENCE. SPECIFIC TRAINING ON THE USE OF NALOXONE WILL BE INCLUDED IN BOTH EMT CERTIFICATION AND EMT/PARAMEDIC RECERTIFICATION TRAINING. MENTAL HEALTH TRAINING DELIVERY WILL INCLUDE SAMHSA-GENERATED MODULES FROM THE MOUNTAIN PLAINS /GREAT LAKES ADDICTION TECHNOLOGY TRANSFER CENTER NETWORKS AND MENTAL HEALTH TECHNOLOGY TRANSFER CENTER NETWORKS. THE PROJECT WILL ALSO ACCESS THE COVID-19 BEHAVIORAL HEALTH MODULES PRODUCED THROUGH BEHAVIOR HEALTH BRIDGE, A SANFORD/UND COLLABORATION. THE FY 2021 EMS TRAINING PROJECT WILL IMPLEMENT ASTRUCTURED, ITERATIVE MONITORING AND DATA COLLECTION PROCESS TO DRIVE ONGOING PROJECT MANAGEMENT AND TO STRENGTHEN SHORT- AND LONG-TERM OUTCOMES. THE PROJECT DIRECTOR AND PROJECT GUIDANCE TEAM WILL OVERSEE AN ADAPTIVE MANAGEMENT APPROACH THAT UTILIZES REQUIRED DATA COLLECTION AND REPORTING. THE PROPOSED RECRUITMENT, TRAINING, RECERTIFICATION/MENTAL HEALTH TRAINING AND RETENTION INITIATIVES WILL RESULT IN AN INCREASE IN EMERGENCY MEDICAL SERVICES PERSONNEL AT ELEVEN SANFORD AND OTHER AFFILIATED RURAL AMBULANCE SERVICES OR RESCUE SQUADS ACROSS THE RURAL AND FRONTIER FOOTPRINT IN MINNESOTA, NORTH DAKOTA, AND SOUTH DAKOTA.

FY 2023 RURAL EMERGENCY MEDICAL SERVICES TRAINING - POPULATION SERVED: SANFORD HEALTH EMS EDUCATION IS FORTUNATE TO BE THE RECIPIENT OF THREE CONSECUTIVE YEARS OF FUNDING UNDER THE AUSPICES OF THE SAMHSA RURAL EMS TRAINING PROGRAM. THIS PROGRAMMATIC CONTINUITY HAS ENABLED SHEMSE TO BUILD STRONG AND EFFECTIVE IMPLEMENTATION PARTNERSHIPS ACROSS AN EXPANDING AREA OF RURAL AND FRONTIER NORTH DAKOTA, SOUTH DAKOTA AND MINNESOTA. IN FY 2023, THE RURAL POPULATIONS ACROSS THESE PROJECT PARTNERS WILL BENEFIT FROM CONTINUED TRAINING, CERTIFICATION, AND RECERTIFICATION OF NEW AND EXISTING EMS PROVIDERS. THE PROPOSED PROGRAM WILL ALSO IDENTIFY THE ORGANIZATIONS INVOLVED WITH TREATMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE AND THE INTERRELATIONSHIP WITH TRAUMA-INFORMED, RECOVERY-BASED CARE, TO IDENTIFY LINKAGES FOR PATIENT FOLLOW UP TREATMENT. PROJECT GOALS/OBJECTIVES: THE OVERARCHING PURPOSE OF THE SAMHSA FY 2023 RURAL EMS TRAINING PROGRAM AS PROPOSED IS TO RECRUIT, TRAIN AND MAINTAIN EMS PERSONNEL THAT CAN EFFECTIVELY AND COMPASSIONATELY SERVE RURAL POPULATIONS. THESE PROVIDERS WILL BE COGNIZANT AND PROACTIVE IN THEIR ABILITY TO ADDRESS PATIENTS WITH SUBSTANCE ABUSE DISORDERS, PARTICULARLY AS THEY CO-OCCUR WITH MENTAL HEALTH CONDITIONS AND/OR PRIOR TRAUMA, INCLUDING RECOVERY CARE OPTIONS. A SECOND PRIORITY WILL FOCUS ON STRATEGIES TO IDENTIFY AND LINK PATIENTS WITH SUBSTANCE USE DISORDERS AND CO-OCCURRING MENTAL HEALTH CONDITIONS TO COMPREHENSIVE AND INTEGRATED THERAPY OPTIONS AND OPPORTUNITIES. PROJECT STRATEGIES/INTERVENTIONS: THE PROPOSED SAMSHA FY 2023 RURAL EMS TRAINING PROGRAM WILL BE IMPLEMENTED IN TWO INTEGRATED TRACKS. EMT AND PARAMEDIC STUDENT SCHOLARSHIP CANDIDATES WILL BE IDENTIFIED AND TRAINED ACROSS THE PROJECT PARTNERSHIP AREA, TO ADDRESS THE ONGOING SHORTAGE OF RURAL EMS PROVIDERS. THIS CERTIFICATION PROGRAMMING WILL BE AUGMENTED WITH SPECIALIZED TRAINING ON MENTAL AND SUBSTANCE USE DISORDERS, TOGETHER WITH OPTIONS FOR TRAUMA-INFORMED RECOVERY-BASED TREATMENT OPTIONS. THE CURRENT SCOPE OF PRACTICE FOR EMS PROVIDERS FOCUSES GENERALLY ON THE PROVISION OF SHORT-TERM, TRANSIENT CARE TO ADDRESS SUDDEN, UNPLANNED MEDICAL EMERGENCIES. THE ADAGE OF “ARRIVE ALIVE” IS FOLLOWED BY A PATIENT HAND OFF TO THE DESTINATION EMERGENCY DEPARTMENT FOR MORE DEFINITIVE CARE. HOWEVER, THE CONTINUING PREVALENCE OF MENTAL AND SUBSTANCE ABUSE DISORDERS THAT REACH THE LEVEL OF A MEDICAL EMERGENCY REQUIRES COORDINATION BETWEEN EMS, MEDICAL/CLINICAL PRACTITIONERS, PUBLIC HEALTH SPECIALISTS, AND SUBSTANCE ABUSE-TARGETED TREATMENT SYSTEMS. IN ADDITION, A SIGNIFICANT CHALLENGE FOR SHEMSE’S RURAL PARTNERS IS THE OVERALL LACK OF BEHAVIORAL HEALTH WORKFORCE RESOURCES, BY AVAILABILITY AND DISTANCE. THE PROPOSED STRATEGY WILL LAUNCH WITH AN ASSESSMENT OF THE CURRENT LEVEL OF SUBSTANCE ABUSE AND MENTAL HEALTH DISORDERS ENCOUNTERED BY EMS PRACTITIONERS, COUPLED WITH A REALISTIC MEASURE OF THE EXISTING MENTAL HEALTH WORKFORCE ACROSS THE PARTNER AREA. THIS WILL INCLUDE AN EVALUATION OF THE CROSS COORDINATION BETWEEN PROVIDERS AT THE EMERGENCY MEDICAL SERVICE, EMERGENCY ROOM, AND MENTAL HEALTH/SUD SERVICE LEVELS. THIS ASSESSMENT WILL CULMINATE IN A SERIES OF ROUNDTABLES TO IDENTIFY EXISTING OPTIONS AND OPPORTUNITIES FOR INTERACTIVE TREATMENT COORDINATION AND COOPERATION. IN ADDITION, THE EXPANSION OF SANFORD’S COMMUNITY PARAMEDIC PROGRAM THROUGH CERTIFICATION TRAINING FOR RURAL PARTNERS WILL BE EXPLORED AS AN ADDITIONAL MEANS OF EFFECTIVE, IN-DEPTH CARE FOR PATIENTS WITH SUBSTANCE ABUSE AND MENTAL HEALTH DISORDERS. THE SAMHSA FY 2023 EMS TRAINING PROJECT WILL IMPLEMENT A STRUCTURED, ITERATIVE MONITORING AND DATA COLLECTION PROCESS TO DRIVE ONGOING PROJECT MANAGEMENT AND TO STRENGTHEN SHORT- AND LONG-TERM OUTCOMES. THE PROJECT DIRECTOR WILL OVERSEE AN ADAPTIVE MANAGEMENT APPROACH THAT UTILIZES REQUIRED DATA COLLECTION AND REPORTING.

FM AMBULANCE RURAL EMERGENCY MEDICAL SERVICES