In August 2003, the Missouri Foundation for Health (MFH) identified the need for EMS/Trauma reform in the state, and designated planning for this reform as one of its policy area priorities. In addition to being the largest health care foundation in the state and among the largest of its kind in the country, MFH also is the largest non-governmental funder of community health activities in Missouri.
In October 2003, MFH initiated a conference call that brought together Missouri’s EMS/Trauma community. Participants included emergency room physicians, trauma nurses, state health officials, and other health care professionals. Throughout the fall, the State Advisory Council (SAC) on EMS met several times to work on a white paper detailing problems with the EMS system and examining possible solutions. The SAC identified funding as a major obstacle. At MFH’s urging, Dr. J. William “Bill” Jermyn, DO, FACEP, then Chair of the SAC, also joined in the MFH planning effort, bringing his decades of emergency medical experience on board as the state’s preeminent EMS reform champion. In November 2003, Department of Health and Senior Services (DHSS) Director Dick Dunn accepted MFH’s offer to fund research on EMS reform.
In March 2004, MFH brought together hundreds of Missouri’s emergency care professionals, as well as legislators and other public policy leaders, to discuss the planning process. The group asked the State Advisory Council and Dr. Jermyn to take the lead. MFH hosted a second statewide summit two months later that more narrowly defined the strategic planning process.
In July 2004, MFH drafted a Missouri EMS/Trauma/Disaster Planning white paper describing a planned approach for providing excellence in emergency medical and trauma service in the state of Missouri.
Throughout 2005, draft components were compiled. Although there was a large dedicated and professional effort, the statewide group realized the scope of the project was too large to accomplish on a strictly voluntary basis. Realizing the importance of this project, MFH and DHSS stepped forward to partner and move the reform ahead with the help of the SAC.
In April 2006, DHSS developed a draft EMCS strategic plan to include what would become 360°/365 EMCS. Shortly thereafter, DHSS worked with MFH to draft a health policy agreement to provide a means of accountability and leadership for emergency care in Missouri by assessing the current status of the EMCS.
In February 2007, The Vandiver Group, Inc. began working with MFH and Dr. Jermyn to communicate the importance of EMS reform to legislators, health officials and the general public.
In May 2007, under the leadership of Dr. Lynthia Andrews, the State Advisory Council agreed to create a Time-Critical Diagnosis (TCD) committee.
In July 2007, potential funding for the Time Critical Diagnosis System was finalized with the award of a partial CDC grant to the Department of Health and Senior Services. This award is expected to last five years. In conjunction with other monies available to the Unit of EMS, it allows funding of dedicated positions to assist the three arms of the Time Critical Diagnosis System.
In October 2007, DHSS Director Jane Drummond called for the formation of a Steering Committee and Task Force to make formal recommendations for the design of a TCD System for stroke and STEMI that coordinates with the current trauma system.
Between January and March, 2008, a Time Critical Diagnosis Task Force convened in Jefferson City for a series of meetings and planning sessions to develop the strategy and the operational structure of a TCD system in Missouri. More than 100 stakeholders and partners attended the meetings.
May 16, 2008 the Missouri state legislature passed House Bill 1790 to officially enable a state-wide Time Critical Diagnosis System. The bill was sponsored by Rep. Wayne Cooper in the House and Sen. Charlie Shields in the Senate. After months of hard work by the Task Force and stakeholders across the state, the bill unanimously passed on the final day of session. Missouri Governor Matt Blunt is signed the bill on July 11, 2008.
Through June 2008 the Task Force held a public comment period for input on the new system development. A prepublication of the report to be submitted to DHSS Director Drummond can be accessed for review and feedback. Click Here
In August 2008 the Task Force will submit a final report detailing recommendations of the Missouri Time Critical Diagnosis system.