RETAC Forum & RHTP Strategic Planning Committee

Summary of Survey Results and Regional Health Transformation Program (RHTP) Planning

This RETAC taskforce met on April 6 to continue its work toward use of the new federal Rural Health Transformation Project funds that will come to Colorado. They met to analyze the results of the recent RETAC (Regional Emergency Medical and Trauma Advisory Council) forum survey and to establish a unified direction for the upcoming Rural Health Transformation Program (RHTP) planning effort. Nick Nudell supplied a comprehensive data review, guiding the group through the current landscape of EMS challenges and opportunities across the state.

SIDEBAR: Colorado RISE Collaborative is a proposed Rural Health Transformation Program framework for advancing a stronger rural health system in Colorado.

Statewide Survey Findings: A System under Strain

The survey received 119 responses from 10 of 11 regions. The respondent mix was diverse, including medical directors, hospital administrators, and EMS agency leadership, predominantly from rural (80%) and frontier (30%) areas.

Key Findings at a Glance

The data painted a stark picture of the operational hurdles facing rural EMS:

• Workforce Stability | 75% of agencies report their workforce is currently unstable.
• Access Challenges | 29% of respondents operate more than 60 miles from the nearest Emergency Department.
• Service Gaps  |  57%  offer no extended care or community paramedicine services.
• Operational Burden | Inter-facility transports (IFTs) comprise 10% or more of volume for nearly half of respondents.

Financial viability and workforce availability are the twin "existential threats" to the system. While EMS reimbursement reform was ranked as the #1 long-term investment priority, workforce development emerged as the most immediate and consistently critical issue statewide.

Regional Variations and "Heatmap" Analysis

Mr. Nudell introduced a color-coded heatmap to illustrate how priorities shift across geography. While workforce remains a universal concern, specific regions displayed unique needs:

• Central Mountains:  Focused heavily on IFT coordination.
• Southwest:  Showed a significantly higher interest in community paramedicine than the state average.
• San Luis Valley:  Prioritized reimbursement reform above education.
• Southeast:  Indicated a notably lower interest in community paramedicine compared to other regions.
• The group noted that while the role of RETACs in RHTP implementation is still being defined, there is a clear expectation that they serve as either regional coordinators or advisory bodies to ensure state-level support meets local needs.

RHTP Funding Strategy: "Use It or Lose It"

The discussion shifted to the practicalities of the RHTP application, which is expected to open in mid-April 2026 with a tight two-month window.

Strategic Spending Constraints

Sarah Weatherred and Reuben Farnsworth emphasized a critical "use it or lose it" factor: unused funds in year one risk being reallocated, which could jeopardize future funding. This creates a unique challenge for year-one planning:

• Feasibility over Aspiration:  Investments must be actionable and reimbursable within the funding period.
• The Ambulance Problem:  Long-lead items, such as ambulances (which currently have multi-year build times), are likely disqualified for year-one spending.
• Front-Loading Capital:  The group agreed to prioritize "durable" investments in the first year—such as  simulation labs and training equipment —which facilitate long-term programs without the immediate payroll burden of new personnel.
• The 5-Year Vision:  While year-one spending is the immediate hurdle, participants stressed that all applications must include a five-year sustainability plan to ensure that regional transformations outlast the initial grant cycle.

Moving Toward Collaboration: Working Groups

To maximize scoring and impact, the group reached a consensus that multi-agency regional proposals would be prioritized over individual applications. To help this, ad hoc working groups are being formed:

Next Steps and Commitments

With the funding announcement looming in approximately two weeks, the timeline is aggressive.

Mr. Nudell will circulate a survey/form via SharePoint for stakeholders to opt into specific subgroups.  Subgroup Meetings will be scheduled immediately to begin drafting coordinated proposals. Mr. Mr. Farnsworth confirmed the application will be streamlined to encourage participation and requested that stakeholders remain active in the public comment process.