Members present:                                        
Rick Barney                                                    
Marv Birnbaum                                               
Tim Bjelland                                                                             
Dick Collyard                                                  
Cheryl Glomp                                            
Don Hagen                                                    
Don Hunjadi                                                    
Cal Lintz
Gloria Murawsky
Terri Richards
Steve Teale
Lorie Utech                                         
Dan Williams   

Bureau Staff:
Deb Crawford
Mary Jean Erschen
Jon Morgan
Marianne Peck
Nan Turner
Lee Ann Cooper

Others in Attendance:                                   Representing:
Jim Keiken                                                       Madison FD
Judy Jones                                                        Luther – Eau Claire
Keith Kesler                                                     Douglas Co. Emergency Management
Don Kimlicka                                                   Gunderson Lutheran
Patricia Padjen                                                 UW Hospital
Laura Ahola                                                     UW Hospital
Brian Litza                                                        Paratech
Bruce Erickson                                                 Waukesha County Technical College
Dave Henning                                                   Gold Cross
Gary Winters                                                    Community Ambulance
Jan Victorson                                                   Bayfield Co. Emergency Management
Joy Erb-Moser                                                 St. Joseph Hospital - Marshfield
Tracy Froiland                                                  Appleton Medical Center
Gary Leyer                                                       Gateway Technical College
Mary Powers                                                   Children’s Hospital of WI
Lynn Crawford                                                 St Clare Hospital – Baraboo
Jerry Miller                                                       Waushara Co EMS
Kathy Crandall                                                  Lifestar EMS
Suzanne Martens                                              Orange Cross/St. Nicholas Hospital
Beth Natter                                                      Mercy Hospital – Janesville
Cindy Diedrich                                                 Fitch-Rona EMS
Larry Knuth                                                      Paratech
Barb Kuska                                                      Beloit Memorial Hospital
Martha Florey                                                  Bureau of Transportation Safety
Robin Schultz                                                   Sacred Heart Hospital – Eau Claire
Diana Bower                                                    UW Hospital – EMS Program
 

Agenda item #1 Introductions

Dan Williams called the meeting to order at 9:05 at the Comfort Inn, Madison.   Everyone in attendance introduced themselves.  Dan specifically introduced the new board members: Cal Lintz and Lorie Utech.

Agenda item #2 Approval of September Minutes

Motion by Tim Bjelland, second by Dick Collyard to accept the September 2002 Board minutes.  Cheryl Glomp requested one modification in the minutes for the Education Committee.  The wording on terrorism training should have been: The committee recommended that the training be incorporated into existing courses.  The number of hours should be four (4) hours  incorporated into the refresher course and, if needed, added to the basic course.  All Present – Aye.  

Agenda item #3 Committee Updates

The Standing Committees gave their reports.  Included in each standing committee report was a report from any ad hoc committees that are assigned to the standing committee.

Education

Gloria Murawsky reported on education issues.

1. IV Tech summary results from a survey of IV Tech students and instructors was presented.

2. A pediatric IV tech module needs to be developed.  Deb Crawford is forming an ad hoc committee.

3. An IV Tech refresher course also needs to be developed.  Deb Crawford is forming an ad hoc committee.

4. Evaluation of Instructors and quality of education continues.

5. Survey Questions for a possible provider survey were brought up, but no specific questions have been developed.

6. Jim Keiken gave a presentation on Blackboard as a web-based learning tool.

Policy & Practice

Dick Collyard reported on the committee meeting.  The committee discussed the First Responder rule draft, which they were reviewing for the third time.  They hope to be done in January to forward to Board.

Systems Management

Marv Birnbaum reported on the committee meeting.

Ad-hoc Committee activities:

CQI committee –

Minimum CQI program was the charge of the committee. This CQI program developed sets a minimum standard for care.

The committee has created a template for two conditions

1. Chest Pain

2. Respiratory distress

The template is not meant to replace existing CQI activities.  It’s a first attempt to get a picture from throughout the State.  The document presented includes:

• Definitions

• A form to complete for the two listed conditions in two formats: algorithm and written, with specific tiered information by license levels

• A summary form to be sent to State

• An Access database will be set-up for direct entry as well as via paper form

• There is also a teaching guide as a reference document

The goal is to have the document piloted for 3 months by volunteer services around the State. There was some discussion about the document to clarify its use.  The question was also raised about how to promote CQI as an ongoing issue.

Motion by Marv Birnbaum, seconded by Cheryl Glomp to accept the report as written.  All Present – Aye.

Motion by Marv Birnbaum, seconded by Cheryl Glomp that the EMS Board Chair should send a letter to the committee commending them on their work.   All Present – Aye.

Motion by Marv Birnbaum, seconded by Cheryl Glomp that the committee go ahead with a pilot for no more than 1 year and report back to the Systems committee.  All Present – Aye.

Dr. Barney noted that the document should go to the Physician Advisory Committee (PAC).  It was also noted that pediatric input be included.  The document will be sent to PAC and EMSC members for review and comment and will be on the December 19, 2002 PAC agenda.

Disaster Management – The committee discussed what the EMS role is in Disaster management.  There were some specific questions that need to be answered as a quick fix and then a broader set of questions to develop a formal long-term plan.   The immediate questions to answer are what should occur in an initial EMS response and a follow-up question is what does EMS do for the interim period when the agent is suspicious and EMS should not enter the area.

A meeting is set for December 4, 2002 for additional input.  The meeting will occur after the Trauma Advisory Committee in Madison.  Information on a site and exact time is forthcoming.

System Committee activities:

1.      The EMS finance report is still being edited to finalize costs and income from a variety of sources.  Most of the data is in the document and conclusions and recommendations are the next step along with summarizing the document for a budget request.  The highest priority issue identified by several sources was staffing. Detail for the full report needs to be completed by March 2003.  The executive report should be done in January.

EMS-Children

Highlights included:

• Childhood Emergency Care Conference dates are October 16 & 17, 2003 at the Kalahari Resort in Wisconsin Dells.  The Midwest EMSC Conference will be in conjunction with the Childhood Emergency Care Conference, as well as a possible data workshop by the National   Data and Resource Center ?? (NEDARC).

• BELSS - Basic Emergency Lifesaving Skills in Schools.  Pilot activities have begun and training of school staff is occurring.

• Emergency Preparedness for schools is done and being printed by WI Emergency Management.

• 70% of State is now covered by Child Alert program.

Action requests to EMS Board:

1.      Request to EMS Board to have DOT review Trans 309 for:

• Child Safety seat requirement

• Child being transported on parent’s lap

2.      Update Standards and Procedures manual to include pediatric patients.

Dan Williams recommended that EMSC submit a specific written list of issues and recommended changes.  The Board will then review them to determine the best course of action.

Physician Advisory Committee (PAC)

Dr. Rick Barney reported that the PAC is working on

• An EMS “Report card” to analyze an EMS service and compare a service with a set of standards for operational issues.

• Completing the EMS MD web-based course.

• Recommended CPAP use for EMT-basic services.  This still needs further discussion, including a recommendation to the EMS Board.

• BLS pediatric protocols were approved by PAC.  The protocols were developed by PEPP as guidelines. 

Motion by Marv Birnbaum, seconded by Gloria Murawsky that Basic Life Support pediatric guidelines be distributed to service Medical Directors and Ambulance Service Directors, with the note that they are available in electronic, paper or laminated format for the ambulance service upon request.  All present – Aye.  Motion by Cheryl Glomp, seconded by Tim Bjelland that the guidelines should also be distributed to EMS Educational institutions as a resource.  All Present – Aye.

New technology for pediatric defibrillation has occurred.  Should this be the standard for care was discussed with no immediate resolution.

There was a discussion about past pediatric curriculum requirements and how to inform training institutions and implement.

Injury – Jon Morgan stated that Linda Hale has been very active giving injury presentations to groups such as the WI Association of Local Health Departments, the Emergency Nurses Assn. WI Education Association Council and others.

Agenda item #4 Medical Director Report

1.      Dr. Rick Barney and Nan Turner attended the National Association of State EMS Directors (NASEMSD).  Highlights were:

• The national physician group was impressed with WI’s use of additional skills at the EMT-basic Level.

• Diversions were discussed at PAC and at the national conference.  The consensus from the State Medical Director meeting at PSOW was that diversions were only a problem in a small number of areas.  The national discussion was to potentially make diversions a reason for denying accreditation by the Joint Commission on Accreditation of Healthcare Organization.

• Motion by Cheryl Glomp, seconded by Don Hunjadi to request that Dr. Barney  write a letter affirming the JCAHO accreditation requirement that diversions are not allowed.   All Present – Aye

• Discussion of the first hour or two of a disaster and what is the EMS role and direction.  FEMA funds are designated for first responders, but EMS is sometimes lost since it’s mistakenly always linked with Fire Service.

Nan Turner also reported on the NASEMSD meeting.  Highlights included:

• NHTSA is sponsoring a writing group to develop a national standard scope of practice for EMTs. 

• A HIPAA summary was discussed and a summary document will be developed for providers.

• A NASEMSD representative will be on trauma consultation groups.

2.      RTACs have been meeting and starting to form.  Different regions have different implementation issues and levels of agreement on how the system will work.

3.      Dr. Barney has been traveling to present to various groups and discuss issues.

Committee realignment was deferred.  Dan Williams assigned Lorie Utech to Education, Cal Lintz to Policy and Practice as interim assignments.

Agenda item #5 - Legislative & State Office Update

Jon Morgan reported on state issues that included:

1.      Terrorism grant activity.  The recent report that Wisconsin was rated as poorly prepared for bioterroism response was somewhat misleading.  The report was based on a single meeting in May 2002 with Centers for Disease Control staff.  The primary focus for that meeting was preparedness for distributing the National Pharmaceutical Stockpile.  That distribution plan is now much better delineated and Wisconsin’s preparedness plan is on a timeline similar to the other states.

2.      Trauma System –  Marianne Peck distributed handouts on guidelines for RTAC development and a letter for EMS services and hospitals to declare what region they will be associated with.  A trauma rules outline is being developed and a committee to draft rule language will be meeting soon. 

3.      The State EMS Plan and the State EMS Communication Plan are now in final DHFS review and will be released this month.

Agenda Item #6 - - Old/New Business

1.      Reminder - There has been past discussion about sending out a new EMS survey for a variety of information.  Committees should consider and submit questions after the January meeting.  The goal will be to send out the survey in the spring.

2.      Meeting schedule for 2003.   The schedule will remain at every other month alternating between Madison and Mosinee/Wausau.  It was also recommended that additional meeting rooms be reserved to avoid recent scheduling conflicts.  Requested meeting time for the January committee meetings are:

Systems – 3 hours
CQI – 1 ˝ hours
Disaster- 2 hours
Policy – 3 hours
Education – 3 hours

3.      Larry Knuth gave an update on the regional Medicaid reimbursement issues. A group representing WI met in Chicago which resulted in:

• Contact information being exchanged

• A better understanding of the billing process by both sides

• A better exchange from both perspectives

Medicaid will use these meetings to disseminate answers to EMS Providers about the questions raised during the meetings. 

Motion by Dick Collyard, second by Cheryl Glomp to adjourn.  All present -Aye.  Meeting adjourned at 11:45 AM.

The next regular meeting is in Mosinee, January 7 & 8.

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