Emergency Medical Services Board Meeting

December 7, 2005

Board Members Present:                              Bureau Staff:

Joe Covelli                                                       Meg Taylor

Steve Bane                                                       Brian Litza

Brenda Fellenz                                                  Cathy Etter

Troy Haase                                                       Helen Pullen

Cal Lintz                                                           Ann Moses

Ken Johnson                                                     Paul Wittkamp

Steve Teale                                                       LeeAnn Cooper

Travis Teesch                                                    Dan Williams

Mark Fredrickson                                         

Gloria Murawsky

Tracy Aldrich

Keith Wesley

Board Members Excused:

Others in Attendance:                       Representing:

Keith Kesler                                         Douglas County Emergency Management & 9-1-1

Bruce Gordon                                       MSTC EMS Medical Director

Jan Victorson                                       Bayfield County Emergency Management

Ann Peggs                                           PFFW

Vickkie Zietlow                                    Mid-State Technical College

Jerry Haberl                                         Wisconsin Emergency Management

Gregory West                                       Waukesha County Technical College

Marty Aubol                                         North Central Technical College

Carrie Meffert                                      Dane County EMS

Ann Krainyk                                         UW EMS Program

Jan Beyer                                             UW EMS Program

Steve Pilsner                                         Wausau Fire Dept.

Jim Brien                                              Marinette County Rescue Squad Assoc.

Linda Pace                                           MATC – Madison

Lauryl Pukansky                                   Milwaukee County EMS

Bart Jahnke                                          LifeQuest

Suzanne Martens                                  Sheboygan County EMS

Jeff Grimm                                           Theda Star/STAC

Bob Nack                                             Fox Valley RTAC

Nettie Jenkins                                       Thedacare

Karen Wesley                                       Gold Cross, Eau Claire

Dan Diamon                                          Lake Superior RTAC

John Schindler                                       Meda-Care Ambulance

Brian Reynolds                                      Milwaukee County EMS Council

Fred Hornby                                          Bell Ambulance

Mike Jankowski                                     Franklin FD

Sue LaFlash                                           DPH-EMSC

Jerry Miller                                            LifeQuest-Mobile Healthcare Alliance

Tom Fennell                                           Gold Cross-Mayo Medical Transport

Tracey Froiland                                      State HRSA Leadership/Thedacare

Judy Jones                                             Luther Hosp Eau Claire/NWRTAC

John Duffy                                            Fond du Lac FD

Sandy Johnson                                       St Josephs Hosp-Marshfield

Don Kimlicka                                         St Clare’s Hosp-Weston

Beth Natter                                           Mercy Hosp-Janesville

Barb Kuska                                           Beloit Memorial Hosp

Larry Knuth                                          Paratech Ambulance

Welcome and Introductions: Chair Steve Bane called the meeting to order at 10:00am at the Crowne Plaza Hotel - Madison, WI. Steve welcomed everyone and asked the audience to introduce themselves.

1.      Approval of previous Board Meeting Minutes: 

1. August, 2005. Motion by Murawsky, second by Aldrich to approve the minutes from the August, 2005 meeting as presented. Motion carried.

2. October, 2005. Motion by Murawsky, second by Aldrich to approve the minutes from the October, 2005 meeting as presented. Motion carried.

2.      Committee Updates:

EMS Education: Gloria Murawsky, committee chair reported the following meeting topics:

It was established that Ken Sternig would be the Vice Chair and that Don Kimlicka is the Recording Secretary.

1. Reported that the committee that was working on the revised EMT-Basic curriculum had completed their work and submitted to the Committee for approval. Linda Pace the project manager on the project advised the Board of the Status and next steps. One final review was planned to pull any other minor changes that may need to be made. Motion by Murawsky, second by Haase to support the draft curriculum as presented pending final changes by January 10, 2006. Motion Carried. It is anticipated that the final product will be presented at the EMS Instructor Workshop in late February.

2. An ad-hoc committee to develop the core content curriculum items for the EMT-Basic Refresher was established and will move forward as quickly as possible to determine this content.

3. The next area for general curriculum review and revision will be the EMT Basic IV-Tech.

4. The committee still feels the need to research, review, develop and implement a method for EMS instructor competency.

EMS Policy and Practice Committee: Travis Teesch, committee chair reported on the following meeting topics:

1. Continuing the activity for review and revision of HFS-110. It was felt that the general review would be finished after the next Board Meeting.

2. The committee is developing a narcotics template that can be used for services that have either not developed one for themselves or are looking to provide a more comprehensive system. Further work is needed prior to finishing the final product.

3. There was a discussion regarding that if the licensure period for Basic EMT’s were to move to four years would the other levels of EMS providers come along. Dan indicated that if that does happen it would most likely be for all levels, as it would be difficult to manage various formats.

4. Verification of training in the newly discussed educational format was discussed. Several methods for tracking and verification are still being discussed and will continue to be reviewed and brought forward.

5. Emergency Rule for HFS-110 and HFS-111. Dan Williams explained that his office was going to introduce an emergency rule in February that would remove the EMT-Basic IV-Tech from HFS-110 and place it in HFS-111. This is being done to address two issues. One, to better identify the type of care that this level of provider provides to enhance the ability to receive the proper reimbursement. The second issue is to change the refresher course requirements to allow for more flexible methods which also will be a substantial savings to the providers. Meg Taylor also advised the Board that there was initiative to move the EMS rules out of the 146.00 category and establish its own place in Statute in the 257.00 area. The Statutes in 146.00 are misc. Statutes that have no relevant relationship other things in the same area.

EMS Information Management: Ken Johnson, committee chair reported on the following:

1. Dan Williams updated the Committee and the Board on the progress of the new Data Collection system that had been signed with ImageTrend.

2. The committee will work on a talking points paper to help identify key points and a list of frequently asked questions that will be sent out services as the EMS Office begins to role out the project.

3. It was noted that approximately 12 services have indicated that they want to be in the pilot testing and a training session has been held with them to get started.

4. The committee will start to work on the various rules and methods for the management of the data as we move forward. The committee has representation from the State of Minnesota and the issues that they went through as their system was being developed will prove to be helpful as Wisconsin develops its system.

            CQI – Sub-Committee.

It was determined that the CQI Committee will be an ad-hoc committee to Information Management. They will not appoint members at this time. It is intended that they will the data starts to be accumulated and the develop methods for the most efficient use of the data.

EMS Public Health: Brenda Fellenz, committee chair reported on the following meeting topics:

1. The committee worked to better define their mission. They want to position themselves to be as effective as possible. The committee set on two specific areas to begin to work on. The first one is to promote projects that will have a direct effect on youth and more specifically youth programs involving youth driving related issues. The second area of emphasis will raising the awareness on an existing issue, that of yielding to emergency vehicles.

They plan to identify stakeholders to bring to the table so as to not re-invent the wheel but to determine what has been and what might be done in the future to make those programs more effective.

            Disaster – Sub-Committee

The Disaster Sub-Committee has been assigned as a sub-committee to the EMS Public Health Committee. The Chair of the Committee is Mark Fredrickson. The committee has established several initiatives to work on.

1.      Standardization of triage tags. Not necessarily in how they look, but for the information that is on them.

2.      Adopt a statewide “Triage Tuesday” initiative to have all EMS services use triage tags on all patients every Tuesday to accomplish a better understanding of how to use them as well as having the hospitals get use to seeing them and using them.

3.      Raise the awareness of existing disaster plans to assure that they represent a realistic response capability and have some level of potential success if needed and used.

4.      Develop an assessment tool for finding out where the various disaster trailers are located in Wisconsin and what type of equipment is in them. It was felt that this has not been tracked very well in the past several years and if needed it may be difficult to really know what is out there.

EMS Systems: Cal Lintz, committee chair reported on the following meeting topics:

It was established that Keith Wesley would be the Vice Chair and that Jan Beyer would be the Recording Secretary.

The committee has started to develop the template for determining that the many changes that have taken place over the past several years are being evaluated for effectiveness. The following are several of the areas that the committee felt were areas that needed to be reviewed.

1. The committee will be determining the extent of use of formal and not so formal use of the priority dispatch and emergency medical dispatch in the State. How wide spread is its use? How many PSAP’s are trained and using commercial software or cards, etc? December of 2006 completion.

2. The committee will be reviewing and developing a survey instrument to determine the impact of the changes in the funding assistance program on EMS agencies in the State. June of 2007 completion.

3. Will be working towards reviewing the impact of the statewide trauma system and injury prevention programs since the implementation of the new rule and after the funding has taken place. February of 2008 completion.

4. Reviewing the impact of the revisions to the various administrative rules. Developing an information gathering tool to manage this task. Completion sometime in 2008.

5. Review the impact of any changes that may be made in Trans 309. We are still awaiting the appointment of the next ambulance inspector. It was felt that once this person is on board and working for a while they may have some issues that need to be addressed. This task has no current time frame for completion.

6. Review the need for EMS leadership training for EMS Service Directors, EMS Managers, and EMS Supervisors. The State EMS Office is conducting training on the main things that they would like EMS administrators to know. It was decided to see how that training is accepted and to then develop a strategy for the future.

7. The committee has made it self available to work on the provider handbook. The initial emphasis is to look at the old handbook and make recommendations on updates and information from the provider’s perspective. Looking at as what a provider would like to have and need to have.

EMS-C:

No Report.

PAC: Suzanne Martens reported on behalf of PAC chair Dr. Cady, on the following.

1. The interfacility transport guidelines had been completed and that the EMS Office would be circulating them for final comments.

2. Medical Director’s course is in final editing and will initially be placed on the Department website so that the information can be used while we try to determine the best method for issuing credit to those that take the course.

3. The CPAP QA project is reaching the final stages and will be discussed and a recommendation is expected at the next PAC meeting in January of 2006.

4. PAC is working on the development of a non-visualized CQI airway form. This form will be used to review the use of a non-visualized airway in any situation.

State Medical Directors’ Report:

No Report. Dan advised the Board on the progress of the recent RFP that had been let by the Department to fill the position of State EMS Medical Director. The process should be completed by the end of January 2006.

State Trauma Report:

Marianne Peck, State Trauma Coordinator advised the Board that legislation has been introduced to provide some protective language to the groups and people that will be reviewing information for performance improvement.

Legislative Issues:

Representative, Sheldon Wasserman has introduced legislation to change the requirement in the public access defibrillation rule for the public to notify EMS that one has been placed in the community someplace. It was decided that because these devices can now be purchased at pharmacies, catalog outlets, etc. that it would be virtually impossible to enforce anyway.

State Office Issues:

No Report

Old Business:

All old business had been dealt with.

New Business

1. The Interfacility Transport Guidelines will be distributed in the next few weeks for consideration.

2. Meeting location issues. Dan Williams advised the Board that we have developed considerable conflicts with making arrangements for the 2006 meetings at the Crowne Plaza. Because of these issues the February meeting will be held at the Sheraton Inn at 706 John Nolan Drive, Madison, WI. Further information will be announced as soon as it is available.

Other Board Related issues:   None

Adjournment:  Motion by Teesch, second by Aldrich to adjourn. Motion carried. Meeting adjourned at 11:45 AM.