Members present:                                        
Steve Bane                                                      
Marv Birnbaum                                               
Dick Collyard                                                  
Don Hunjadi                                                    
Ken Johnson                                                   
Cal Lintz
Gloria Murawski
Steve Teale
Travis Teesch
Gloria Wall
Dan Williams

Bureau Staff:
Jon Morgan
Nan Turner
Bruce Gordon
Linda Hale
Mary Jean Erschen      

Others in Attendance:                                    Representing:
Barb Kuska                                                      Beloit Memorial Hospital
Beth Natter                                                      Mercy  Hospital – Janesville
Don Kimlicka                                                   Gunderson Lutheran
Judy Jones                                                        Luther – Eau Claire
Mike Kresovic                                                 Bell Ambulance
Vickkie Zietlow                                                MidState technical College
Joy Erb-Moser                                                 EMSC
Tracey Froiland                                                ThedaCare - Appleton
Mike Jankowski                                               Franklin Fire Dept
Mark Madigan                                                 County Rescue - Green Bay
Keith Kessler                                                   Douglas County Emergency Management
Jan Victorson                                                   Bayfield County Emergency Management
Ken Sternig                                                      Milw Co EMS
Lorie Utech                                                      Project Adam
Chris Batchelder                                               EMS Educator
Cheryl Glomp                                                   St. Mary’s – Madison
Joe Covelli                                                       WEMSA
Jan Beyer                                                         UW EMS Program
Pat Padjen                                                        UW EMS Program
Dr. Luan                                                           Visiting Vietnam Physicians
Dr. Binh                                                           Visiting Vietnam Physicians
Jim Swan                                                          Divine Savior Health Care
Mike Petersen                                                  Divine Savior Health Care
Mitch Waite                                                     WI Rapids FD
Suzanne Martens                                              Sheboygan Co EMS
Rick Sherman                                                   Deputy Director Baraboo District Ambulance
Dan Buchanon                                                  Deputy Director Baraboo District Ambulance
Jeff Grimm                                                        ThedaStar Air Medical
Brian Schertz                                                    EMS Coordinator, Shawano
David Henning                                                  Gold Cross/EMSC
Brian Litza                                                        Paratech
Kathleen Crandall                                             Heart Hospital of Milw
Tim Hillebrand                                                  Dane Co EMS

Agenda item #1 Introductions

Dan Williams called the meeting to order at 9:10 at the Comfort Inn Madison.  Dan Williams welcomed Dr. Bruce Gordon, the new State EMS Medical Director.  Dr. Gordon gave a brief introduction of himself and his background.  Everyone in attendance introduced himself or herself.

Agenda item #2 Approval of January 2004 Meeting Minutes

Motion by Steve Bane, seconded by Travis Teesch to approve the January Board minutes with the following amendments:

1.      EMSC presented a written report and Gloria Wall gave a brief oral summary.

2.      The EMS Board voted to modify the Funding Assistance formula for this year to ensure there are enough funds available to cover training.

3.      The EMS Board made a formal motion that EMS be considered for more involvement in all preparedness discussions, activities and funds, as they become available.

All Present – Aye.

Prior to the committee reports Dan Williams gave a brief report on the recent meeting of DHFS representatives with Dan and Marv Birnbaum.  He reported that the meeting was a valuable exchange of information, but he did not get into details pending a presentation later on the agenda by Tom Alt, Interim Administrator of the Division of Public Health.

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

1.      Competencies vs. curriculum development. The committee is preparing a report listing the pros and cons, and recommendations on competency-based education vs. development of standard curricula for each level.  This will be submitted to the Board at the next meeting.

2.      Distributive learning. Ken Sternig will have a completed report on the committee's recommendations on distributive learning for the May meeting.

3.      The template to review curricula has been developed and is being piloted on the EMT-Basic level.  As part of the review process, a survey will be sent in April for feedback from educators and services.

4.      The committee reviewed the draft EMT-B scope of practice.  Comments will be forwarded to PAC.

5.        Linda Pace – EMT-B course review.  The sub-committee is looking at content, hours, alternate delivery methods, frequency, competencies for refresher.  They will begin in May.

Policy & Practice

Dick Collyard reported on the committee meeting, which included:

1)      EMS Funding Assistance Program (FAP) – No additional information from Rep. Rhodes’ office on the draft statutory language change.  The language is done, but will probably not be introduced this legislative session.  The next opportunity is January 2005.

Dan Williams asked that Policy and Systems look at refresher training and make recommendations.  Motion by Gloria Murawsky, second by Cal Lintz that Policy and Practice and Systems look at the frequency and amount of refresher training and make a summary of impact and recommendations

Systems Management

Marv Birnbaum reported on the committee and sub-committee meetings. 

CQI – Followed up on first pilot.  Getting feedback from 1^st pilot and 2^nd pilot beginning for chest pain.

Disaster –

• Discussion regarding incident command systems (ICS) and the National Incident Management System (NIMS) draft report.  Issues to consider are structure, training needs, and credentialing and what would the model look like for responders.  Motion by Marv Birnbaum, seconded by Gloria Murawsky that the EMS Community must be made aware and begin preparation for ICS training for all EMS personnel to meet the proposed requirements being developed by NIMS.  All Present – Aye.  Suggestion that the Board be proactive and recommend needed levels of training depending on roles.

• Discussed interstate issues for disaster management.  Issues included credentialing,

Systems –

1.      Reviewed the draft EMT-Basic Scope of Practice document and made suggestions on the following areas:

• MAST - CQI by MDs

• ET intubation – not recommended

• Restraint guidelines

2.      Communicator bill recommendations were discussed and given back to the legislative sponsor (Sen Lazich)

EMS-Children

Written report distributed.  There was discussion about the EMSC resource center.  There have been discussions with UW-Children’s Hospital, Children’s Hospital of Wisconsin, and St. Joseph’s Hospital – Marshfield to develop a resource center under the non-profit Children’s Health Alliance of Wisconsin.  The reasons for a resource center include:

1. Streamline work and work product approval

2. Expand staff

3. Maximize resources

4. Expand current initiatives

Physician Advisory Committee (PAC) – Dr. Gordon and Nan Turner reported on the PAC meeting in February that included:

1. Discussion on the DPH restructuring

2. Scope of Practice for EMTs-basic

3. Policies for physical restraints

4. Due Process guidelines

5. CPAP project going forward

The question was raised on whether PAC would look at set levels with names/labels or review the scope of practice documents using open levels of practice. 

The EMS Section has drafted a document on an altered scope of practice that could take effect in disaster situations.  Dan Williams asked that the Emergency Waiver of Rules for EMTs be assigned to Policy and Practice for additions and a recommendation.  Motion by Steve Bane, second by Travis Teesch to forward the draft Emergency Waiver document to Policy & Practice.  All Present - Aye

         Medical Director Report – Given with PAC report.

Injury

• Linda Hale gave an update on the WISH database, which includes injury data that can be viewed by county or RTAC.  The site is at

• Injury is also developing an electronic reporting system for medical examiners and a database for violent injuries.

• There is work being done for suicide prevention and falls prevention.  If anyone is interested in more details, contact Linda.  The WISH module can be found at http://dhfs.wisconsin.gov/wish/main/InjuryMortality/InjuryMortality_home.htm

Agenda Item #4 - Statutory Review

The Board has looked at a draft document of potential statutory language changes.  Motion by Cal Lintz, second by Ken Johnson to send the draft document to Policy & Practice for further review and recommendations on statutory language changes.

Agenda Item #5 - Division of Public Health Restructuring

Tom Alt, Interim Administrator of the Division of Public Health gave an overview of what is in the DPH restructuring report and how it impacts EMS and was attending to listen to feedback from the Board and audience.

Tom discussed the reason for restructuring, which included increasing efficiencies and decreasing costs.  The recommendations still need to be further evaluated and determine any statutory or budget requirements that need to take place to implement the recommendations.  He also noted that there were statewide budget cuts that resulted in the elimination of 14 positions.  This included the elimination of the management and program support positions in the Bureau of EMS and Injury Prevention.

The report also recommended looking at a stable funding source for EMS, streamlining the FAP grant process and reviewing the current license cycle and whether the 2-year period should be changed to a 3-year period and whether the expiration date for renewals should be staggered.

The current proposal has the Injury Prevention Section being placed in the Bureau of Community Health and Prevention and the EMS Section being placed in the Bureau of Local Relations. 

Questions from the audience included:

In looking for EMS funding, will an increase of total FAP dollars be pursued? 
That was not addressed in the report, but future budget dollars will be tight.

Will a different way of licensing be looked at for change?
A recommendation to look at this function is in the report and will be pursued further as follow-up to the report.

Is the EMS Section moving intact to its new bureau?
Yes

Who else is in the proposed Bureau of Local Relations?
The Public Health Regional Office staff and the EMS Section will be placed in that bureau.

There was a recommendation that EMS be part of the title for the new bureau where it is to be relocated.

After Tom Alt left there was further discussion of the report.  Issues included:

• If new funding sources are found, it should include funding for RTACs.

• What are the efficiencies that will be gained in the restructuring?

• The EMS constituency will need to be involved and actively pursue their agenda.

• A coalition of EMS stakeholders needs to be developed and actively pursue EMS initiatives.

Agenda Item #6 - State & Legislative Update

EMS Office Update

Jon Morgan reported

1.      License renewal via EMSS is progressing well. A number of new licenses have been issued through 2004 and automatically been issued a license through 2006 because all the requirements were met and validated.

2.      SB 120 is in the assembly for a vote.  The bill creates a public health council, reimbursement for quarantine costs, intrastate mutual aid, requires use of incident command system in an emergency, provides exemption from liability during state of emergency, penalties for threats to release or disseminate harmful chemical, biological or radioactive substances

In response to a question from Marv Birnbaum Don Hunjadi reported that there were 2700 people at the annual WEMSA conference and greatly expanded exhibitors.

Agenda Item #7 – Old/New Business

• First Responder rules are at the Secretary’s level.  Jon Morgan will check on First Responder status and report back on specific information.

• Marv Birnbaum reported that there are federal initiatives looking at Fire and EMS and he encouraged others to contact Senator Feingold’s office to encourage more funding to be directed to EMS. 

• Distribute EMS Talking Points Paper to Board mailing list.

• Jon Morgan thanked the charter members of the EMS Board: Dan Williams, Marv Birnbaum and Dick Collyard, whose terms are expiring.  It was noted that if they are not reappointed, this might be their last meeting and they deserved recognition for their contributions.  Jon also noted that this might be his last meeting because of the recent restructuring and thanked all in attendance for the valuable work that they provide in caring for patients in Wisconsin.

Motion by Dick Collyard, seconded by Ken Johnson to adjourn.  All Present - Aye

The next regular meeting is May 6 & 7, 2004 in Madison.

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