Emergency Medical Services Board Meeting

April 6, 2005

Board Members present: Bureau Staff:

Tracy Aldrich Meg Taylor

Steve Bane Bruce Gordon

Brenda Fellenz Dan Williams

Troy Haase Ann Moses

Don Hunjadi Brian Litza

Cal Lintz Marianne Peck

Ken Johnson

Steve Teale

Travis Teesch

Gloria Wall

Joe Covelli

Board Members Excused:

Gloria Murawsky

Others in Attendance: Representing:

Barb Kuska Beloit Memorial Hospital

Ann Peggs PFFW

Allen Hefter PFFW

Todd Van Langen West Bend Fire Dept.

Jan Beyer UW EMS Program

Jennifer Roman Madison Fire Dept.

Joseph Immermann Southwest RTAC, Coordinator

Don Kimlicka Sparta Area Ambulance

Judy Jones Luther – Eau Claire

Vickkie Zietlow MidState technical College

Gary Leyer Gateway Technical College

Fred Hornby Bell Ambulance

Pat Padjen UW EMS Program

Steve Pilsner Wausau Fire Department

Suzanne Martens Sheboygan Co EMS

Mary Austin Monroe Clinic

Tracy Froiland Theda Care/Fox Valley

Larry Knuth Paratech Ambulance

Cheryl Glomp St. Mary’s Hospital

Tom Brazelton UW Hospital

Jerry Miller Life Quest Billing

Charles Cady Physicians Advisory Committee

Jim Brian Marinette County Rescue Association

Beth Natter Mercy Hospital – Janesville

Bob Nack Fox Valley RTAC Coordinator

Ted Tautges Wausau Fire Dept.

Tom Fennell Mayo Medical Transport

Jim Swan Divine Savior Healthcare

Agenda item # 1 Introductions

Chair, Steve Bane called the meeting to order at 10:00 AM at the Crowne Plaza, Madison. Steve asked everyone in attendance on the Board and the audience to introduce him or herself.

Agenda item # 2 Approval of November 2004 Meeting Minutes:

Motion by Teesch, seconded by Haase to approve the February 2005 Board minutes. Motion carried.

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.

Executive Committee

1. The main committee did not meet.

EMS Partners ad hoc: Cal Lintz, committee chair stated that the committee reviewed the following issues:

a. Web based training system discussion. The committee discussed the issues surrounding the web based changes being proposed regarding education and relicensure period. The education program development can begin but can not be implemented until the process rules are established. The intent is for the Technical College system to be on the front end of the process to be able to provide this type of education within the current system.

b. The committee has decided that they should maintain the current meeting frequency, which seems to be meeting the intended goals and tasks that the committee was intended to deal with.

Education

Steve Teale reported on behalf of the committee:

1. Steve reported on the progress of the review of the basic EMT curriculum. Steve stated that the group was moving to a practice based approach to training. The committee provided an analysis of the major modules of the course. The first two units are completely done and are moving forward with the completion and time line. Time line will not allow for a fall roll out in 2006. The intent would be to implement in May of 2007. Steve also handed out the template for how the curriculum will be laid out.

Policy and Practice.

Don Hunjadi reported on the committee meeting, which included:

1. The main discussion centered on the topic of the Basic EMT Refresher and relicensure requirements. The committee has previously been discussing and planning with regards to the length and quality of training that is needed as well as the length of time for re-licensure. Several committee members suggested that a four (4) year re-licensure period should be looked at. The committee stated that many formats for education need to be examined, such as, virtual classrooms, web based programs, conferences, etc. It was the consensus that the education can and should be exciting and renewed with a variety of educational formats. A committee was put in place to develop the rules for how the entire process on procedure and makeup so that the education programs will have a template for how to access and work within the proposed system. The committee decided to meet again on May 3, 2005 at 1:00 PM in Wautoma, WI at the LifeQuest Billing office.

2. The proposed National Scope of Practice Draft 2.0 has been updated from the 1.0 draft and is available. The original National EMS Scope of Practice Model was of great concern for many people nationally. The scope committee received many, many letters of concern and protest to the product. They also received many letters of support to certain aspects of the draft. It would appear that the scope committee is now moving to minimal criteria as opposed to maximum criteria. More information will be made available as it is released. The Committee needs to complete another evaluation and response regarding Draft 2.0 and send it out in the time period given to respond.

SYSTEMS MANAGEMENT.

3. The Systems committee is also continuing its work on inclusion and exclusion transport criteria for stand alone emergency departments. Part of the document will address the main issues surround the delivery of patients to locations other than designated hospital emergency departments. The committee will develop a template for this purpose than can be used in the event that another situation like this comes up and can be forwarded to the appropriate EMS service at the time.

CQI

Ken Johnson reported that the committee has begun to receive feedback on the CQI templates and are preparing responses.

The committee needs to answer the question as to what direction they should move toward as the next phase of the project. The changes in the Stroke patient care protocols may be a good area to provide education back to the EMS services so that the patients can be cared for in a positive way. The committee needs to determine how they will use the information and how the patient care can be changed.

The committee will develop a packet of information that will be available to services that will better define the entire process.

The committee feels that there will be natural move into the information enhancement committee as the data management system starts to take shape. It will be quite a while before that transition can take place however. The committee needs to continue to move forward so that the momentum that has been built is not lost while waiting for the data system.

Disaster The committee is reviewing and working on the following:

1. Suzanne Martens presented the first-in document for review as an information piece for the WEEPP. A document was settled on and will be provided for approval.

Motion by Johnson, to accept the document by exception with a 15-day period to respond to the department with any concerns. Second, Lintz. Motion carried.

EMS Injury & Illness Prevention

Gloria Wall reported on the following committee meeting actions.

1. The committee is identifying the role that they need to play. There is a better understanding that a pro-active approach is taken to educate and understand the working relationships that could and should be considered.

2. The committee also needs to identify & strengthen the relationship between Public Health and EMS. EMS office is available to attend the regional meetings to educate the regions on the linking roles of EMS and Public Health agencies.

3. LEPC’s (Local Emergency Planning Committee’s) may be the link to getting all of the players to the table for a common platform with regards to disaster linkages between Public Health and EMS.

Information Enhancement

The committee worked to outline the item that they felt would be the backbone needs of whatever Data Management system/program that would be eventually decided upon. The committee discussed the following.

1. The committee developed a three-page document on the essential components of what should be part of a system for the development of an RFP. Motion by Haase, Second Teesch, to approve the document developed by the committee and to be used in the development of the Ambulance Run data management RFP. The motion is by exception with a 15-day period to send any further comments to EMS office (Dan Williams). Motion carried.

2. The committee will then move toward the development of RFP evaluation criteria. Because of the short time frame we are now working under another meeting has been scheduled for May 3, 2005, to be held in Wautoma, WI at the LifeQuest Billing office

EMS-Children

Dr. Tom Brazelton reported that a collaboration group was being established to bring all of the various EMS groups together to better integrate our processes and procedures to assure that we don’t have anyone left out. The first organizational meeting was held today with representatives from EMSC, EMS Advisory Board, EMS Office Staff, State Trauma Coordinator. The next meeting is scheduled for Wednesday, June 1, 2005 after the next STAC meeting.

Physician Advisory Committee (PAC)

The PAC met in February and revised the meeting schedule for the year. Looked at the scope of practice and made an effort to bring the scope into what is necessary and needed at a certain level and then develop the training curriculums to mirror the scope.

Interfacility transport guidelines are being re-worked to bring them up to date with current medications and practices. It is anticipated that the review will be complete within the next 4 – 6 months.

The Medical Directors course is in final stages of refinement and about ready to be placed on a State supported site. Further enhancement has been discussed, but the current plan is to get the course operational and then move for improved enhancements at a later date.

Medical Director Report. The Medical Directed discussed several areas that he was currently working on.

Agenda item # 4 EMS HRSA Disaster plan project

Dan advised the Board that the plan had been approved at the last Board meeting and the current task was the educational component of the WEEPP. Cathy Etter from the EMS office has worked with the EMS Alliance to develop a training tool to distributed to EMS services through the Regional RTAC’s. The RTAC’s will receive train the trainer, training which will allow them to actively involved in moving the plan and the corresponding training forward.

Agenda item # 5 Legislative Issues:

There were no legislative issues pending at this time that seems to have direct EMS impact.

FAP funding within the budget bill. Currently in the Governors budget bill there is a provision to change the process and amounts that will be available for EMS providers. The major change is that all of the $2.2 million will go directly to the providers in yet to be determined formula. There no longer will be link between DHFS, the providers and the Technical College system for the payment of training and testing.

AB 246 for all tech college programs to use standardized health curriculums.

It was noted that the Prevention Block Grant funding in the Federal budget has a zero budget. The impact on the State EMS office would be significant if this remains. Approximately one half of the EMS office staff positions are funding by this grant. Further the Federal Trauma system and EMS for children are also zero budgets.

Agenda item # 6 State Office Issues:

1. Brian Litza reported on the changes to EMT IV-Tech exam.

2. National Registry Exam Changes. Dan Williams advised the Board that he attended a meeting St. Louis sponsored by the National Registry where they rolled out the first information regarding their proposed move to an all computer based testing system. The system will be effective January 1, 2007. The purpose of the meeting was to introduce the reasoning behind the change and to solicit input from State EMS Directors from around the country. The discussions were centered on Costs, Access to testing sites and Logistics. There will be much more discussion in the future on all of these issues as the process moves forward. Dan did advise the Board that there will be a significant increase in the cost of the written exam. The 1^st Responder exam will be $65.00; EMT basic will be $70.00; EMT – Intermediate will be $100.00 and the Paramedic exam will be $110.00.

Agenda item # 7 Old/New Business

RTAC concerns. Several of the committees as they met were wondering if they could get more information on what was occurring in the regional RTAC’s. Specifically the interest was primarily the EMS activities. The Board would like to know the possibility of each RTAC coordinator providing a one paragraph report on EMS issues within their RTAC. The purpose would be to potentially offer assistance if needed to assist in those issues. As an interim method to provide the EMS Board with STAC and RTAC information the STAC meeting minutes with sent out with the Board meeting announcement and minutes.

CPAP issue. The Physician Advisory Committee, at the request of the EMS Section has redefined the CPAP project to identify that the project will be completed on December 31, 2005. The PAC will then make a decision, after a review of the submitted documentation to either recommend its use at the basic EMT level or to withdraw it use. More information is needed, so if you are participating in the pilot you need to submit the CQI form to the EMS Office as you use the procedure so that on going evaluation can be completed.

Steve Bane announced that the Professional Fire Fighters of Wisconsin (PFFW) has made a generous offer to provide funding for the Board Chair to attend a National conference in June and to provide funding for any Board member to the upcoming Paramedic Seminar in Appleton. Discussion followed regarding how this could be accomplished under State guidelines. The Section will consult with administration on the feasibility of the request and how they would be able to manage the offer. Further discussion centered around the bigger question of how the Board would manage other requests of this nature that could come from other groups, organizations, vendors and private industry. The Board needs to establish a process for the acceptance of gifts, awards, grants, etc. and confer with the Department to determine proper management practices.

Agenda item # 8 Other Board Related Issues.

A discussion was held regarding the next Board retreat. Historically the retreat was held the week of June. That was prior to the change to a regular June Board meeting. It was the feeling of the current Board members that it may be better to allow for any new Board members that may be appointed to attend a few regular Board meetings. There would be two regular meetings prior to the retreat that way they would get a feel for what is going on before having to discuss and plan for what is needed for the future. It was decided to start looking into a retreat for possibly September 12 & 13, 2005. Dan will check on meeting location availability and will keep the Board advised.

Agenda item #11 Adjournment.

Motion by Lintz, second by, Johnson to adjourn. Meeting adjourned at 11:59 AM.