Members present:
Marv Birnbaum
Cheryl Glomp
Don Hagen
Terry Richards
Gloria Wall
Dan Williams
Karen Richter

Bureau Staff

Jon Morgan, Rick Barney, Nan Turner

Others in Attendance: Representing:
Judy Jones Luther - Eau Claire
Keith Kesler Douglas Co. Emergency Mgt.
Jan Victorson Bayfield Co. Emergency Mgt.
Michael Fraley St. Joseph's Hospital - Marshfield
Mark Madigan County Rescue
Bill Snoke Gundersen Lutheran
Bob Baird PFFW
Michael Kunesh PFFW
Don Hunjadi WEMSA
Mindy Allen Green Co EMS
Diane Eberdt Lodi EMS
John Connor North Central Technical College
Bruce Gordon Riverview Hospital
Kathy Worden Rib Mountain Fire
Joe Jensen Regions Hospital EMS
Greg Carlson WI Indianhead Technical College
Scott Wuerch Gold Cross - Eau Claire

Agenda item #1 Introductions
Dan Williams called the meeting to order at 10:05 at the Stoney Creek Inn, Mosinee. Everyone in attendance introduced himself or herself.

Agenda item #2 Approval of January Minutes
Motion by Terry Richards, to approve the minutes, seconded by Cheryl Glomp.
Unanimous approval.

Agenda item #3 Committee Updates

* Policy & Practice
Karen Richter reported on the highlights of the committee meeting: Interfacility Guidelines: The committee reviewed guidelines and will tighten up the document to match with proposed rule language, and be in line with Medicare reimbursement standards. The committee is also reviewing the guidelines to make sure that Trans 309 equipment rules are consistent with the interfacility guidelines.

* Data and Research
Judy Jones: The committee went down their list of tasks. WEMSIS - It was reported that 268 copies of WEMSIS have been distributed. Data is now being received. The committee needs input on what statewide reports should be generated (Action Item - ask providers, MDs, committees, etc. what they would like for statewide reports). The committee discussed the potential mandated use of WEMSIS and decided to wait for feedback that will come from provider renewal information before making any recommendations.

* Systems Management
Marv Birnbaum reported on the continued work of the Systems Committee. Funding Survey -The survey is done & will analyze funding needs/capabilities. The group has started the survey process of 50 providers and looked at the pilot data from 6 services. The database for analysis is being completed. An initial review of the pilot data has shown some interesting contrasts in provider information. Dispatcher Training: The White Paper is being reviewed and a draft will be sent to committee members to edit and return to Dr. Birnbaum. The goal is to finalize the document at the July meeting. The committee also discussed dispatcher meetings by professional groups such as APCO that are also looking at dispatcher certification. It was recommended that the Board should provide input to this group once the dispatcher paper is done.

* Education
Cheryl Glomp presented the highlights from the committee meeting: Bridge Course: The committee is assembling a curriculum for the bridge course that will allow EMTs-basic to progress to current the EMT-Intermediate level. There will be a meeting May 23 in Madison to finalize the curriculum. Competency based training - Competency based training seems to work best with refresher courses, but these were put on hold until all the licensing and scope of practice issues are clarified by rule changes. Critical care - The committee reviewed critical care curriculum from Maryland for use in WI critical care transports.
There is a vacancy on the Education Committee which will be filled at the July Board meeting.

There was discussion about the future levels of care in Wisconsin. 5 levels were identified:
· First Responder
· EMT-Basic
· EMT-Advanced (current EMT-Intermediate)
· EMT-Intermediate (similar to National EMT-Intermediate and Enhanced EMT-Intermediate pilot level)
· EMT-Paramedic

There was a recommendation that a matrix be developed to summarize the future license levels. Action Item: the bureau will prepare the document prior to the next meeting.

EMS-Children Gloria Wall reported on the EMSC meeting which included the following highlights: Pediatric triangle assessment cards are ready and can be obtained from Mary Jean Erschen. Protocols are being developed for specific pediatric conditions. There will be an EMSC & Injury conference October 10, 2000 at the Paper Valley Hotel. The next meeting will be July 11 in Madison.

Agenda item #4 Legislative Update
Jon Morgan reported on the following items:
· Do Not Resuscitate bracelets are now available through MedicAlert. MedicAlert will be doing a mass mailing to WI physicians in the next month. The EMS office will be mailing information to providers in the next numbered memo series (newsletter).
· HFS 110/112 will go to Legislative Council this week. The plan is to hold hearings in June at 5 sites. Dates, times and places will be announced.
· EMS Board appointments have not occurred due to the Governor's busy schedule. No date was given for the appointments.
· First Responder legislation is now law as Act 56. Representative Johnsrud's office is looking at alternative funding options.
· Volunteer EMT/Fire retirement funds bill was passed as Act 105. The law allows for municipalities to award $250 annually to volunteer EMTs and firefighters as a retirement benefit, which will be matched by State funds.
· The initial budget requests have been submitted to DHFS. The EMS proposals include a global request for a more stable funding source and assistance is several areas. The initial department screening of requests will happen in June.

The Executive Committee has temporarily put on hold the recommendation of a position statement on first responder implementation. That will be ready for the July Board meeting.

Bike helmet & seat belt legislation did not make it out the legislature so it will have to be reintroduced in the next session and go through the full legislative process.

Agenda item #5 Medical Director Report
Rick Barney reported on the PAC (Physician Advisory Committee) meeting in Oshkosh
1. Protocol templates are being developed for administrative items such as patient restraint, DNR, no transport, etc. to be used as minimal guidelines for services and medical directors.
2. Medical Director education requirements were recommended by PAC starting with EMT-P Medical Directors. The recommendation was a 1-day mandated course for EMT-P Medical Directors, and potentially expand later to EMT-I. There was discussion on the pros and cons of requiring a MD education course. This will be discussed further at the next meeting of the PAC and EMS Board. AGENDA Item for July - Further discussion on MD requirements.

Dr. Barney noted he is 50% done with reviewing Enhanced EMT-Intermediate data and some good information is being found. He is also spending time assisting with the trauma committee meetings.

Agenda Item # 6 - - Presentation on Enhanced EMT-Intermediate
Rick Barney presented information on the Enhanced EMT-Intermediate pilots along with Bruce Gordon, Ed Mischefske and Don Hunjadi.

Don Hunjadi reported on Wind Lake's experience in the Enhanced EMT-I pilot. Wind Lake serves 10,000 population and also intercepts with several services. 8 of 9 students completed the course. Training was excellent and clinical time was very beneficial. Ride-along time was not of much value because of limited ALS calls.
Findings: knowledge increase was of great value, 90% of patients could be treated by previous EMT-I skills, CHF diagnosis was initially low.

Dr. Bruce Gordon reported for Higgins and Nekoosa ambulance services. They combined for 710 runs during the pilot. 20% of the runs were Enhanced EMT-I or had some drug intervention. Findings: "Educated" students did better than "trained" students because they understood what was taught. Chest pain interventions were done well, but morphine should be added. Medical director involvement in training is essential. Scenario based practice needs to be examined.

Ed Mishefske reported on Chippewa Falls FD experience in the Enhanced EMT-I pilot. He reported on the pilot from a fire chief's perspective. The Enhanced EMT-I fit their community needs. Intercept rates went up 700% with surrounding EMT-B services & 200% for Chippewa calling Eau Claire's EMT-Paramedic service because of better understanding of what ALS can do for patients. PNB saves went from 1/year to 13 in a 18-month period. Chief Mishefske also handed out a summary report of their experience.

Dr. Barney summarized that 7% of the runs are Enhanced EMT-I, CHF evaluation is the most problematic, overuse of interventions and drugs has not been a problem. He emphasized that this level is not for everyone, but it will fit very well in some communities.

It was suggested that a follow-up evaluation survey be done with the providers involved in the pilot and look at key issues, including cost. The final data review will occur by July and work on the final curriculum will begin soon. Action item - bureau will develop follow-up survey.

Agenda Item # 7 - - Status Report
The Board reviewed the status report with no comments.

Agenda Item # 8 - - Old/New Business
Cheryl Glomp summarized the last meeting of the Public Health Advisory Committee since she is the EMS Board representative to the committee. The PHAC items discussed were use of the Blue Cross/Blue Shield monies and the Tobacco Control Board activities.

The Board will vote in July on a vacancy for the Education Committee and 2 EPAC positions. Interested parties should forward names and CV to Linda Watson at the EMS Office.

Motion to adjourn by Karen Richter seconded by Cheryl Glomp. All present - Aye. Meeting adjourned at 12:10pm.

The next meeting will be held on July 12 at the Comfort Inn, Madison.