Members present:                                         Bureau Staff:
Marv Birnbaum                                                Rick Barney
Tim Bjelland                                                     Mary Jean Erschen                  
Dick Collyard                                                   Jon Morgan
Cheryl Glomp                                                   Nan Turner
Don Hunjadi                                        
Terri Richards                                                  
Steve Teale                                                     
Gloria Wall
Dan Williams                                                                                                               

Others in Attendance:                                   Representing:
Barb Johnson                                                   Gunderson Lutheran
Barb Kuska                                                      Beloit Memorial Hospital
Beth Natter                                                      Mercy Hospital – Janesville
Bob Stedman                                                   Waukesha County Technical College
Brain Litza                                                        Paratech Ambulance
Bruce Erickson                                                 Waukesha County Technical College
Cal Lintz                                                           Green Bay FD EMS
Dave Henning                                                   Gold Cross – Fox Valley
Don Kimlicka                                                   Gunderson Lutheran
Gary Winters                                                    Community Ambulance
Jan Victorson                                                   Bayfield Co. Emergency Management
Jeff Grimm                                                        Theda Star
Jerry Miller                                                       Waushara County EMS
Joe Covelli                                                       WEMSA
Joe Jensen                                                        Regions Hospital
Joy Erb-Moser                                                 St. Joseph’s Hospital
Judy Jones                                                        Luther – Eau Claire
Julie Brady                                                       Waukesha County Technical College
Kathy Crandall                                     Lifestar EMS
Kathy Worden                                                 Rib Mountain Fire
Keith Kesler                                                     Douglas Co. Emergency Management
Larry Knuth                                                      Paratech Ambulance
Laura Ahola                                                     UW Hospital
Lisa Ott                                                            Paratech Ambulance Service
Lorie Utech                                                      Prohealth Care Inc.
Lynn Crawford                                     Baraboo, St. Clare’s
Michael Fraley                                      St. Joseph’s Hospital
Mike Kellum                                                    Mercy Walworth
Patricia Padjen                                     UW Hospital
Patrick Kilbane                                     PFFW
Robert Haight                                                   Marshfield Fire
Sherry Kirkpatrick                                            Mercy Walworth         
Suzanne Martens                                              Sheboygan County EMS/PAC
Tracy Froiland                                                  Appleton Medical Center

 [Others who were in attendance may not be listed because the attendance sheet was not returned]

 Agenda item #1 Introductions

Dan Williams called the meeting to order at 10:05 at the Holiday Inn, Mosinee.  Everyone in attendance introduced himself or herself.

 Agenda item #2 Approval of May Minutes

Marv Birnbaum asked that the March motion regarding hospital diversions be edited to better reflect the intent, which was for the bureau to initiate a meeting with the Wisconsin Hospital Association to proactively deal with EMS concerns about hospital diversions.  Motion by Cheryl Glomp, second by Dick Collyard to accept the March 2002 Board minutes with corrections.  Unanimous approval.  

 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.

 Data & Research

Don Hunjadi reported that he met with Dan Williams, Jon Morgan and Nan Turner to discuss the future direction of EMS data collection and analysis.  This will be an agenda item for the June Board retreat.  Don then summarized the committee meeting:

1.      The committee watched a presentation on the EMS portal project by Terry Gonderzik and discussed the possibilities of how that database might be involved with data collection of ambulance run information.

2.      WEMSIS project data was presented to the committee and at the Board meeting.  It will be sent to providers in some format.  Highlights of the EMS demographic data for 21,000 runs were:

·        5% of patients were age 12 or less
50% were age 60 and above
25% of all runs used lights and sirens

Motion by Marv Birnbaum, second by Tim Bjelland, to charge Don Hunjadi to write and distribute EMS data reports to all services with particular emphasis on services that submitted data.  Report should also be sent to Training Centers.  All Present – Aye.  The draft will be reviewed by the EMS Section and distributed to providers.

Education

Cheryl Glomp reported on two education issues that are being worked on by ad hoc groups:

1.      Quality of Instruction and Evaluation.  The group is looking at quality of instruction.  They have reviewed State and national models and continue to draft the report.  Their report should be done by 5/2003.

2.      Bridge and Modular EMS courses.  The committee is working on evaluating the feasibility of developing and implementing transition curriculums between license levels.

The committee has concluded:

·        That bridge courses are done in other educational fields and from EMT-B to EMT-Basic IV and Old EMT-I to new EMT-I level.

·        Hurdles include how to do this for assessment based courses, identifying minimum competencies to be eligible and whether to do this in modules and will that work. 

Liaison & Public Relations – The Liaison and Public Relations committee activities are currently on hold, primarily because of Board membership turnover.  This committee will be reconstituted after the June Board retreat.

Policy & Practice

Dick Collyard reported on the committee meeting.  The committee met twice.  The initial meeting was to look at training costs and use of the EMS Funding Assistance Program (FAP) funds.

The committee discussed options for changing the EMS-FAP distribution.  The legal opinion was that the statutory language requires training funds be given to training institutions, which would preclude direct distribution to providers.  Motion by Dick Collyard, second by Cheryl Glomp to: 1) Place a cap of $800,000 as the maximum that can be used to pay for EMT training; 2) set EMT-basic training reimbursement at the WTCS diploma level rate for fiscal year 2003; 3) Seek opinion from Attorney General on apparent contradictory language; 4) Reopen 146.50 to change statutory language governing EMS-FAP.  There was considerable discussion about the impact of capping training costs.  All Present - Aye

The committee also had a brief discussion on how injury prevention activities should be part of the role for EMS.  This will be discussed at the Board retreat.

There was a discussion on the reimbursement rate for EMT-basic IV from federal health care dollars.  Jerry Miller gave an overview of how EMT-basic IV services would lose revenue depending on how the federal language is interpreted.  Motion by Dick Collyard, second by Tim Bjelland that the EMT-basic IV, EMT-intermediate and EMT-paramedic levels be recognized as advanced life support (ALS).  All present –Aye.

Marv Birnbaum stated that all “advanced” medications (i.e. albuterol) should be considered for higher reimbursement rates and that the Board should be active in promoting this concept.

Systems Management

Marv Birnbaum reported on the committee meeting.  The committee discussed the objectives still pending from the 2001 retreat:

Ad-hoc Committee activities:

CQI committee – Developing 2 CQI templates

·        Chest pain –

·        Respiratory distress

The committee’s plan is to accumulate simple information that is already being collected.  A few data items are added for each higher level (Basic to IV to Intermediate to Paramedic).  These templates will be piloted with a small group.

Disaster Management – The committee discussed two grant related requests: one on a needs assessment that will look at hospital preparedness for terrorism events and the second on FEMA funding that will be distributed to States.  The committee made recommendations on the grant-related activities to include:

·        Some EMS needs assessment questions should be included on the hospital survey.

·        Suggestions for use of FEMA funds will be incorporated into the response.  Suggestions included some local flexibility for use of the money, the need to train management and field staff about the incident command structure, and not to encourage the citizen corps concept as another line of disaster responders because funding existing groups would be a better use of the funds.

System Committee activities:

1.      Summarized CQI and Disaster committee

2.      Discussed the concept that zones of collaboration should be done as needed, rather than as a separate objective.  Development of trauma regions will be used as an example.

3.      The EMS finance report will be summarized by the June retreat.

Communications – Jon Morgan reported that the committee reviewed and made recommendations to the draft of the State Communications Plan and completed most of the first and second sections of the document.  The first part of the document is an overview of EMS communications, the second part is a description of EMS communications in Wisconsin and the third part is a set of minimum standards for providers on equipment and protocols for logistical and medical communications.  The group hopes to be close to a final product after their July meeting.

EMS-Children - written report

A written report was submitted that highlighted EMSC activities.   Mary Jean Erschen also expanded on the following:

1.      The childhood emergency conference is being developed with multiple tracks for various interest groups.  The dates are September 16 & 17 in Wisconsin Dells

2.      Basic Emergency Lifesaving Skills in Schools (BELSS) is being developed for use in schools.  Training will occur June 28 & 29 and the program will target 5 schools to pilot.  Will also be working with an injury prevention curriculum called RiskWatch in the school setting.

3.      The Child Alert program is expanding and working well.

It was noted that Mary Jean was named the National EMS Coordinator of the Year. 

It was decide that there should be a July Board meeting.  Committee chairs were asked for their requests for meeting time needed at the July meeting: 

July 9 & July 10

Communications  - meeting Monday July 8^th from 10:00 AM to 1:00 PM at 1 W. Wilson street in Madison.

Wednesday, July 9

Systems – 2 hours                                                             

Exact times will be set after the June Board retreat.  The schedule will be drafted and sent to chairs for comment prior to distribution

Agenda item #4 Medical Director Report

Dr. Barney reported on his activities and the activities of the Physician Advisory Committee and highlighted the following:

1.      PAC appointments are coming due.  Interested physicians should submit a CV and letter of interest to Nan Turner at the EMS office.  The bureau should put out a notice about PAC openings and solicit candidates.

2.      There is continuing work being done on the Medical Director web course.  The goal is to have it on the web by the end of the year.

3.      Looked at data needed for review and decided on three main uses for EMS data:

·        For MD and local services

·        State level data to look at medical trends

·        Surveillance data that will trigger an “alarm” to note immediate problems

4.      Reviewed and approved interosseous infusion use administered in the sternum for EMT-I and EMT-P.

5.      Dr. Barney has been involved with a number of meetings around the State of Wisconsin.

6.      Dr. Barney and Terry Gonderzik discussed the draft Interfacility guidelines with regional HCFA coordinator.  EMTALA interpretations by HCFA will be discussed at a meeting in June with the Bureau of EMS and Injury Prevention, the WI Hospital Association and the Rural Health Cooperative.  This will likely cause the draft document to be reexamined.

Agenda item #5 – June Board Retreat

Dan Williams asked for Board input on materials needed for the June retreat.  He noted that the 2001 retreat document will be used as a starting point for evaluation and reprioritizing of objectives.  There were no other requests.

Agenda item #7 - Legislative & State Office Update

Jon Morgan reported on state issues that included:

1.      Trauma System – In the Governor’s budget repair bill; out in the Senate version.  This budget item is up for discussion along with the other 320 budget items.   Regional Trauma meetings are scheduled and taking place over the next few months.

2.      Statutory changes.  How statutory language is changed was summarized.  Technical correction requests can be submitted annually by DHFS.  New language or policy changes must be introduced as legislation.

3.      2002 – 2003 State EMS Plan – the state plan is in draft form and will be discussed at the EMS Board retreat.  There were no objections to the new draft format.

4.      DHFS audit of EMS program – A copy of an internal department audit of EMS resources was distributed to the Board members.   It highlighted the workload issues around EMT license renewal and the feasibility of first responder certification.  Discussion on the audit was deferred to a later meeting.

5.      The Centers for Disease Control Bioterrorism grant was summarized.  There are a number of specific EMS items included, as well as many that impact EMS.  Specific EMS items include: 2 staff positions for first responder certification and communications, Training of EMTs on basic hazardous materials response, dollars for EMS IT/Data development, Medical Direction which will involve Dr. Barney, and medication caches to respond to certain agents.

Agenda Item #8 - - Old/New Business

Nan Turner read the Governor’s proclamation for EMS week.

Don Hunjadi commented on activities that WEMSA has helped organize for EMS week, including TV and radio coverage.

Marv Birnbaum reported that the federal Feingold-Collins bill which calls for coordination of federal EMS grant monies that are distributed by several federal agencies.  There was also a federal meeting to discuss hospital diversions.

Don Hunjadi raised the issue of allowing for a phase-in of EMT-basic IV level services.  This will be discussed at the Board retreat.

Motion by Dick Collyard, second by Cheryl Glomp to adjourn.  All present -Aye.  Meeting adjourned at 12:30 PM.

The Board retreat is June 3 and 4 in Sturgeon Bay.

The next regular meeting is in Madison July 9 & 10.

FOLLOW-UP: