Emergency Medical Services Board Meeting

 August 3, 2005

 

 

Board Members present:                             Bureau Staff:

Steve Bane                                                      Meg Taylor

Tracy Aldrich                                                   Dan Williams                                                          

Brenda Fellenz                                                 Cathy Etter

Troy Haase                                                      Marianne Peck

Cal Lintz                                                           Dr. Bruce Gordon

Steve Teale                                                      Ann Moses

Travis Teesch

Joe Covelli

Gloria Murawsky

Mark Fredrickson

Keith Wesley

 

Board Members Excused: Dr. Ken Johnson

                                                                                                                       

Others in Attendance:                                  Representing:

Barb Kuska                                                     Beloit Memorial Hospital

Allen Hefter                                                     PFFW

Todd Van Langen                                            West Bend Fire Dept.

Jan Beyer                                                         UW EMS Program

Don Kimlicka                                                   Sparta Area Ambulance

Judy Jones                                                       Luther – Eau Claire

Fred Hornby                                                    Bell Ambulance

Steve Pilsner                                                    Wausau Fire Department

Suzanne Martens                                              Sheboygan Co EMS

Larry Knuth                                                     Paratech Ambulance

Beth Natter                                                      Mercy Hospital – Janesville

Bob Nack                                                        Fox Valley RTAC Coordinator

Tom Fennell                                                     Mayo Medical Transport

Keith Kesler                                                    Douglas County Emergency Management

Jan Victorson                                                   Bayfield County Emergency Management

Laura Ahola                                                     U.W. Hospital

John Duffy                                                        Fond du lac Fire Department

Tim Hillebrand                                                  Dane County EMS

Carrie Meffert                                                   Dane County EMS

Brian Reynolds                                                 Milwaukee Fire Department

Mike Jankowski                                               Franklin Fire Department

Susan LaFlash                                                  DHFS - EMS for Children

Dawn Wolfcale                                                Northeast Wisconsin Technical College

John Kramer                                                    Delavan Rescue

Jeff Jensen                                                        Advocates for EMS & Zoll Medical

Linda Hale                                                        DHFS – Injury Prevention

 
Agenda item # 1 Welcome & 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 June 2004 Meeting Minutes:

 

Motion by Teesch, seconded by Aldrich to approve the June 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 and discussed the following issues:

 

1.      Status of HFS – 113. Dan advised that the process is moving according to schedule and that the EMS office is getting significant contacts from services wishing to participate in the new advanced skills.

2.      Dan advised that the department is reviewing the RFB applications and will be selecting a vendor very soon.

3.      Travis Teesch, Chairman/Policy and Practices Committee reported on committee actions from 7/14/05 meeting specific to (1) the proposed formula for FAP funds, and (2) the proposal to extend EMS licensure for EMT-Basic to 4-year cycle with 48 hours refresher training.

Document will be prepared by WI EMS Section detailing the language and intent of the abovementioned proposals.

4.      Ken Sternig reported Ad-Hoc Committee for Distributive Learning Announced tentative one-day workshop in December, 2005 to discuss technical aspects of distributive learning for audience of EMS training administrators and EMS educators

    

Education

 

                 Gloria Murawsky reported that:

 

1.      EMT-B Curriculum Review:  Dan mentioned that at this point the only thing needed is core content changes and the format of the curriculum (such as WIDS) can wait.  For time sake it was suggested a small ad-hoc to go through the EMT-B core content to pull out items that should be part of the refresher.  An ad-hoc was established consisting of Gloria Murawsky, Troy Haase, Brian Reynolds, Mike Jankowski, Steve Teale and Nicky Symons. Steve asked if the optional advanced skills should be in general refresher. It was felt that they would not since not all services will use the same equipment.

2.      Scope of Practice: Gloria handed out the scope of practice lists for review. Several changes were made to the first responder and EMT-Basic scopes to keep continuity between levels. Suggestion was to change all mouth to mouth, nose, stoma, etc to basic airway maneuvers. Also automated BP will be removed from approval required to extra training needed. It was decided to add another star line. The new scope will show ** for extra training needed and *** as approval and extra training needed. 

 

Question on manual defibrillation was raised as why it is still there. It was   mentioned by Steve that this was due to a hardship of some services. Hemorrhage control list will be revised to have consistency between levels. Tracy raised questions on Nitro and Epi as to training & approval. Dan mentioned that it will probably become part of the curriculum and therefore will not require the approval and extra training if this happens.  Suggestion to revise the Albuterol and Atrovent listings to state “unit dose” and remove “combined”, also to separate Epi auto-injector and manually drawn Epi.  It was felt that administration of manually drawn Epi should require extra training and approval.

 

3. First Responder Modules: The modules developed by an ad-hoc group in        2001 were handed out for review. Steve mentioned that he is not sure if the information still applies well to the first responder as they were based off the EMT-Basic training. Gloria mentioned she will clean up the modules by the end of the week and send to all committee members. Members will need to get any suggestions and/or changes to Gloria within 2 weeks. One change made was to remove the name “Combitube” and replace it with “dual lumen non-visualized airway”.

 

Policy and Practice.

 

Travis Teesch reported on the committee meeting, which included:

 

1.      Chairperson Travis reviewed the motions that were made at the July meeting.  In order to clear up the motion regarding FAP Funding, he asked for a motion to move the $200,000 dollars that had been shifted from the general fund to the training fund back to the general fund to restore that funding level to the previous $3588 dollar base amount for each service.

2.      Chairperson Teesch re-read the motion from the July 14 meeting “...to use the following weighted formula for use in distributing the previous training allocation funding which is $800,000: 1/3 – population, 1/3 – number of EMS licensed personnel, 1/3 – service call volume.”  After discussion and questions, Dan Williams stated that his office would need to clarify in information sent to the services that the 1/3 of the roster numbers should be basic EMT’s only.  The information will also state that each EMT-Basic must declare their primary department so that they appear on only one roster.  With these clarifications, the committee affirmed that they still approved the motion as passed in July.

3.      The EMS office will also develop a uniform set of skills check-off lists that the services will be expected to use as verification that the provider has demonstrated competency during the retraining period.  This will be done after the core skills have been defined. 

Steve Teale pointed out that services will need to be reminded of their     responsibility for record keeping with the changes in continuing education for re-licensure.  The Bureau will need to develop a form so that all services use the same format for documenting training according to Dan.  Dan also pointed out that it is, always has been, and will continue to be an individual’s responsibility to maintain their own license.  Therefore, each individual should be encouraged to maintain their own accurate records.

 

Information Enhancement

 

            1. The committee did not meet.

 

EMS Injury & Illness Prevention

 

Brenda Fellenz reported on the following committee meeting actions.

 

1. Public Health Data Collection:

Each Committee member contacted public health agencies in their local counties and reported the data collected regarding the current and potential working relationship between public health and EMS. There were various levels of activity between EMS and the local Public Health offices, ranging from very little to completely involved. The committee then outlined the following strengths and areas of concern.

 

What is working well with EMS & Public Health?

Ø     Bioterrorism

Ø     Injury Prevention

Ø     Interest in working together

Ø     Hospital Injury Prevention

 

What are the obstacles for EMS & Public Health?

Ø     Finances

Ø     Independence of each agency

Ø     Turf protection

Ø      Lack of understanding

Ø     Bureaucracy

Ø     EMS resources are being cut

 

What are the opportunities?

Ø     EMS is an excellent human resource for disaster/crisis planning

Ø     EMS council/alliance with public health

Ø     Partnership with public health

Ø     Partnership with programs

Ø     Development of a list of resources for each agency

 

SYSTEMS MANAGEMENT.

 

1.      EMS Protocol for Ambulance Transports to Free-Standing ERs – Step 1:

·        Completed the final language for generic EMS protocols for referencing guidelines specific to the transport of patients to free-standing emergency rooms

·        The categories formatted into these EMS protocols will include (1) a glossary of  DEFINITIONS, (2) the PURPOSE of the document, (3) a POLICY STATEMENT for the guidelines used of determining destination choice and (4) the EXCLUSION CRITERIA with declarative explanations 

·        The final document will be reviewed by the Committee at the October 4th, 2005 meeting for submission to the WI EMS Advisory Board for final approval

·        If approved by the Board, the WI EMS Section will prepare a “package” of documents to supplement these guidelines including (1) WI Chapter 118 – Trauma Care, (2) WI EMS Section Position Statement on Hospital Destination dated 1997, and (3) guidelines for establishing free-standing ERs from the WI Bureau of Quality Assurance

 

  CQI

 

  Committee did not meet.

 

  Disaster

 

1.      The committee did not meet.

 

EMS-Children

 

Susan La Flash handed out National performance measures that were released 7/2005.

 

Physician Advisory Committee (PAC)

 

The interfacility Transport guidelines should be completed at the September PAC meeting and will then be sent out to several groups, including the Board for final comment.

 

 Medical Director Report.

 

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

 

Marketing committee involvement. Communications movement to for EMD education.

 

STAC Report.

 

Marianne reported that the Legislature and the Governor had approved funding for the Trauma System that will begin July 1, 2006. This was a tremendous effort on many people’s part and everyone that sent letters of support should be congratulated on a job well done.

 

Agenda item # 4 Legislative Issues.

 

Dan advised the Board that the Board that no new EMS legislative issues were being discussed at this time.

 

Agenda item # 5 State Office Issues:
 

     Most items have been reported on previously.

 

Agenda item # 6 Old/New Business

 

  1. EMS Advisory Board Retreat. Dan advised the Board that the dates have been secured for the EMS Board retreat and are Monday and Tuesday September 12 & 13 2005. The location is Stone Harbor Resort. A block of rooms has reserved for Sunday and Monday evenings. Meeting will start at 8:00 AM Monday morning and should be completed approximately at noon on Tuesday.

 

  1. Physician Advisory Board term expirations and seeking interested physicians to serve. Mark Schultz, Tom Braselton, Eric Voter. The packets should be Aug 31 to be submitted and voted on at the October meeting. The Board is seeking interested Physicians to fill the vacancies.

 

  1. Discussion on sub-committee and Board minutes. Board committee minutes 15 days. After the meetings. Dan will include with announcements.

 

  1. At large membership to EMS Board sub-committee term expirations.

 

Resumes for those interested in committees must be submitted by September 2, 2005. The open positions will be voted on and appointed at the October meeting.

 

Agenda item # 7 Other Board Related Issues.

 

The Board offered a special thanks to the WEMSA Board for their letter of support for the Trauma System.

 

Agenda item #10 Adjournment.

 

Motion by Covelli, second by Teesch, to adjourn. Motion carried. Meeting adjourned at 11:10 AM.