August 2, 2006
Board Members Present: Bureau Staff:
Gloria Murawsky Paul Wittkamp
Steve Bane Ann
Moses
Brenda Fellenz Marianne Peck
Troy Haase Helen
Pullen
Cal Lintz LeeAnn
Cooper
Mark Fredrickson Nicky Symons
Joe Covelli Dan
Williams
Tracy
Aldrich Keith Wesley
Travis Teesch
Tom Brazelton
Board Members Excused:
Ken Johnson
Steve Teale
Others in Attendance: Representing:
Kyle Marohl Plymouth Ambulance Service
Chuck Cady Physicians Advisory Committee
Gregory West Waukesha County Technical College
Sandy Johnson St. Joseph’s Hospital - Marshfield
Barb Kuska Beloit Memorial Hospital
Joyce Anderson DHFS/DPH/MCH/EMSC
Tom Thrash Antigo Fire Dept.
Cindy Lazorik WITC Ashland
Fred Hornby Bell Ambulance
Christopher Mohrman Michael – Best
John Schindler Meda-Care Ambulance
Suzanne Martens Sheboygan County EMS
Don Kimlicka St. Clare Hospital, Weston, WI
Terry Helton LJH Ambulance
Steve Krantz Gold Cross – Fox Valley
Jean Green St. Nicholas Hospital
Paul Stiegler Dane County EMS/9-1-1 Medical
Director
Carrie Meffert Dane County EMS
Jeff Grimm Theda Star/STAC
Bob Nack Fox Valley RTAC
Merrilee Carlson Memorial Medical Center - Ashland
Susan Harvey DHFS – EMSC
Ann Peggs PFFW
Nettie Jenkins Thedacare
Steve Stroman Aurora Bay Care/STAC
Dan Diamon Lake Superior RTAC
Jim Austad Oshkosh Fire Dept.
Mitch Waite Wisconsin Rapids Fire Dept.
Dave Kerkman Wisconsin Rapids Fire Dept.
John Duffy Fond du Lac Fire Dept.
Brian Reynolds Milwaukee County EMS Council
Cinda Werner Children’s Hospital of
Wisconsin/EMSC
Linda Hale DHFS
Nan Turner EMSC
Tom Fennell Gold Cross Mayo Medical Transport
Keith Kesler Douglas County Emergency Management
Jan Victorson Bayfield County Emergency Management
Laura Ahola Divine Savior EMS
Frank Koehn South Shore EMS
Karen Wesley Gold Cross Mayo Medical Transport
Joyce Anderson DHFS/DPH/MCH
Judy Jones Luther Hosp Eau Claire/NWRTAC
Larry Knuth Paratech Ambulance
Robin Schultz
Sacred
Heart Hospital, Eau Claire
Welcome and Introductions: Chair Steve Bane called the meeting to order at 1:30
PM at the Sheraton - Madison, WI. Steve welcomed everyone and asked the Board
and audience to introduce themselves. Steve also welcomed the most recent
appointment to the Board, Dr. Tom Brazelton.
1.
Approval of previous Board Meeting Minutes:
A Motion by Haase, second by Aldrich, to
approve the minutes from the June 2006 meeting. Motion Carried.
2.
Committee Updates:
EMS Education: Gloria Murawsky, committee chair reported on the
following meeting topics:
1.
Gloria reported that the committee was continuing
their work on the proposed changes to the EMT-Basic Refresher. It has been
decided to develop five different types of pilot courses that will attempt to
validate what method will be acceptable in the future. Several rules for the
pilots were established and more will be coming as the pilots are further
defined. The following are some of the highlights but is not to be considered
as an all inclusive list.
a.
All courses will be 24 hours.
b.
All training must be within the scope of practice.
c.
A pre & post course written and skills review will
be conducted to assist in determining the effectiveness of the pilot.
d.
Non-traditional pilots must have training plan
approved by State EMS office.
2.
An ad hoc committee has been established to develop
skill competency criteria and a standardized evaluation form.
EMS Policy and Practice Committee: Travis Teesch, committee chair reported the following
meeting topics:
1.
Dr. Wesley discussed the draft that is being put
together regarding the changes to the AHA AED/CPR standards. It was noted that
AHA recently had stated that “using the AHA 2000 guidelines do not represent
any detriment in patient care”. (Dr. Wesley will be presenting the draft in his
report to the Board)
2.
Paul Schilling, the new DOT Ambulance Inspector was on
hand to meet and discuss issues with the Committee. Paul indicated that the DOT
was interested and will plan for opening the rule sometime this year to begin
the process. Paul indicated that things were going very well and he was getting
to as many services that he can. Paul stated that he would keep the committee
updated on things and would be back as necessary with issues. It was suggested
that members of the EMS Advisory be part of the group that reviews Trans 309.
It was also noted that EMSC representation should also be part of the group.
3.
Protocols. Travis stated that the committee would be
receiving sample protocols that are both of high quality as well as some that
need improvement to illustrate the problems that exist with the various styles.
Dan Williams will supply the committee with sample protocols so that the
committee can then create a list of pros & cons for each type.
4.
Verification of training, this topic is an ongoing
process that relates to the pilots of the proposed EMT-Basic Refresher changes.
Policy is being asked to assist in the development of a training course that
will provide instruction to those interested in being a certified competency
evaluator. The other task is to start working on the administrative rule
changes that will be needed to make the refresher course changes allowable in
rule.
5.
Safety stand-down project. This project is tabled and
will be discussed further at the Board strategic planning meeting in October to
determine if it should be continued future project.
6.
Ambulance reports to hospitals. There are basically
three issues with this situation.
a.
What information do the hospitals want and need?
b.
How to deal with paperwork that is lost in the shuffle
in hospital to hospital transfers.
c.
Assuring that original paperwork from intercepts or
first responder groups is also gathered and made part of the patient care
report.
EMS Information Management: Mark Fredrickson chaired the meeting for Dr. Johnson
who was on vacation and reported on the following:
1.
Ann Moses assisted with and overview of the WARDS
system. It was reported that 120 services were either actively or casually
using the system and that 40 were exchanging data and 10 more services would be
added next week.
2.
The committee discussed how they could get more
services involved in the system. It was felt that a deadline date would need to
be established for several reasons. One, it would allow for services to budget
for any expenses that would be incurred and two, it may force the third party
vendors to develop the needed interfaces to allow for data transfers. Motion by Haase, second by Covelli to
encourage all services to begin using the WARDS system by January 1, 2007 and
to make it mandatory to participate in the WARDS system by January 1, 2008.
Motion
Carried
3.
The committee also reviewed some sample reports to
begin the process of understanding the system and how the various reports would
be useful to EMS providers.
CQI – Sub-Committee. Cinda Werner reported on the following on behalf of
the committee.
1.
The committee is looking for ways that the WARDS
system can be used to aid in such things as scene time reduction, pain
assessment criteria, etc.
2.
The committee’s goal will be to build educational
packets and provide links to resources once a services identifies a possible
problem.
3.
The committee will put together a presentation that
can be used by services that will show them the benefits of a CQI program and
the WARDS system and how it will help them with improving patient care as well
as other enhancements and improvements within the service.
4.
The committee will also work on a presentation modeled
after the very successful program that has been developed by Dane County EMS on
the development of a service CQI program.
EMS Public Health: Brenda Fellenz, committee chair reported on the
following meeting topics:
1.
The committee accepted the resignation from Nan
Peterson from the committee due to other work commitments. The committee
thanked her for her participation and providing an important link to EMSC.
Replacement for her will be discussed at the Board’s strategic planning meeting
in October.
2.
The committee finalized the Pandemic Influenza plan
for EMS and asked the Board to officially approve the document. Motion by Murawsky, second by Lintz to
approve the EMD Plan for responding to Pandemic Influenza. Motion carried.
The Board asked the EMS office to place the document on the website and
distribute it through the normal EMS memo series as well as sending it out to
the State’s Public Health offices.
3.
Pediatric Falls program. It was decided to place this
project on hold due to the changes in personnel in the EMSC program.
4.
Safety awareness initiatives and future projects will
be evaluated and developed and discussed at the strategic planning meeting in
October.
Disaster – Sub-Committee Mark Fredrickson, committee chair, reported on the
following meeting topics.
1.
Mark held a discussion on the development of and use
of the Triage Tuesday model that has been established. It was noted that there
is much education needed yet on this topic as many locations are still unaware of
the purpose and the process. However on the positive side systems that are
using it are finding it to be a very valuable tool to the overall awareness of
how to use the tags and also the pro’s and con’s of the various systems and
their capabilities to manage this process. It is still too early to draw any
conclusions because many systems are just getting started in August. More
discussion and evaluation will held at the October meeting.
2.
Mark announced that the OJA grant was successfully
awarded to Wisconsin, although not to the requested amount. Approximately $35
Million was requested and just under $9 million was awarded. The portion that
was requested for Disaster trailers was still in the grant but at a reduced
number. Upcoming meetings will be held to determine how to best use the money
that is available. Early discussions are suggesting that each region be able to
have a trailer that can be deployed and go anywhere that it is needed. Also
future discussions will be held on the proper equipment to be placed in each
trailer. More information will be made available as the details are determined.
Further discussion was held on the continued work to obtain a complete list of
current trailers, their location, what equipment is on them, what work if any
that needs to be done to refurbish them and their ability to move to any
disaster location. Some trailers have been donated and have response
restrictions.
3.
Triage Tags were discussed again and it was decided
that it is too early to make any decisions on making recommendations on what
type of tag should be used. There are many options, styles and systems to
consider. Feed back from system users to the committee will continue to be
sought.
4.
Disaster Master Template. The committee discussed that
they were originally charged to develop a template that can be used by services
to evaluate their current disaster plans to assure that there are no gaps in
the plans and that they will provide an effect method for dealing with the
disaster at hand. It is not intended to be another plan but more of a method
for evaluating the various current plans that a service may have. (Somewhat of
a gap analysis or report card)
5.
Dennis Tomczyk was on also on hand at the meeting to
present the HRSA work plan for the 2006 – 2007 year as it relates to EMS
activities.
EMS Systems: Cal Lintz, committee chair reported on the following
meeting topics:
1.
Cal advised the Board that the committee had completed
its work of making suggestions to the content and layout of the State EMS
website.
2.
The committee will be working in conjunction with the
Education committee on the details of the new refresher course. The charge to
the EMS Systems committee is to look at the five pilots that have been proposed
and to develop a pro’s and con’s list for participating in each pilot. The
committee will also develop a checklist for the evaluation of the resources
that were used to conduct each pilot to determine a comparison of the cost
effectiveness for each so that a cost consideration can be used in the final analysis
of a specific refresher model.
3.
Paul Wittkamp, communication coordinator for the State
EMS office, presented a revised version of the State Communications Plan for
the committee to review and provide input. Several issues came up at the
committee meeting and it was decided that more comment was necessary and that
the committee would accept comment until August 10, 2006. Comments should be
sent to Chairperson Lintz to compile and determine a plan of future action.
EMS-C: Dr. Tom Brazelton reported on the EMSC meeting.
1.
Dr. Brazelton reported that Nan Turner would be
working as an LTE to replace Susan Harvey while Susan in on two month leave of
absence.
2.
It was announced that Dr. Bill Perloff was retiring
from the EMSC Board. The considerable contributions that Dr. Perloff has made
to the group as well as to EMS providers statewide in his tireless pursuit of
providing quality pediatric education to the EMS community were
acknowledged.
3.
EMSC education committee is reviewing the newly
revised EMT-Basic curriculum to assure pediatric information is appropriate.
4.
Federal performance measures are moving forward and
appear to be on schedule.
5.
The group is also developing a speaker’s bureau and
informational topics that can be used by local EMS or government groups to
provide community education when needed.
6.
EMSC will be working with the HRSA Pediatric Expert
Panel to assist in the development of needed equipment for the disaster
trailers that are being funded by an OJA grant.
PAC: Dr. Charles Cady, PAC chairperson reported on the
following.
1.
The committee recognized Dr. Tom Brazelton on his
recent appointment to the EMS Advisory Board. Dr. Brazelton will be difficult
to replace on the PAC as his pediatric perspective and EMS system knowledge was
always a valuable asset to the committee.
2.
Dr. Cady asked the EMS Advisory Board to replace Dr.
Brazelton as soon as possible. Dr. Cady also stated that two other positions
were up for replacement or re-appointment. (details of PAC appointments is
later in the agenda)
3.
Dr. Cady advised the Board that PAC was continuing to
work on protocols. The first task is to review and revise all of the current
protocols that are on the State EMS website. The ongoing other protocol project
is the development of an all inclusive protocol that could be used by services,
medical directors that don’t have the resources to develop protocols on their
own.
4.
The committee was working with Dr. Wesley to develop
guidelines on the transition from the 2000 and 2005 AHA CPR and AED
recommendations.
5.
The committee also went on record as saying that is
was their recommendation that fully automatic AED’s not be used by EMS
transport agencies. The committee felt that there is too much of a chance for
accidental shocking of rescue personnel because of all of the activity that
surrounds resuscitation efforts.
6.
The committee will continue the development of an
evaluation tool to be used by the department for the evaluation of the State
Medical Director.
State Medical Directors’ Report: State EMS Medical Director, Dr. Keith Wesley gave the
following report.
1.
Dr. Wesley is working with PAC on the evaluation tool
for the State Medical Director position.
2.
Working with PAC on the protocol project and it is
expected to be completed by early 2007.
3.
The department was notified that HRSA will be funding
a project to provide final develop of the medical directors education course
and the placement of the course on an interactive website. Project should be
completed by October 2006.
4.
Dr. Wesley stated that he will be hosting a Medical
Directors forum at the PSOW conference on September 13, 2006 from 2:30 to 4:30
PM at the Paper Valley Hotel in Appleton, WI.
5.
Dr. Wesley presented a draft of the AHA transition
guidelines that is being proposed to be sent out to EMS providers. Several issues
were discussed and it was recommended to have the process completed by October
2006.
State Trauma Report: Dr. Steve Stroman provided a
report from the STAC meeting.
1.
Dr. Stroman thanked everyone for their support in
honoring Senator Ron Brown on his efforts to provide financial and legislative
support to the Statewide Trauma System.
2.
Dr. Stroman also advised that the HRSA activities for
2007 were announced by Dennis Tomczyk as they relate to STAC and hospitals.
3.
It was reported that the bulk of the meeting was taken
up Department staff Attorney Eric Wendorff who was asked to respond to several
legal questions asked by STAC. It was a very enlightening meeting and provides
further guidance to STAC as they move forward with the hospital verification process.
Legislative Issues: Dan Williams advised the Board.
Dan
reported on the public hearings that were held on the Emergency Rule for
HFS-110 and HFS-111. Dan reported that one person attended the Madison hearing,
but did not testify. Several people attended the Eau Claire hearing, but did
not testify. One person attended the Green Bay hearing, but did not testify.
Dan received one e-mail that represented written testimony. Generally everyone
was in support of the Emergency Rule. Dan advised the Board again that the
Emergency Rule only shows the areas that have proposed changes and is not the
entire rule. They are blended back together after the legislature has an
opportunity to review the testimony and make their comments.
State Office Issues: Dan Williams, EMS Chief reported that the office was
continuing to process renewal applications. He indicated that as predicted a
significant number of individual and service applications were received by the
office in the last week of June. Dan indicated that as long as services and
individuals had their applications in by June 30, 2006 that they would remain
in good standing until the office issues the 2006 – 2008 licenses.
Old Business:
No
old business.
New Business:
1.
Physician Advisory Committee Terms.
a.
The following positions on the Physicians Advisory
Committee are up for either re-appointment or replacement. Dr. Michael Curtis
and Dr. Charles Cady have terms that are expiring. Also there is a need to
replace Dr. Tom Brazelton due to his recent appointment to the EMS Advisory
Board. The EMS office will distribute a recruitment process for those
interested for consideration to the PAC.
b.
There also is an opening on the EMS Public Health
Committee. The Board decided to take no action on this replacement until the
October Board meeting after review of all committee’s takes place at the
strategic planning meeting prior to the Board meeting.
Other Board Related issues:
1.
Mark Fredrickson
advised the Board on the development of an EMS Honor Guard that has the following
mission. “The Mission”
of the Wisconsin Emergency Medical Service Honor Guard is to represent all
members of the EMS profession with honor, dignity, and respect by our presence
at funeral ceremonies, public parades, and other occasions. We will strive to
provide compassion, support, and assistance to the families and colleagues of
fallen EMS personnel, and pledge to promote the core values of EMS in our
appearance and our conduct at all times. More information on the Guard can
be found at www.wisconsinemshonorguard.org
Adjournment: Motion by Haase, second by Teesch, to adjourn. Motion carried. Meeting adjourned at 2:45 PM.