Members present:
Marv Birnbaum
Cheryl Glomp
Gloria Murawsky
Dick Collyard
Tim Bjelland
Don Hunjadi
Mark DeGuire
Dan Williams
Terri Richards
Steve Teale
Don Hagen

Bureau Staff:
Jon Morgan
Rick Barney
Debbie Crawford
Ann Moses
Mary Jean Erschen

Others in Attendance: Representing:
Judy Jones Luther – Eau Claire
Don Kimlicka Gunderson Lutheran – LaCrosse
Jim Keiken Madison FD
Robert Haight Marshfield Fire
Bill Snoke Gunderson Lutheran
Kathy Worden Rib Mountain Fire
Jan Victorson Bayfield Co. Emergency Management
Keith Kesler Douglas Co. Emergency Management
Mark Madigan County Rescue
Robin Schultz Eau Claire Sacred Heart
David Bloom Town of Madison FD
Judith Johnson Dane County EMS
Tim Hillenbrand Dane County EMS
Len Orlando Professional Firefighters of WI
Pat Kilbane Professional Firefighters of WI
Jack Anderson Southwest Tech. College
Linda Pace Madison Area Tech. College
Michael Fraley St. Joseph’s Hospital – Marshfield
Steve Andrews Flight for Life
Laura Ahola UW Hospital
Keith Wesley Sacred Heart – Eau Claire
Beth Natter Mercy Hospital – Janesville
Barb Kuska Beloit Memorial Hospital
David Bloom WI State Fire Chief’s Assn.
Tom McCarrier Mid-State Technical College
Ken Sternig Milwaukee County EMS
Martha Florey Dept. Of Transportation
Kathy Crandall EMS Coordinator
Scott Schneider Two Rivers FD
Lorie Utech Prohealth Care Inc.
Dave Henning Gold Cross – Fox Valley

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

Motion by Gloria Murawsky, second by Dick Collyard to accept the July 2001 Board minutes. Unanimous approval.

Agenda item #3 Committee Updates

There were 2 action items that were carried over from the July meeting:

• Acceptance of the committee recommendations for action on the past legislative reports

Motion by Cheryl Gloom, second by Tim Bjelland to accept the committee recommendations for action on the past legislative reports. All Present - Aye

Motion by Tim Bjelland, second by Cheryl Glomp to formally accept updated Board operating procedures. All present - Aye

Dick Collyard reported on the committee meeting.

1. EMT-Intermediate I/C qualifications. EMT-I must be new (enhanced) EMT-I or above and ACLS instructor. The EMT-Intermediate rules will go to public hearing soon.
2. EMT-I bridge course 180 hours est – next fall. EMT-I full course 400 hours (est.) ready January 2002 and contingent on rule being in place.
3. The Interfacility Transport guidelines are being worked on by an EMS Section committee and a draft should be completed yet this year.
4. Critical Care paramedic curriculum looks to be about 80 hours + clinical time and implementation date is estimated to be 2003.
5. HFS 112 – Dr. Barney outlined the proposed rule. The paramedic rule is approved except for one small portion related to flexible staffing options for existing Paramedic services. The new rule allows for new paramedic service areas to be staffed with 1 paramedic and, at a minimum, 1 EMT-basic. The approved portion of the rule can be filed, but there is a complication in the rule that was affected by the objected to language. The point in question is the ability of the first paramedic on seen to provide any care above the EMT-intermediate level. This issue needs to be clarified before the rule is filed. The objected to portion of the rule regarding flexible staffing now goes through a legislative process of bill introduction and passage necessary to sustain the objected to language. This will likely take months.

Mark DeGuire reported on the data meeting activities that included:

1. Clarification of the role of the Ad Hoc committee for EMS data issues & implementation. The three areas for further review and recommendation are:

a) Add an open forum to get input from providers and other data stakeholders
b) Evaluate WEMSIS background history problems & potential solutions
c) Identify alternatives & assess potential use (resource needs for provider & State)
The timeline for completion of a report answering these questions is by the May 2002 Board meeting.

2. Data & Research standing committee

Short term Goals

• EMS Office will develop WEMSIS reports to distribute.

• Confidentiality of data – EMS Office will send providers basic information on HIPAA and the medical record confidentiality statute and a template for confidentiality of medical records.

3-5 years goals – Use of data (future agenda items/priorities)

• Possibly evaluate (survey) existing data collection and analysis ability
• Data committee to generate questions of what data is needed – priority of what can be asked for now (required), including reason why & explanation/education back to providers
• CQI model reports to send to providers

Marv Birnbaum reported on the committee meeting. The committee discussed:

Ad-hoc Committees

• Tim Bjelland will chair CQI committee
• Mike Fraley will be Systems rep on Disaster Management
• Communications – coordinated by bureau
• Ad-hoc committees to meet prior to Systems at Board meeting in November

Medical Communicators report (Dispatchers): A legislative sponsor has been identified, but it was uncertain where a draft bill was in the process. The committee will apply for DOT funds to develop an Internet course for dispatchers.

Two motions resulted from the Systems meeting that were proposed to the Board:

1. Motion by Marv Birnbaum, second by Cheryl Glomp that the committee proceeds with a highway safety grant proposal for a distance learning course for Emergency Medical communicator’s course. All present -Aye
2. Motion by Marv Birnbaum, second by Tim Bjelland, that the oversight of the course objectives will be the responsibility of the Systems Management Committee as outlined in the Emergency Medical Communicator report. All present – Aye. There was also discussion about applicability of this process for broader application for EMS learning via distance education.

The finance report is due by November and was discussed in light of Trauma funding being vetoed in the State Budget.

Gloria Murawsky reported on several education issues.

There were 3 old items

1) EMT-I curriculum, which is now in its final stages.
2) IV Tech curriculum revision, which is now done. Pediatric additions will be added later.
3) Advanced skill modules: albuterol & glucagon module for refresher course The modules were distributed to Board members and approved by exception as of July 25, 2001.

The committee then looked at their priority list:

1. First Responder curriculum (Ad hoc committee for quick insertion of advanced skills into FR course). Steve Teale will forward to PAC to review scope of practice.
2. Evaluate EMS education with EMS Education Agenda for the Future. IN progress.
3. Determine feasibility of the use of a bridge course between license levels. Jim Keiken will form ad-hoc to evaluate feasibility of bridge course and at what levels. Due back January 2002.

A written report was submitted that highlighted EMSC activities.

Dan Williams recommended that there be a report from STAC (trauma), PAC (physicians) and EMS Coordinators, either as a written or brief oral report as part of the Board agenda.

STAC – Have been inactive over the summer. The committee is meeting next week and will discuss next steps for trauma implementation in light of the budget veto.

EMS Coordinators – Judy Jones reported on coordinator activities, which included:

Being a resource for information, activist for EMS issues, providing bimonthly training on specific topics of interest to members and serving as mentors for new Coordinators. Membership is about 60 people.

Keith Wesley reported on the following which all should be ready in October

1. Medical Director Course – content is being completed and staff and PAC are looking at options for interactive content on the web.
2. b) A due process piece is being developed for medical directors to understand how actions on EMT practice impact them and the need to include a remediation process.
3. A sample MD contract is also being developed to assist services and physicians.

Dr. Barney reported on the highlights, which included:

1. Best practice templates for ALS are being developed
2. Sample protocols for BLS are completed.
3. EMT-I curriculum will be done this week. Committee will finish up remaining loose ends
4. Working on Enhanced EMT-I article for Prehospital & Disaster Medicine
5. Draft Interfacility guidelines will be done by end of the year and distributed for input
6. Involved with investigations and educating medical director of their role in solving problems.
7. Involved with data review for freestanding emergency department.
8. Outreach - Spoke with Merrill FD and will provide medical oversight to Fat Tire festival.
9. PSOW meeting in October
10. EMSC conference in October 14 & 15.
11. Presentation at Trauma conference in November.

There was a discussion of the committee positions and updates to the list.
Motion by Cheryl Glomp, second by Marv Birnbaum that the Liaison/Public Relations committee be expanded to 5 outside representatives for a total of 7 members.
Motion by Mark DeGuire, second by Terri Richards that the Data Ad-hoc Committee be a total of 5 members, with 1 data representative.
Motion by Marv Birnbaum, second by Tim Bjelland that the CQI committee be a total of 7 members with 1 systems and 1 data representative.
Motion by Marv Birnbaum, second by Dick Collyard, that the Disaster committee be a total of 7 members with 2 reps from Systems.
Communication – Appointed by bureau. May be additions to applicant list.

The list of applicants for the various committees was modified as follows:
Jeffrey Hevey – add to Data & Research
Randy Sellnow –add to Education
Tim Franz – Add to Policy & Practice
Gary Wieczorek – Add to Systems & Management
Charlie Meyers – add to Liaison/Public Relations
Robert Haight – add to Data Technical & Implementation ad-hoc
Henry Butts – add to CQI
John Stanley – add to Disaster Management
Jerry Haberl – add to Disaster Management

Votes were held for committees with the following results:
Data & Research: Elected members are Martha Florey, Judy Jones, Jon Rubin
Education: Elected members are Linda Pace and Ken Sternig.
Policy & Practice: Elected members are Larry Knuth, Barb Kuska, Bill Snoke, Mitch Waite
Systems Management: Elected members are Michael Fraley, Mark Madigan, Pat Padjen.
Liaison/Public Relations: Elected members are Jeff Dostalek, Pat Kilbane, Charlie Meyers, Thomas Twait, Lorie Utech
Data Technical & Implementation: Elected members are Barb Johnson, Keith Wesley, Rick Merryfield and Bob Haight. Martha Florey will be the Data & Research representative on this committee.
CQI: Elected members are Julie Brady, Cindy Diedrich, Rosemarie Forster, Kathy Noe, Lorie Utech
Disaster Management: Elected members are Jerry Haberl, Judy Jones, Keith Kesler, Suzanne Martens, Jan Victorson

Details for ad hoc committee meetings need to be worked out and committee members will be notified when more information is decided.

Agenda item #6 - Legislative & State Office Update
HFS 111 - The intermediate rule is now at the Department rule writer for final editing. It will go to public hearing in the next 1-3 months.
MD Contract - Dr. Barney's contract was extended. He is now contracted for another year with options for two additional years.
State AED purchase contract is on the Dept of Administration website. The contract provides for greatly reduced rates for defibrillators.
Operational plan templates meetings have been held throughout the State and were very successful.
The bureau is working on a web-based data entry option by the end of the year. This will allow direct entry and submission of training courses and potential for edits to provider rosters online. It is possible that some of the license renewal process will be done electronically

New Bureau staff include:

• Debbie Crawford – EMT-Intermediate Coordinator
• Ann Moses – EMS Data Coordinator
• Mark Flood – Licensing program assistant
• Vinod Daniel – Injury epidemiologist

Trauma System – The Governor vetoed the trauma proposal that included $185 K in the first fiscal year for 2 project positions (a trauma registrar & an injury educator) a $40K contract for a consultant to determine a trauma data system and $25 K for RTAC expenses. Year 2 had $500K for the 2 positions, $50K for RTAC expenses and $290K for grants to RTACs. There was a discussion about the next steps and that stable funding is essential. The Board will await the results from the STAC meeting next week before a decision on how to proceed is made.

Jon Morgan noted that the Department and Division of Public Health have been extremely supportive despite across the department budget cuts. The bureau will be fully staffed for the first time at the end of September.

NHTSA Workshops
Two NHTSA resources were discussed: Technical Assistance on EMS Information Systems and Technical Assistance on Quality Improvement for EMS Systems. The question was whether the Board wants to request technical assistance? The EMS Section will get more information for the November meeting.

Hospital Diversions – Assigned as a follow-up item at the November meeting.

EMT bridge course subcommittee is looking for members. Contact Jim Keiken or the EMS Office.

Motion by Cheryl Glomp, second by Don Hunjadi to write a letter to John Chapin thanking him for his support of EMS. All present -Aye

Motion by Marv Birnbaum, second by Dick Collyard to formally thank Jon Morgan for his work and support of EMS. All present -Aye

Motion by Dick Collyard, second by Mark DeGuire to adjourn. All present -Aye. Meeting adjourned at 12:45 PM.

The next regular meeting is November 6 & 7 in Madison.