Emergency Medical Services Board Meeting
September, 14 2004

 

 

Members present:

Tracy Aldrich

Steve Bane

Brenda Fellenz

Troy Hasse

Don Hunjadi

Ken Johnson

Cal Lintz

Gloria Murawsky

Steve Teale

Travis Teesch

Gloria Wall

Dan Williams

 

Bureau Staff:

Meg Taylor

Bruce Gordon

Marianne Peck

Ann Moses

                                                                                                           

Others in Attendance:                                   Representing:

Barb Kuska                                                      Beloit Memorial Hospital

Beth Natter                                                      Mercy Hospital – Janesville

Don Kimlicka                                                   Gunderson Lutheran

Judy Jones                                                        Luther – Eau Claire

Vickkie Zietlow                                                MidState technical College

Keith Kessler                                                   Douglas County Emergency Management

Jan Victorson                                                   Bayfield County Emergency Management

Gary Leyer                                                       Gateway Technical College

Fred Hornby                                                    Bell Ambulance

Pat Padjen                                                        UW EMS Program

Steve Pilsner                                                     Wausau Fire Department

Ted Tautges                                                     Wausau Fire Department

Mark Fredrickson                                            Gold Cross

Suzanne Martens                                              Sheboygan Co EMS

Mary Austin                                                     Monroe Clinic

Laura Ahola                                                     UW Hospital EMS Program

Jerry Miller                                                       Lifequest/Mobile Healthcare Alliance

Robert Stedman                                               Waukesha County Technical College

Jeff Grimm                                                        ThedaStar Air Medical

Tracy Froiland                                                  Theda Care/Fox Valley

Jerry Haberl                                                     Wisconsin Emergency Management

Nettie Jenkins                                                   St. Agnes, Fond du lac

Gerry Isbell                                                      Orange Cross Ambulance, Sheboygan

Jack Hill                                                           Gold Cross Ambulance, Fox Valley

Tom Fennell                                                     Gold Cross – Mayo Medical Transport

Mitch Waite                                                     Wisconsin Rapids Fire Dept.

 

 

 

Agenda item #1 Introductions

Dan Williams called the meeting to order at 10:00 AM at the Holiday Inn, Mosinee.  Dan Williams welcomed the Board and Attendees: Everyone in attendance on the Board and the audience introduced himself or herself.

 

Agenda item #2 Approval of July 2004 Meeting Minutes:

 

Dan advised the Board that the documentation of the election of the Vice Chair position from the previous meeting was omitted from the July minutes. The following is that documentation and action. 

 

Motion by Ken Johnson, seconded by Gloria Murawsky to approve the July Board minutes with the following correction: Dan advised the Board that because Dr. Marvin Birnbaum was not reappointed that we were now in need of a Vice-Chair for the Board and he opened the floor for nominations for the position of Vice-Chair. Don Hunjadi nominated Gloria Murawsky, second by Cal Lintz. Dan asked if there were any other nominations. Troy Haase nominated Steve Bane, second by Tracy Aldrich. Paper ballots were handed out for the vote. Gloria Murawsky was voted in as the EMS Advisory Board Vice-Chair. All Present – Aye.

 
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.

 

2.        Stakeholders ad hoc:  Cal Lintz, who chaired the meeting in place of Dan Williams who was in another meeting, reported that this committee met yesterday and started to sort out the issues that have been previously identified.  The committee reviewed the following issues:

 

a.      Bioterrorism training. Several questions came up again regarding the Bioterrorism training requirement. The questions pertain to what will happen the next re-licensure period. It is required that every licensed EMS person in the State must take the four (4) hour training course every 2 years. What will the training be? Are there other types of training that could meet the requirement? The department has the authority to approve training programs. It was discussed that there will be a need to establish a process for determining what programs will qualify for acceptable completion of this training.

 

b.      The questions today centered around the authority for this course, the method of delivery and other ways to meet the requirement without attending this particular training session. It was decided that the entire instructor training program be reviewed to determine if current practice is efficient and meeting the needs of the training centers and EMS in general. Steve Teale stated that a review had been completed and this workshop has proven to provide a very efficient method for providing this training that is mandatory in Statute.

 

c.       CPR Cards. Is it necessary to pay the AHA $4.00 for each CPR card? The American Heart Association charges $1.00 for their cards. If the cost is higher than $1.00 then the training facility is marking them up. They do have the right to do this to recover the cost of creating them. It would be nice if there were another method for verification of successful completion of CPR training, but this is the only method that the Heart Assoc. has to assure that process.

 

Education

 

                 Gloria Murawsky reported on the committee meeting, which included:

 

1.      Gloria reported that the committee had completed the Stakeholders survey and it was ready for review action.

 

2.      The committee has divided the tasks and revised the action plan to include a review and a potential change to diagnostic based education as opposed to symptom based.

 

3.      Gloria advised that the process and methods for how the committee will approach and deliver the curriculum review is as follows.

a.       Developing the objectives.                                      4/05

b.      Development of Model curriculum.                          6/05

c.       Curriculum rollout.                                                  8/05

d.      Mandatory implementation of new basic curriculum 1/06

 

Policy & Practice

 

Don Hunjadi reported on the committee meeting, which included:

 

1.        The first responder rules may not be as ready as first thought by the committee to go to public hearing. There has been a change in rule writers and the new person feel as though more work is needed. Meg stated that she would try to determine what is needed and report back to the committee. One of the committee’s next tasks of combining all of the existing rules into one may be on hold to determine how to work with the new rule writer.

 

2.        The proposed National Scope of Practice was reviewed by the committee and was determined to not meet the needs for how Wisconsin practices. The committee review the document and identified at least 12 points of contention and will determine between now and the next meeting if there are more. It was generally agreed that a statement from the Board was necessary and it should be sent as soon as possible to the National group working on this project. Motion by Don Hunjadi, second by Ken Johnson that states; The Wisconsin EMS Advisory Board has reviewed the draft document for the National EMS Scope of Practice Model, and has come to the following broad statement: Due to the progressive level and direction of EMS currently found and practiced in the State of Wisconsin, the EMS Advisory Board finds the National EMS Scope of Practice Model as too restrictive, and therefore, unacceptable as currently drafted. All Present – Aye.

 

Systems Management

 

Cal Lintz reported on the committee meeting, which included:

              

1.                  The committee is planning to review the potential impact that would take place if the training and or re-certification hours and frequency were to be altered. The committee will research all aspects of the issue and report back with an outline of tasks and issues and how the tasks will be accomplished.

 

2.                  An issue came before the committee regarding a hospital that was closing as a hospital but wanted to maintain an active ER. The question is how do EMS providers deal with that situation. Are they able to transport patients there? Are there guidelines, rules Statutes that prohibit this type of activity? Is an ER different from an Urgent Care facility? The committee will research the issues surrounding this topic and work to develop protocols for how EMS may deliver patients to this type of facility and report back to the Board.

 

CQI The committee determined that most of the services that will use the tool would be smaller services. After reviewing the documents that were originally in place it was felt that the current system was too complex. The committee worked to boil down the current 19 pages to 4 pages and will continue to develop a user-friendlier version of the process without sacrificing the original goals.

 

Disaster The committee is reviewing and working on the following:

 

1.      Investigating and informing all EMS related agencies that the NIMS training is coming and it is planned to be 28 hours and there is federal funding available to pay for the courses.

 

2.      They will be looking into the many cross border issues that exist regarding levels of authority, differences in care etc. to recommend how those issues can be dealt with in the future.

 

3.      They will also be working to identify how EMS can be integrated into other disaster programs and plans in a way that represents a true picture of what will actually happen.

 

Information Enhancement

 

Ken Johnson stated than the committee was just beginning and they were discussing all of the surrounding issues so as to not have any preconceived ideas that would prohibit them from looking at every and all options. The following is a list of items to start working from.

 

1.      Look at what programs are out there and will it meet the needs for Wisconsin once the needs are identified.

 

2.      Look at the work of the previous Data Committee to make sure that some of the same pitfalls and mistakes are avoided.

 

3.      Will review the work issues that were identified at the special stakeholders meeting from several years ago to determine if there is any useful information to be used.

 

4.      Want to assure that if they start work on what will be a very large project, will there be stable financial backing to move forward.

 

TRAUMA

               

1.      Raising awareness of the Trauma System through marketing

2.      HRSA Hospital Preparedness will provide $733,000 for Trauma with an additional $200,000 to EMS

3.      Having discussions about the relationship between STAC and the Board

4.      Very interested in the Guidelines for Interfacility Transport.

5.        Trauma Triage guidelines

 

EMS Injury & Illness Prevention

 

Gloria Wall stated that this committee was also just beginning and the main initial focus would be to determine how Public Health and EMS could work together for mutual benefits. As the committee becomes more established they will identify other issues and tasks to work on and move forward. Gloria has requested a meeting with Meg Taylor, Linda Hale and others to assure that all issues are considered.

 

EMS-Children

 

No written report was presented.  Dr. Gordon had just come from their Strategic planning session that was taking place in Door County to plan for now until year 2008. They are working to determine what to do next and they very much want to keep the lines of communication open with the EMS Advisory Board. They plan to have regular attendees at the Board meetings in the future.

 

Physician Advisory Committee (PAC) Bruce Gordon reported on the PAC meeting that included:

 

1.      Education for on-line learning

2.      Review and reestablish priority of the Interfacility transport guidelines.

3.      EMS safe transports for children.

4.      Streamline their activities and strengthen the relationship with the Board.

 

Agenda item #4 Assignment of Committee Openings

 

The following people were added to fill the openings on the Standing Committees.

 

Policy and Practice had one (1) opening. Filled by Ann Peggs.

 

Systems Management had one (1) opening. Filled by Ted Tautges.

 

EMS Injury & Illness Prevention had three (3) openings. Filled by

 

Information Enhancement had three (3) openings. Filled by Jerry Miller, Lauryl Pukansky. The final position will be filled by a yet to be named rural billing person.

 

Agenda item #5 Legislative Issues: There were no legislative issues pending at this time.
 
Agenda item #6 State Office Issues:
Meg reported on the following items:

 

1.      EMS Section position was advertised and closes on September 20, 2004.

  1. The other two EMS Section vacancies have been approved for hire and will be officially announced in the next few weeks.
  2. Mark 1 kits have been sent out with the trainers to all EMS services.
  3. Joe Cordova will presenting to the new Chem Packs to EMS groups and would like to provide the Board with a presentation and information on the program.
  4. EMS and the Trauma System will be receiving approximately $1 million dollars to support education, staffing and planning resources over the next year.
  5. Approximately $250,000.00 has become available to support the EMS Data system.

 

Agenda item #7 Old/New Business

 

1.                  The Board held a discussion on the issues surrounding the IV Tech reimbursement or lack there of. Medicare does not recognize the IV Tech level as an advanced level provider and will not reimburse those types of services for their supplies.

 

Agenda item #8 Adjournment: Motion by Don Hunjadi, second by Travis Teesch to adjourn. Motion carried. Meeting adjourned at 12:30 PM All Present – Aye.