Region I Emergency Medical Services Council Meeting

Sheridan County EMS, Hoxie, Kansas

April 14, 2010

 

David Stithem, Region Chair, called the April 14, 2010 meeting of the Region I EMS Council to order at 19:00. John Miller, Kansas Board of EMS member and Norton County Commission, and Steve Sutton, Interim Executive Director, Kansas Board of EMS, were welcomed.

The minutes of the February 17, 2010 Council meeting were posted on the web site for review. Motion for approval as written was made by Aden Schillig with second by Kenny Gatlin. Motion carried.

The financial report was presented and motioned for approval by Aden Schillig. Nancy Schmidt provided motion second. Motion carried.

 

Old Business:

The ESF-8 Mass Casualty Appendix Draft had been presented at the last meeting. Comments are due back before the end of April. Please send your comments to David Stithem, Gary Winter, or Deb Kaufman.

Trauma Committee Report:

  • Deb Kaufman reported Kerry McCue had a conflict and could not attend tonight. The ACT had not met since the last Region meeting.
  • The NW KS Trauma Committee met on March 10, 2010 and minutes were distributed. http://www.kstrauma.org/nw_council.htm.
  • Circulated was a KDOT-SAFE Teen Driving Program. If interested in the program contact tparks319@sbgloval.net.
  • The ITV Trauma Education Series is available on the 4th Tuesday of the month from 12:00 p.m. to 1:00 p.m.
  • The Kansas Rural Health Options Project (KRHOP) funding application for trauma education (ATLS, TNCC, PHTLS, and RTTDC) is available.
  • Each service trauma representatives should have received packets for the general membership meeting in Hays, KS on May 5, 2010. Registration is due by April 28, 2010. In addition to other speakers, Steve Sutton and Dr. Hornung are presenting on the SCOPE regulation and the involvement of medical direction in Kansas EMS. There is also a segment on identifying trauma cases in your system for quality improvement. An EMS Executive Council position currently held by Deb Kaufman is up for re-election as well as several other members. Please nominate those interested. The trauma education needs assessment survey has been completed. Please refer to the minutes for more information.

 

Homeland Security Report:

  • Deb Kaufman reported the minutes for the March 8, 2010 meeting of the NW KS Homeland Security Council are available at http://www.ksready.gov/NWKRC_Minutes.shtml. Please review as there is much information.
  • We were reminded there is training available at Crisis City at no cost. KDOT is now managing that program under the direction of Frank Coots. Contact information is on the KDEM website.
  • Tami Wood gave a report on the hospital strategic plan. Deb Kaufman has the document available to send out by request. Their 800 MHz training is beginning and they will be exercising the system.
  • Representatives from the Fire Marshall`s Office gave a presentation regarding the International Association of Fire Chiefs resource typing information system they will have funding to develop. More details are forthcoming. We also viewed bomb squad and fire investigations resources they have available to the area.
  • A reminder we need to be very aware of narrow-banding of frequencies and budget accordingly. Mike Albers is gathering information for the Region. We do not anticipate there will be Homeland Security dollars to assist local counties and are reminded of the January 2013 deadline.
  • The GIS school mapping project is progressing. The contract will need to be renegotiated.
  • The Highway Patrol reported they are putting computers, GPS, and printers in their vehicles to have more access to information.
  • We did an analysis of Cross Match systems and all Sheriff`s are reporting them in use.
  • The IMT teams are busy with additional training. Each member has position specific training as well as general team training. They continue to outfit their response trailers. The initial contracts are up. We need to recruit more members. Please contact them if you are interested.
  • The emergency medical response trailers are here. The process to acquire equipment and outfit the trailers is time intensive, but we are making progress.

 

KRAF Grant: Gary Winter reported their final meeting was March 23, 2010. At that meeting they finalized the approved list and that document was submitted to the Board for their final approval. The committee meets again August 24, 2010 to make recommendations for changes in the program for the following cycle. Steve Sutton reported the award letters will be sent as dollars are available. $238,000 is available now. Matching funds will need to be validated. Steve Sutton will meet with Jeff Scott at Fisher in regard to same equipment pricing discrepancies. There is still $92,000.00 available from KDHE H1N1 hospital bio-terrorism awareness dollars that will be utilized.

 

EDTF Committee Report: David Stithem reported the report will be given in conjunction with the report on the Board meeting. There is currently a position open. If you are interested, contact David Stithem.

EMSC Pediatric Symposium: Pat Conrad will be awarded a scholarship to attend.

 

April Board of EMS Meetings: David Stithem reported on the meetings.

Planning and Operation Committee:

  • Condolences were expressed to Joe Moreland as his father had just passed away.
  • Joe Megredy thanked the audience for all the public comments following Dale Wasson`s passing.
  • The agreement between the board and Fleetwood Transport has not yet been signed and returned. It was supposed to have been mailed the previous day. The denial for licensure will be withdrawn when received. The new radios are in place per Dave Cromwell.
  • Heartland Park wants to use EMTs and MICTs at the raceway. A committee motion was made to recommend approval.
  • There was a lot of discussion regarding who could sign protocols on the protocol approval report for 2009. A letter will be mailed to services the board staff did not feel had correct signatures for 2010.
  • Steve Sutton would like to change the committee to a working committee and provide information and work on issues prior to the board meeting, i.e. scope changes.
  • The 3rd group has started in the KEMIS project. Steve Sutton wants to look at their involvement in the process due to the costs. This would include the trauma agency, Hospital Bridge, etc. Joe Megredy requested a list of the projects to see where the money is being spent.
  • Kerry McCue gave a report on statewide communications. SB 48, the E911 bill, died. The sunset may be extended for another year to keep it in place with the current funding. The Sherman and Graham County towers will be completed with NW Homeland Security funding. Kerry McCue reminded everyone to be planning for the narrow banding deadline for reprogramming radios. That date is January 1, 2013. This includes pagers, storm sirens, as well as radios. Kerry suggested adding the national hailing frequencies when reprogramming. (NPSTC Channel Naming Plan)
  • Sarah House with EMSC reported the pediatric protocols are coming along. There are eight left. The pediatric symposium is coming up. She also gave a handout for the STEMI Summit on May 20, 2010 in Hutchinson.
  • Chris Way reported Kansas received a grant to field test the field triage guidelines in the Southeast region. They will meet in Atlanta for three days. He also reported the trauma education grants are now available online (www.kstrauma.org) for PHTLS, etc.
  • Jane Faubion reported for the Office of Local and Rural Health. She provided a copy of the Trauma Education Needs Survey to the committee. There was a 96% response rate from EMS services.

 

Executive:

  • Steve Sutton gave a report on 2010 legislation:
    SB220 - died in House Committee (definitions)
    SB221 - was pulled by the Board
    SB222 - has not progressed out of committee
    SB223 - may be dead (subpoena)
    SB224 - may be dead (fines)
    SB262 - passed (scope bill)
    SB497 - Allows carrying of a switchblade knife with a blade less than 4``
    HB2685 - would allow anyone to carry a concealed weapon anywhere - will probably die.
  • An additional $93,000 was just made available for the KRAF Grant
  • Darrel Kohls presented the KRAF Committees recommendations for the grant. JR Behan suggested a ``helpful hints`` document be sent to services to show why they did not receive grant funding. The committee moved to accept the recommendations for the grant.
  • 36 services have made application for EIG funding so far, for a total of $83,763. There is approximately $20,000 left.
  • Dr Hornung gave a presentation on the Medical Advisor Council. Following the presentation, the committee moved to approve the makeup of the council with a Board member, a physician Board member, two urban physicians, a rural physician from the east, a rural physician from the west, and two physicians at large. There was another motion to allow Dr Hornung to select the names and bring them to this committee. It was also recommended the Board chair select the board representative.
  • The ability of the board to define or refine the scope was removed from SB262. There was discussion as to whether or not the board already had this ability due to other statutes.
  • Board staff is trying to set up a secure site for some board information for the next meeting, i.e. investigations cases.

 

Education:

  • The EDTF presented the clean-up changes to 109-5-1 (continuing education), 109-5-3 (program provider) and 109-11-1 (definitions).
  • The committee reviewed two versions of 109-15-2 (non-Kansas certified credentialing)
  • The EDTF will look into the process of allowing out-of-state entities to provide Kansas continuing education.
  • The concerns over the makeup of the EDTF were discussed.
  • Attendant Education audits will begin on April 29, 2010. The delinquent letters are being updated. The process will be: audit notices mailed. If no response, notice of intent to revoke sent, followed by a summary order of revocation.
  • There was a variance request to gain a TO certification. The person was advised BCCC was holding a class. The variance was withdrawn.
  • Another variance request was a request to gain an IC certification without an IC class. The individual has been a college instructor and holds a PhD. Carman Allen recommended allowing it, but with the required Kansas specific training. There was a motion to deny the variance, but allow him to follow Carman Allen`s recommendations.
  • Jon Friessen gave a Scope update. He is working on lesson plans. There is ongoing discussion on requiring testing during the course modules versus a comprehensive exam after the course, or the possibility of Medical Director sign-off.
  • The committee moved to conceptually approve 109-5-1, the continuing education regulation. It is at the AG`s office.
  • The committee moved to conceptually approve 109-11-1, which contained definitions for continuing education. It is at the AG`s office.
  • The committee moved to approve 109-11-3, 109-11-4 and 109-11-6, which had been waiting on 109-11-1 before being able to move forward.
  • The committee moved to approve 109-15-3, which would allow distance learning through a program provider.
  • The committee moved to approve the EDTF version of 109-15-2
  • The question was asked if an EMT would need to become an AEMT prior to becoming a paramedic, or could they go directly to the paramedic. The new guidelines are set up that each level contains more depth and breath of education and understanding than the previous level.
  • The committee went into two executive sessions with Carman Allen, Steve Sutton, and the attorney to discuss the exam MOAs. When back in open session, Region II was recommended as the vendor.
  • A representative from Junction City would like to maintain education certificates electronically instead of printing certificates and putting them in a file. Board staff will look into this.

 

Investigation Committee:

  • The case involved a minor killed at a MVC. The service director took photos of the scene and at the funeral home with the intent to use the material for EMS education. She is no longer the director of the service. Dr Allin believes the service should have a policy in place to account for this. There was a motion to dismiss. Board staff will put a recommendation on the list-serv for service to have policies to address this type of situation.
  • The self-reported case involved an EMT-I who removed IV solutions and supplies and started an IV on his ex-wife. He was not on duty. He was place on administrative leave, suspended for 3 days without pay, had to write a paper, teach continuing education and placed on probation for one year by the service. The committee moved to accept local action and close the case.
  • An EMT-I falsified applications to obtain her EMT and EMT-I. She marked NO on the felony questions. A paramedic background check revealed 2 felony convictions for habitual violation of driving on a revoked or suspended license. The felony convictions have now been expunged. She was dismissed from the paramedic program and from her position with the college. She will be required to teach 10 hours of CE on falsifying records within the next year.
  • This came from a previous case. An attendant worked for an ambulance service without a certification, continuing to work after the certificate was suspended. Following a hearing on the revocation, the attendant was reinstated. The committee wants to know why the service allowed her to continue on the service. The service renewed online and it had not been caught. This person no longer works there. The service had no idea she was suspended, and removed her immediately upon finding out she was no longer certified. The service knew she was going to be suspended, but not when it was going to happen. The committee moved to close the case.
  • The applicant marked yes on the felony question on a renewal application in 2008 due to a felony conviction in Texas. The renewal was denied in 2009. He has now finished probation, being released almost a year early, and is now seeking reinstatement. He has filed the application and has obtained the hours. The committee moved to allow reinstatement.
  • Joe Megredy requested a case log be included in the committee members` packets.
  • Joe Megredy questions if the investigations are getting back logged due to education audits. He was to discuss this with Steve Sutton and Jerry Cunningham to find resolution.
  • There was discussion on a 2008 case involving an individual audited, failed to get the necessary education after receiving the order, and asked for a hearing prior to having his certificate revoked. He though he could get his certification back with additional hours. The committee will require him to take an initial course and have him come before the committee prior to gaining his certification.
  • The felony question is now at the beginning of the education process. If the question is marked yes, but expunged prior to the end of class, it does not need to come before the committee.
  • There was an inspection in Kansas where the service was missing files, call logs, and attendant cards. They also had a new service director for 10 months without any notification to board staff. There were many new problems also. They will be re-inspected. If not better, they will be brought to this committee. They have 30 days. The service has had historically bad inspections for 3 years.

 

Full Board

April 2, 2010

 

  • The minutes for the previous board meeting and two teleconferences were approved.
  • Dr Allin thanked Joe Megredy for agreeing to take over the investigations committee. Rick Rook will chair the planning committee.
  • The regulations from the education committee were recommended to move forward.
  • Deb Kaufman reported on a group working on the initial courses and the decision that has to be made regarding designing a Kansas level specific curricula vs guidelines.
  • The MOA RFP award to Region II was approved.
  • The KRAF recommendations were approved as presented.
  • The recommendations for the medical advisory council were approved: the Board makeup, having the Chair appoint the Board position, having the doctor position on the Board recommend the remaining positions to the executive committee for appointment, and the recommended purpose of the council. The purpose of the council is to consider proposed changes in the scope of practice, yearly review current scope of practice, review/approve protocols as requested by services, approval of medical devices for EMS use, weigh in on any project requiring medical opinion to the Board, investigate quality of care issues, advise the Board on trends in EMS medicine, and make recommendations to the Board as requested.
  • The office is moving toward electronic data exchange. They are planning to start with two secure log-on sites, one for medical directors and one for investigations material.
  • New attendant cards are not being issued until a new executive director is in place. A certificate will be issued.
  • Patti Artzer updated the Board on the executive director job description and the hiring process. The Board will remove ``Kansas`` from the certificate requirement. The Board moved to go forward and post the job.
  • It was suggested to get recommendations from the EMS public and national organizations/publications on where to post the job opening. They will look at putting it in the Kansas Register, Kansas League of Municipalities, KLM and KAC publications. The Board is aiming for June interviews.

Public Comment

  • Chy Miller would like for representatives from independent instructors, non-accredited community colleges who teach EMT classes, and accredited institutions to be included in the initial education discussions. He also thanked JR Behan and Joe Megredy for letting him speak yesterday, since it does not happen with all other organization`s committees. Additionally, he thanked the Board for the hard decisions they have made.
  • Chad Pore thanked the Board and everyone else. The new Greensburg hospital grand opening was in March. He thanked everyone for their assistance during the rebuilding process.
  • Terry David thanked the Board for their attendance and let them know it was appreciated.
  • KEMSA is having a one day workshop in Salina. There will be three separate tracts dealing with medical director issues, legal issues and fire issues. The cost is $35.
  • The committee chairs met after the meeting to discuss committees and organization.

 

Discussion was held regarding complications with service renewals. Service rosters were not updating in some cases despite local information submitted.
Noted all attendants will need to operate under medical protocols effective January 15, 2011.
John Miller lead discussion on the 911 Funding issue. Current funding is based on a 75/55 formula. It may be the legislature will be extending current levels for the next year. After that it may go to a 40/60 formula. He asked each county to look at funding levels to see what actual expenditure levels are. Get that information to John Miller, Deb Kaufman or David Stithem to forward to Kansas Associations of Counties or Kansas Legislative Policy Group.
Narrow banding was again discussed as well as the need for county wide coordination.

Steve Sutton reported the transition is still in the decision making stage. The regulatory process will take a minimum of 6 months following Board action and regulatory changes made and approved. Please check the Board website and Friesen Transition website for updates.

Pat Conrad moved to adjourn. Nancy Schmidt provided motion second. Motion passed.

Respectfully submitted,

Deb Kaufman, Secretary
(These minutes are pending Council approval.)