|
REGION
1
EMS
COUNCIL
April 28, 2005
Rome, GA
MINUTES
Chairman
Curtis Vincent welcomed guests and Clarence Ford gave an
invocation before the meeting. A quorum was determined to be
present and the meeting was called to order.
A motion to approve
the minutes of the last meeting was made by Bud Owens, seconded
by Herbert Dodd and was carried.
David Loftin gave
the executive committee minutes. He reported that a quorum was
not present and no business was conducted. All subjects
discussed were also on the council agenda so Mr. Loftin chose to
defer discussion of items until they are addressed in the
council agenda.
Dr. Mabley gave the
Regional Medical Director report. Dr. Mabley stated that she
serves on the Georgia Stroke Task Force with Dr. Pat ONeal from
the Office of EMS. The first task of the two EMS representatives
is to educate the American Heart Association about how the EMS
system functions in Georgia. The problems with implementation of
a system for stroke care are differences in different areas of
the state such as number of EMS professionals trained in the
MEND stroke course and the knowledge of hospital personnel about
the program.
Dr. Mabley stated
that David Bean is researching the immunity from legal discovery
of peer review activities by EMS
Services. If EMS Services
are not covered then legislation will be introduced to provide
this for EMS
Services.
EMSMDAC has approved
adult intraosseous devices in addition to the pediatric devices
previously approved. However, EMSMDAC did not specify what
levels can perform the technique and what sites may be used.
EMSMDAC advised that only Paramedics and Cardiac Technicians may
perform the adult technique at this time and may use any of the
sites approved by the FDA. These sites current are sternum and
tibia. Other sites under consideration by the FDA are proximal
humerus, ankle and radius.
Dr. Mabley advises
that the air ambulance rules and regulations approval process
has now began. EMSMDAC has a representative on this committee.
The process will be the same as used for the Ambulance Rules and
Regulations including public comment and a hearing.
Dr. Mabley also
stated that the hospital diversion issue is a problem in other
areas of the state. She asked if any of the personnel present
had experienced diversion problems in Region 1. No one raised
their hand.
Dr. Richard Gray was
present and due to his difficulties in speaking because of his
recent stroke, David Loftin read a prepared statement
(attached).
David Loftin gave the
EMS training report in the absence of Jim Cutcher. He reported
that Jim had taken family leave due to his fathers illness and
will not be back until June 1. David Loftin will be serving in
both Coordinator and Training Coordinator positions until Jims
return.
Mr. Loftin reported that Jims
father had undergone the second surgery to remove one kidney and
is recuperating well.
Mr. Loftin reported
that a new coding system has been implemented for all courses
approved by the Region 1 Office. The coding system is composed
of the region, the year, a code for the type of course (I for
initial and R for continuing education) and a number (ex.
01-2005-I-0001). All courses approved will be given a distinct
number and all certificates issued by the Region 1 Office will
contain this number.
Office of EMS
personnel in Dublin conducted the first EMS
Instructor Screening exam for 2005 on March 23-24. The exam went
reasonably well with several persons from Region 1 successfully
completing the screening. Another screening will be held this
summer and the EMS
Instructor course will be held in the fall. Anyone interested
should contact the Region 1 EMS Office for an application.
All EMS instructors
should have received two new policies involving course approval
and EMS instructor certification/recertification. The new course
approval form must be used for the submission of any courses for
approval. This is a recertification year for all EMS instructors
and all instructors must be monitored before December 31, 2005.
All instructors must also submit a personal information update
form included in the packet.
Due to problems with
the Region 1 website, all courses will be posted on the forum
training section. Webmaster Eric Nix is presently serving a
residency in Connecticut
and does not have the time to maintain the site. Matthew
Crumpton of Whitfield
County EMS has agreed to take this responsibility soon.
The National Scope
of Practice draft has been posted on the Internet at
http://www.emsscopeofpractice.org/ One of the proposals is
to have four levels (First Responder, EMT-Basic,
Paramedic and Critical Care Provider). The intermediate level
would be eliminated and the paramedic level would be reduced to
750 hours. The expanded scope items would be added to a new
Critical Care Provider level. You are encouraged to visit the
site and register you comments.
Several events,
courses and conferences are scheduled for 2005. A Pediatric
Basic Trauma Life Support course will be held on May 12 at the
Fort Oglethorpe Fire Department. BTLS instructors completing the
course will become Pediatric BTLS instructors. The annual EMS-C
conference will be held in Gainesville on June 12-15. The
Sea Palms EMS Conference
will be held on August 2-5 on St. Simons Island. Mr. Loftin
encouraged all present to attend the annual Georgia EMS Awards
Banquet in Macon on May 12.
Finally,
computerized testing for National Registry is being planned for
implementation in 2007. The proposed testing sites for the test
will be Chattanooga and Marietta for Region 1. This will involve
the written exam only and currently there are no plans to change
the practical exam process. The advantage of computerized
testing will be testing upon demand and quicker results. This
may reduce the amount of time for the certification process.
John Hitchens gave
the EMSAC report. Mr. Hitchens reported that the manpower survey
is currently being performed and involves telephone questioning
of every EMS provider.
EMSAC will also be examining
possible changes in the Georgia patient care report (PCR),
which presently is more useful as a statistical instrument than
a patient care report.
There was one item
of old business. A motion to amend the council bylaws to create
two additional at-large positions on the council, which are
reserved only for air ambulance representatives, was read at the
last council meeting. The proposed amendment was read for the
second time (attached) and discussion began. Steve Lawson
questioned the categories listed in the bylaws, which dictates
the council membership. Mr. Loftin explained that the bylaws
were written from a template from the Office of EMS
and the composition of the council should include
representatives of each of the listed categories. The at-large
positions were designed to be used to include representatives of
the categories, which were not included from the council members
submitted by the county commissioners. The council based on
nominations received decides who will occupy these positions.
The terms of all council members including the at-large
positions are two years.
Dr. Mabley spoke in
opposition to the amendment. She stated that only two of the
three air ambulance services might be included in the proposed
two additional at-large positions. She stated that she believed
the air ambulance industry is unique and a valuable part of the
regional EMS system. She believes that they should be included
on the council.
Kevin Nowicki stated
that he believed that the only change to the bylaws should be
the addition of air ambulance services to the list of
categories, which should be included in the membership. He was
opposed to the dedication of positions to a specific category.
Dr. Mabley stated
that she understands that many of the council representatives
may meet several of the categories. However, one of the
employees of an air ambulance company currently serves on the
council as a county representative. She does not believe that
this person should not be considered as a representative of the
air ambulance industry. She should only be considered to
represent the county commission of that county.
Craig Norton stated
that positions on the council representing services should only
be services regulated by Georgia. He stated that the air
ambulance industry is not yet a service regulated by Georgia. He
notes that the positions could potentially include many
services, which might transport patients into Georgia but are
not regulated by Georgia.
Herbert Dodd stated
that there is only one air ambulance service based in the region
and we should determine if we would be including air ambulance
services not based in this region. Mr. Loftin stated that the
old by-laws stated that only persons who worked or lived in the
region could serve on the council but the revised version does
not include this provision.
Greg Lord proposed a
motion that a better solution would be to only increase the
at-large positions by one and to dedicate that position to an
air ambulance service. Dr. Mabley seconded his motion. Bud Owens
suggested a friendly amendment that the position should be
rotated between the air ambulance providers. There was no second
to the friendly amendment or acceptance by Mr. Lord.
________________ of
Emory Flight spoke in favor of Mr. Lords motion. He stated that
he believed that only one dedicated at-large position would be
appropriate and that this is the practice of EMS councils in
other regions. Some of the other councils rotate the positions
and some do not.
Robbie Tester of
LifeForce of Chattanooga also spoke in favor of Mr. Lords
motion.
Robin Logan of Rescue Air One
and Paulding County asked if the motion included dedication of
the one additional at-large position to an air ambulance
company. Mr. Loftin re-read the amendment and stated that it was
his opinion that the position was dedicated to an air ambulance
service.
Larry Ballew asked
why the council was considering changing the original motion.
Mr. Lord explained that the original amendment proposed might
create problems in implementation and setting precedents.
Mr. Loftin explained
that the council must vote on the original motion before any
other motions could be considered. A vote was taken with the
following results:
In Favor of the
motion 0
Opposed to the
motion 20
Abstentions 0
The motion did not carry.
There was more
discussion on the other motions.
Steve Lawson asked
about the function of the district health director in the
approval of members of the council. Mr. Loftin explained that he
used to work for the District Health Director and the original
by-laws included the district health director because he was the
immediate supervisor of the Coordinator. [The District Health
Director was also part of the approval of the zoning process].
The function of the District Health Director has not changed
despite the fact that the Coordinator is not an employee of the
Office of EMS. He/She receives the recommendation of the EMS
Council for all council positions and approves/disapproves them.
There has not been an incident where the District Health
Director did not approve a council appointment. Mr. Loftin did
not recommend a change at this time due to the relationship of
the District Health Office and the EMS program.
Clark Farr asked if
there was a benefit to the health care system by the proposed
amendment. Herbert Dodd stated that he perceived a potential
benefit because if would allow input in decisions affecting
patient care issues by a regulated provider (the air ambulance
industry). Greg Lord agreed.
Larry Ballew spoke
in opposition to the motion of one additional at-large position
by Mr. Lord. He seconded the motion for the addition of the air
ambulance industry to the list of persons required on the
council.
Mr. Loftin explained
that Mr. Lords motion was made and seconded and must be voted on
before voting on the Nowicki motion.
The motion to add 1
at-large position for the air ambulance industry on the council
was voted with the following results:
In favor 9
Opposed- 9
Abstain 3
The motion did not carry.
The motion to
add the air ambulance industry to the list of persons required
to compose the EMS Council was voted with the following results:
In favor 15
Opposed 1
Abstained- 3
Herbert Dodd
made a motion to table the discussion until the next meeting.
Greg Lord seconded the motion. The vote of the motion was:
In favor 20
Opposed- 0
Abstain 1
The discussion was tabled until
the next meeting.
The next order of
business was the discussion of the Clinical Laboratory
Improvement Act (CLIA) and the effect on the ambulance industry.
Recently Polk
County EMS received an on-site
inspection by a representative of the Georgia Office of
Regulatory Services for CLIA.
This was the first inspection of
an ambulance service for CLIA known in Region 1. Curtis Vincent,
Director of Polk County EMS, stated that the inspection involved
the use of a blood glucose measurement device. He stated that he
had paid the fee for several years to exempt his service from
the CLIA regulations. He was told that 3% of EMS services are
inspected for CLIA each year in Georgia. He was informed that
his service was in compliance with CLIA. He advised other
services to document training of all employees on the use of the
blood glucose measurement devices including written and
practical tests, keep daily logs of tests of the accuracy of the
device to include high and low values and retain these records
for two years. Bud Owens did some research into the effect of
CLIA on ambulance services and reported his findings. David
Loftin reported that the hospital-based services are included in
the hospital CLIA program.
David Loftin
reported that the new ambulance rules and regulations were in
effect beginning on March 17, 2005. He could not produce a copy
at this time since they have not been released by the state
printing office. He also stated that most of the policies were
still in the process of being written and will be released as
soon as finalized. Mr. Loftin gave a presentation on some of the
changes in the rules and regulations.
David Loftin
reported that the legislation to provide EMS tags passed the
Georgia legislature and will probably be signed by the governor.
When signed 1000 tags must be purchased.
David Loftin urged
everyone to attend the 2005 Georgia EMS Awards Banquet in Macon
on May 12.
David Loftin stated
that the Automatic External Defibrillators (AED)
grant is in the third year. The grant provides AEDs to services
in rural areas that become licensed AED
providers or licensed services. Only three counties have
expressed an interest in this grant to Mr. Loftin (Murray,
Walker and Polk). He urged any one who is interested to contact
him.
Mr. Loftin stated
that the vehicle identification numbers must be applied to each
licensed vehicle in three-inch letters on both sides of the
vehicle within one year of initial inspection. The deadline has
arrived. All five digits of the number must be included.
Mr. Loftin stated
that he had taken possession of all of the Mark One Plus kits
for ambulances and licensed first responder units in Region 1.
Only a few services have received the kits despite four
train-the-trainer courses last year. Mr Loftin encourages all
services to perform this training for their employees and turn
in the roster in order to receive their kits. One kit will be
received for each licensed vehicle. Greg Lord asked about the
contents of the kits. Mr. Loftin stated that each kit includes
everything to treat each of the two EMTs including 6 Mark One
Kits.
A motion to adjourn
was made by Clarence Ford, seconded by Larry Owens and carried.
The meeting was
adjourned.
Respectfully submitted,
David Loftin
Recording Secretary
|
