EMSAAC GENERAL MEMBERSHIP MEETING

Minutes

May 28, 2002

Embassy Suites Hotel

150 Anza Blvd.

Burlingame, CA 94010

(650) 342-4600

10:00 AM to 4:00 PM

 

1.         Welcome & Introduction: Meeting began at 10:10. Welcome and Introductions around the table.  G. Jones wished L. Inch a Happy Birthday.

 

2.         Changes to the Agenda: Add Ethics Committee to the Agenda.

 

3.         Consent Calendar: Consent calendar  (Minutes and Treasurer’s Report) was approved. M/S/A Inch/Isbell

 

4.         Membership: Jean English, representing Northern Cal-chiefs as an associated member and Teem Clarence San Joaquin EMS were approved M/S/A Lathrop/ Inch.

 

5.         Election Results: Due to the confusion with this year’s election process a motion was approved to redo the ballot process. Ballots will need to be returned by June 13th. M/S/A Inch/ LaVenton  

 

6.         Legislative Report: M. Osur provided the legislation update, in B.Pletz absense. There are a number of Bills to follow. There was discussion regarding the need to establish a legislative platform or limit EMSAAC support with action to a few limited areas. The following bills were discussed: AB883 not moving, all of the Flores Bills not moving at this time. AB1745 Nakano, unsure if out of appropriations. L. Inch was asked by G. Jones to testify.  AB 1833 / 1988 L. Inch will follow up with CMA to see if the recommended amendments have been incorporated.  AB2041 author indicated that language would be added to require training requirements. AB2193 and AB 2204 have merged into one. Focus is on Orange County, Darlene will provide update and will check with Hospital Assoc. Need to watch closely. J Rubin suggested that we also follow SB 1350.  SB 1695, is a repeat of SB 1134, which was vetoed. The author to include our entire request in the amended SB 1695, as we requested in previous letter to indicate support if amended.   There was discussion regarding concern of our support of this bill, and a recommendation to indicate our concern regarding legislating scope of practice. Look at connection of AB1988 and SB447.

 

7.         EMS Commission Agenda: C Baucom reviewed the EMS Commission package and discussed the two items that may require action.  AED Regulations were discussed regarding the training standards and required use of AHA, or ARC or equivalent. A question was asked of the EMS Authority “Could the language be stated to refer to these training materials as guidelines rather that as currently stated”? Sean Trask thought the language could be changed without requiring additional public comment. Nor-Cal EMS Regional Agency is requesting an exemption to the Trauma Regulations. They are requesting an exception to allow either an anesthesiologist or a nurse anesthetist at their Level III Trauma Center be present for all trauma operations. The request indicates that neither facility can obtain and/or maintain adequate anesthesiology staff because of their rural location. According to the local EMS agency, both hospitals are necessary to the support of the overall system because of factors including distance to the nearest hospital and weather conditions that affect transportation. CRNAs are under the direction of the trauma surgeon, and there is a quality improvement process in place.

 

8.         Trauma Funding Update: At the last Assembly hearing the 25 million was put back into the budget. This could change. It is important to notify legislation of the critical needs for this funding.  The Trauma Funding reports due to the State regarding the use of the current funding will provide valuable information and support ongoing funding needs. It is important for those counties that have not submitted invoices to receive trauma funding allocated to their system, to do so ASAP.

 

9.         Vision Committee & Workgroup Update: Prevention; M. Osur, provided an overview to prevention groups progress to date: registry and templates are complete; DHS has reviewed and approved the final copy.  J. Ogar will be meeting with EMSA to finalize the website and work out the details to get the site up and operational. The committee is looking at drafting a resolution to identify a lead at the EMSA and a committee structure to continue providing updates for the website. Lack of ongoing funding for website maintenance and ongoing prevention focused activities was discussed at the last meeting. Education; M. Swanson provided an update and reviewed the guidelines under development for scope of practice committee. N. Steiner and C. Gunter will continue to work on this issue.  The Committee discussed the language of EMT basic and intermediate. This issue and the development of a statewide template will be discussed at the next meeting.  Access; J. McPherson, medical control for EMD continues to be an issue for this group. The regulations do establish standards for programs and training and identifies the need for interaction between the EMS medical directors.  Issues associated with record retention and CQI are not as clear.  These regulations provide an opportunity into public safety medical direction for the EMS Medical Directors.  System Evaluation and Improvement/ Data:  S. Andriese reported that they should have a draft data set to review.  The “Cempsis” system is moving forward and should have a beta system to test at the August meeting.  How to implement the statewide standard data set is being discussed. One option is to place the minimum data set as a requirement in regulation, to move system standardization forward. Testing is required before the data set is finalized and ready to move into regulation or guideline. Adequate timelines for local agencies to implement the standard data set, will be required.  Finance; M. Frenn reported that committee has not met since the April meeting. The “White Paper” has been distributed to the committee members for input. Governance; M. Osur and C. Baucom reported that the committee is working on the assessment issues surrounding local EMS Agencies. The next meeting is scheduled for mid-June. Ethics; J. McPherson reported that the terms for three members are expired and that new members will need to nominated and elected.  A draft document “Code of Professional Conduct” was distributed for comment. Who can bring an issue or concern to the committee, was discussed. There was concern expressed regarding legal issues and that we are an organization representing agencies rather than individual members.

 

10.       Joint meeting with EMDAC: provided an opportunity for small group discussions and provided better forum to facilitate discussion between EMSAAC and EMDAC.

11.       EMSA Report: An update was provided on the three different funding sources to support bioterrorism preparedness, HRSA fund to EMSA for Hospitals, CDC to DHS for Public Health and FEMA to OES for first responders. J. Rubin provided an overview of the “Rough and Ready” exercise. Save the Date cards have gone out for the annual EMSA Disaster Boot Camp on August 29, 2002.  Other dates to note are Oct. 1, 3, & 15 for the Medical Health Disaster Conference and the annual Sate-wide Hospital disaster drill is scheduled for Nov. 14th.   The EMS Authority is considering establishing a three member physician committee to review disciplinary action, the committee would act in an advisory capacity. R. Watson reported that all state programs are required to cut their budget by ten percent, he will make the final decision on how this will be done. The EMSA operational budget will be impacted, which means travel will be limited. The need to make cuts from local assistance programs including poison centers, regional EMS Agencies Regional Disaster Coordinators and Disaster Teams all could be impacted by the required cuts. The Vision conference is scheduled for Dec. 5 & 6 in San Francisco, the conference will provide a wrap-up to the NHTSA and OTS grant objectives and provide a forum to establish a process to continue to move toward implementation on many of the vision issues.  S. Trask discussed the issues and process used to address the EMT statewide standard testing.

 

12.       Conference 2002: S. Andriese reported that the conference was ready to go next week. He stressed a casual dress code, and indicated that a letter was being sent to all attendees with the final conference details.

 

13.       EMSAAC Committee Structure: S. Andriese reviewed the suggested committee structure presented at the April meeting that provides for a stronger coordinated effort by subject mater.  It was recommended that we utilize this process next year.

 

14.       HRSA Grant Committee: D. Isbell reported on the HRSA first phase of the monies to the State. It is important to stress the committee’s desire to reinforce and build relationships at the local level.  The committee is discussing the need to have a formal opinion from the State agencies regarding the concerns of mass decontamination water waste issue and the EPA’s position. The hospitals need some assurance on this issue. There is a lot of intermingling between the CDC monies and the HRSA money. It is critical to communicate what is being developed from each source of money.  The committee recommends developing a statewide training program aimed at hospitals, to standardize training throughout the state.  They have not determined how to distribute the money.  EMSA will hire a consulting firm to conduct a comprehensive hospital assessment.

 

15.       Future Meeting Dates: The next scheduled meeting is August 27th in San Diego, the following meeting is not scheduled until December. 3rd.  S. Andriese would like to schedule a meeting in July with the new officers a tentative date is July 23rd. An additional meeting date was identified for October 22nd, location to be determined.

 

16.       EMSAAC Website: D. Buchanan reviewed the EMSAAC website. It was suggested that EMSAAC purchase the right to “EMSAAC. Com” this could be established as the official site and provide additional support, i.e. email list servers.  Motion M/S/A Buchanan/Petrie to purchase and establish EMSAAC.Com as the official EMSAAC website.

 

17.       HCFA/Ambulance Rate Structure Changes: G. Jones led a discussion regarding the new ambulance Medicare rate structure and how this would affect each county differently. There was a general discussion on the impact to local agencies and how they plan to mitigate the impact. Ventura EMS shared that they have had the county auditors office review the impact on providers agencies and asked the providers to provide an assessment. Included in the review was the providers’ net revenue. They looked specifically at the loss of revenue and its impact.

 

18.       Roundtable: Riverside, reported a hospital loss of MediCal & Medicare reimbursement for one week. Orange, reported that 165 patients were transported to area hospitals after the train crash.  Luckily they had a schedule disaster drill planned, so all the players were in place.  Just before the drill was to start they were notified of the train crash. Providers were able to respond quickly.  Monterey, EMS Council is replacing EMCC.  Contra Costa, hired a consultant to review system in preparation for ambulance bid process.  North Coast, working on a trauma report. San Francisco, disciplinary issues required revoking one EMT certification, they are reviewing the process established, moving office and facing many challenges.    San Diego, RFP out for trauma system assessment, QA Net upgrade targeted for completion June 19th. Alameda, moving its office, Medical Controls issues regarding physician availability on the phone. SSV, is having a restock issue with Valium; working with AMR on a pilot program using paramedics as mental health response team. MVEMS: Trauma System Review, two hospital applied for level II, disaster project is nearing it’s completion; final meeting is scheduled June 19.  Committee has developed sample template for policies. The committee wanted to provide samples and templates and make them available to the local EMS Agencies.  J. Rubin recognized the quality of work and thanked D. Buchanan and MVEMS on the disaster standards project.  Solano, EMS is moving, getting ready for trauma site review team, conducting random sample of paramedic reports and comparing with ED diagnosis.  Results will be available soon.  Santa Clara, is recruiting for an EMS Medical Director. Senior investigator position is also open. Fresno, Kings, Madera, is dealing with the State cut to regional agencies, in addition, their RDMHC will be cut as a result of the state budget cuts. They are involved in an evaluation of the EMS Agency; the Abaris group is conducting the study.  They are also involved in the trauma review process, which will include a pediatric trauma center.  Nor Cal, shared that the Emergency Services Foundation which provided a “how to” book for LEMSA describing the process for establishing a foundation might be useful during these difficult budget times. They are very pleased with their foundation success in receiving donations and grant funds.  Funds were used to purchase 150 AED and are looking to purchase other types of equipment. The Fund generated approx. one million dollars last year.  Nor-Cal recommends that the State establish a foundation of this type to help support California’s EMS System.  The foundation has a very small staff approx. one FTE.  Santa Barbara is the process of hiring two new CQI coordinators; MHAT has been in place in Santa Barbara County and works very well. Cal-Chiefs requested EMSAAC provide representatives to attend the Cal-Chiefs meetings, both north and south.  Bruce Lee and Chuck Baucom will attend the northern meeting and Virginia Hastings has been our southern rep, Barry Fisher will also start attending the southern meeting.

 

19.       Future Agenda Items: none identified.

20.             Meeting adjourned at 4:40

 

Members in Attendance

 

Cindy Abbissinio`

Alameda County

Steve Andriese

MVEMS Agency

Chuck Baucom

Merced County

Doug Buchanan

MVEMS

Darrell Cramphon

San Joaquin County

Jean English

Cal-Chiefs Northern Division

Barry Fisher

Ventura County

Michael Frenn

Solano County

Lenard Inch

SSV EMS

Darlene Isbell

Orange County

Dell James

Inland Counties EMS

Gwen Jones

San Diego County

Nancy Lapolla

Santa Barbara County

Art Lathrop

Contra Costa County

Bruce Lee

Coastal Valley EMS

Chris LeVenton

Monterey County

Daniel Lynch

Fresno, Kings, Madera EMS Agency

Mary Magocsy

San Francisco EMS

Bonny Martignoni

Coastal Valley EMS

Ron Mayfield

Cal Chiefs Southern Division

Jim McPherson

Santa Clara County

Jan Ogar

San Mateo County

Michael Osur

Riverside County

Micheal Petrie

San Francisco EMS

Vickie Pinette

SSV EMS

John Pritting

Imperial County

Dan Spiess

Northern California EMS

Clarence Teem

San Joaquin County

Tim Williams

Fresno, Kings, Madera EMS

Jeff Rubin

EMSA

Sean Trask

EMSA

Miranda Swanson

EMSA

Bonnie Sinz

EMSA