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Southern Tier Regional Emergency Medical Services Council

Council Meeting, Thursday, September 10, 2009; 7:00 PM EMSTAR, Elmira NY

Present: Bob Rajsky, chairperson; Steve Bennett, Frank Brzozowski, Rick Churches, Shirley Churches, Fred Crist, Don Duvall, Patti Gressel, Bill Hawk, Henry Jerzak, Bernadette Josbeno-Oakes, Rick Kimball, Jim Kintz, Daryl Tombs (for Al Lewis), Carol Lucas, Dr. Manganaro, Dave Molyno, Dean Patterson, Ann Repsher, Mike Smith, Mike Sprague, Maryann Sweely, Teri Symonds, Mary Ann Teeter. Staff: Judy Blair
Absent/Excused: J. Chrabaszcz, C. Cuyle, L. Donley, Dr. Huffner, B. Kennedy.
Guests: Ross Zastrow, Art Jones.
Item Description Action
Call to Order The meeting of the Southern Tier Regional EMS Council was called to order at 7:21PM by Bob Rajsky, Chairperson. The roll was called. None
Presentation A plaque was presented to Vanessa Jewett as 2008 Instructor of the Year. None.
Correspondence and announcements Announcements:
• Regional EMS Conference presented by EMSTAR on October 24 at Corning Community College. Topic: Altered Mental Status, including Alzheimers and Autism.

Enforcement Notices were read:
  • Edward Ashley, West Sand Lake NY; 3-year suspension of Basic EMT, 3-month suspension of Paramedic certification 3-year probation effective July 29, assessed a civil penalty of $2000.
  • Jeffrey Monde from Lackawanna, New York. Suspended certification.
  • Darnel Hagins from New York, New York. Suspended effective June 1st.
  • Douglas Recupero from Great Neck, New York, suspended for a year, placed on probation for 3 years and assessed a civil penalty.
Other correspondence:
  • From the Commissioner of Health, Dr. Richard Daines, re-appointing Dr. William Huffner to the State Emergency Medical Advisory Committee.
  • From the Veteran Affairs in Bath stating that they're going back to 24 hour day 7 days a week emergency department.
  • From State Health Department regarding Tuscarora Ambulance - their New York state certification has run out. Letters have gone out to them realizing that they are in violation of that law.
  • Information regarding the H1N1 flu, and flu in general, from the Department of Health, about mandatory influenza immunization for health care workers in Article 28 facilities, home health care and hospice, not only the seasonal flu, but then the H1N1 flu shots. EMS students who do an internship or rotation in the hospital will also have to be immunized.
 None.
Approval of meeting minutes The minutes of the May meeting were approved on a motion by Ms. Josbeno-Oakes, seconded by Ms. Sweely. None
REPORTS
SEMAC/SEMSCo Mr. Duvall Reported: SEMAC did not have a quorum, so met for information only, so no business was really conducted at SEMAC. Discussion about H1N1, the vaccination mandate and who is affected: ambulances are not in the mandate except for those students who are enrolled in clinical rotations and ambulance services that are owned by article 28 facilities - hospital-based ambulances.
SEMSCO discussed H1N1; prehospital providers will be a high priority for vaccination. Strongly encourage prehospital personnel to get vaccinated, both flu vaccine now, and the H1N1 when it becomes available (mid-October).
Training allocations were discussed.
SEMSCo overturned the Administrative Law Judge's decision on a CON by a vote of 12 to 11 - initially there were no stenographic notes available from the meeting and some of the documentation from the original con process were missing.
Lee Burns has been made the Acting Deputy Director of the Bureau of EMS, Ed Wronski is planning to retire.
Mr. Rajsky also reported: Priority Medical, who does Emergency Medical Dispatch protocols, has come up with "Protocol 36," which has not been issued yet. That protocol talks about how a community will reroute those patients may have flu to an alternate destination.
The other issue is that if we get all of flu vaccinations that we think we're going to get, how is the general population goin to be vaccinated? EMS personnel are certified, not licensed, so the critical care and paramedics can't give flu shots. However, the state can empower, through the Model State Emergency Health Powers Act, to authorize EMT-CC and EMT-P to be able to do that in a health care crisis.
New York City just started an organ donor project. Currently, organ donors have to get to the hospital. But with a futile resuscitation - protocols and medical control agrees that the patient that has expired. New York city is piloting a program where they will send a special unit that will be able then to talk to the family, transfer the patient to a specific hospital where organs can be harvested. This program is very successful in Paris.		 None.
STREMAC Mr. Rajsky reported. STREMAC met on August 12. The issue regarding the physician on the scene was resolved. Induced hypothermia protocol - letters will be going out to hospitals regarding this. Induced hypothermia post-resuscitation has been in use in the Niaraga Falls area for about a year, and FDNY has issued a draft protocol.
STREMAC approved the formation of an executive committee, empowered to vote on time-sensitive issues between meetings. The executive committee will consist of the STREMAC chair, vice chair, one voting member and one non-voting member of STREMAC. This comes as a second motion from STREMAC. Roll Call vote taken; motion carried unanimously.
Several First Response agencies within the region have expressed interest in using e-PCRs. They will need to use the "short form" that would go to the hospital immediately with the patient.
AED renewals: Atlanta-North Cohocton Fire District and Elmira Fire Department. These come as seconded motions to the council. Motion carried.
Jasper Ambulance AED renewal. Jasper had a temporary loss of operating certificate, and needs re-approval for their AED permit. STREMAC recommended a probationary renewal for one year. This comes as a seconded motion; motion carried.
ALS Course Funding: cuts in Intermediate, Critical Care and Paramedic training was discussed; it was recommended that a letter be sent to SEMSCO in support of keeping the funding as it is.		 None.
Quality Improvement Quality improvement met August 26. It was noted that we have been reviewing stroke patients for three years now, and no major issues were really noted on any of the reviews.
Attendance and reporting issues were discussed. Some of the areas are having three meetings a year, with no meeting during the summer. Reports still need to be submitted quarterly. The QIPP (Quality Improvement Program Participation) awards will be issued based on attendance and report at three out of four meetings, or where appropriate, two out of three.
The current focus study was initially going to be review of adherence to protocols; after discussion, it was decided to look at controlled substances.		 None
Training Committee Training committee met this evening. Instructor approvals: Michael Heckman and Vanessa Heckman, sponsored by Corning Hospital. Motion made, seconded (Patterson/Teeter) and carried to recommend for CLI certification.
Evaluation forms: the current forms have been in use for over ten years. Ms. Sweely requested samples from other regions, and received two, neither of which would result in any additional information in regard to useful feedback. Current forms will continue to be used, but suggested are welcome.
Flu vaccine for students doing clinical: a question was raised concerning who will pay for it. Sponsors are recommended to contact public health departments and talk to them about clinics, and go back to the hospitals to see if they would provide the vaccines.
The Training Committee discussed the cuts in EMS ALS reimbursement and will send a letter requesting that the funding not be changed from current levels.
Other funding issue: students who drop out of EMS courses. The sponsor has expended half a year's worth of expense on that student, with lab instructors and lectures and equipment. Currently, the sponsor just eats that expense. Sponsors' Committee will meet and review the possibility of having an additional form for either the agency or the student to pick up the funding if the student defaults.
A question was raised concerning pre-tests for EMT courses. A test is available, a free evaluation tool. However, the students would have to go to Corning Community College to take the test, which includes English, reading comprehension, and basic math.		 Letter to be written to SEMSCo' Sponsors to check with hospitals on flu shots for students.
CISM CISM has had one meeting over the summer, at Painted Post Fire Department, which is a central location. A mock debriefing was held. There have been eighteen activities which included debriefing and defusings, and one-on-one sessions with about 20 different people. Evaluation requests are sent out, and some very positive feedback has been received. The process of moving the call schedule to the 911 centers is proceeding, but calls are still being taken at St. Joseph's until the changeover is completed. Addional training courses are being planned and will be posted to the website when available. None
Executive Committee Executive committee met this evening. First is a membership issue - Gary Blitz has retired from the Elmira Fire Department and resigned form the Council, leaving a vacancy. An application was received from Patrick Bermingham, the new fire chief. Motion made, seconded (Sweely/Teeter) and carried to accept Chief Bermingham.
The Executive Committee also reviewed attendance and it was decided that a letter would be sent to each member, showing their attendance and and reminding everybody that you can have two alternates that can come and vote in your place.		 None
Other Business EMS Training Funding: A copy of the letter form STREMAC was distributed, along with a page from SEMSCO showing the current and proposed allocations for EMS training. Intermediate training goes from $530 per student to zero. Refresher training at the Intermediate level goes to zero. Critical Care original goes to from $1200 to zero. Critical Care refresher, from $700 to $400, and Paramedic original goes from $1500 to zero and paramedic refresher training from $700 to $405. This will have a serious impact on rural areas, especially when the ALS personnel are volunteers.
The total amount of funding has not changed, but the budget proposal is to reallocate it to BLS training. And with medical specialization - stroke centers, cardiac centers, trauma centers, and other specialties the question become how do patients get transported to these centers with BLS personnel, especially with IVs or other medical equipment running.
Motion made and seconded (Gressel/Repsher) to send a letter to SEMSCO and the Budget Committee, requesting that the funding not be reallocated.
Amendment to the motion (Smith): to send copies to our state senators and representatives from the three counties, so they are aware of the issue. Agreed to by Ms. Gressel and Ms. Repsher. Roll call vote taken; motion carried unanimously. Letter to be sent to SEMSCo and Budget Committee		 Letter to be sent to SEMSCo, Budget Committee, and state legislative representatives
Adjournment; Next meeting Next meeting is scheduled for November 12. Meeting adjourned at 8:25 PM on a motion by Mr. Kimball.