PRESENT: Paul Card, Jim Chrabaszcz, Rick Churches, Fred Crist, Don DuVall, Kathy Hanville, William Hawk, Dr. Huffner, Bernadette Josbeno-Oakes, Ron Kintz, Al Lewis, Kathy Lunney, Dr. Manganaro, JR Miller, David Molyno, Bob Rajsky, Carol Lewis (for Mike Sprague), Dick Sullivan, Maryann Sweely, Teri Symonds, Mary Ann Teeter, Heidi Wilmott. STAFF: Judy Blair
GUESTS: Trooper Ross Riley, Mary Perham, Shirley Churches, Jim Kintz, Steve Foster, Carol Lucas
ABSENT: S. Bennett, G. Blitz, P. Gressel, W. Kennedy, R. Kimball, M. Smith

(7:09 p.m.)
CHAIR RAJSKY: Let's call the meeting to order of the Southern Tier Regional Emergency Medical Services organization for October 2004. I want to welcome everyone here tonight. We have tonight with us three brand new members. William Hawk, Bill, if you want to kind of -- welcome, from Bath. David Molyno from Schuyler, representing Schuyler. And Heidi Wilmont from Schuyler Hospital. Welcome.
     Other introduction of guests, does anyone have any guests they would like to introduce tonight?

FRED CRIST: Steve Foster from Hornell Fire Department.

CHAIR RAJSKY: Steve, welcome.

STEVE FOSTER: I didn't do it.

CHAIR RAJSKY: I would like to introduce Ross Reilly from the New York State Troopers.

TROOPER REILLY: Hi.

CHAIR RAJSKY: After the heated meeting last time, I brought --. No. Ross is going to talk about a new program that he has on his plate. Anyone else have any guests to introduce? Seeing none, we will move with the agenda. Correspondence, I will read, it was last minute stuff but I finally got them in, the bad boy list. No bad girls this time.
      First one is Cameron Monroe from Hudson Falls, New York, surrendered certification for violations of Part 800. They are all Part 800.16 violations, so I won't add that each time. Nieves Mariano from Bronx, New York, reinstated actually at the paramedic level but on probation until July of 2008. Gregory McCalmonte from Hempstead, New York, suspended for a year, placed on five years probation and assessed a civil penalty of $1000. John Olson, from Staten Island, New York, suspended for one year, placed on five years probation, assessed a civil penalty of $1000. Benjamin Karz from Rensselaer, New York had his certification revoked. Sergey Zimodro from Brooklyn, New York, suspended for a year, placed on four years probation. And James Sage from Hilton, New York, surrendered his certification effective September of '04. That is the correspondence from New York State Department of Health.
      Other correspondence I have, not from me unfortunately, but from our newspaper, the passing of Dr. William Nowill over this past week. Those of you that know, knew and know of Dr. Nowill, he was really the pioneer in the Southern Tier for Advanced Life Support, really the start of Advanced Life Support in our geographic region. And so I think all the ALS in this community kind of fell on his shoulders as he started that. And those that knew him knew he was certainly a big big advocate for what we do on the streets. So Dr. Nowill will be missed.

MARYANN SWEELY: Would it be appropriate if you didn't send flowers or memorial or something to the family because of his past?

CHAIR RAJSKY: I think that would certainly be appropriate.

MARYANN SWEELY: I would make that motion.

DR. HUFFNER: I second.

CHAIR RAJSKY: All those in favor (CARRIED, UNANIMOUS.)

CHAIR RAJSKY: Okay. I will be glad to do that. Approval of the minutes from the last meeting, you should have received those electronically.

DR. HUFFNER: Move to approve.

AL LEWIS: Second.

CHAIR RAJSKY: Motion made and seconded. Any discussions. Seeing none, all those in favor signify by saying aye? Opposed, abstentions. Carried. (CARRIED, UNANIMOUS.)

CHAIR RAJSKY: As promised in those minutes I had said that I would do a, just a brief presentation on EMS in New York State focusing on the Southern Tier, but kind of putting the whole picture together and kind of from top to bottom what it is that New York State EMS is and how are we integrated within that. Because we have had conflicts and things, and just, I really think it was probably not everybody knowing how the system's put together. So if you will go with me the next few minutes, we will kind of look at the whole deal.
      So the person in charge of Emergency Medical Services for the entire community of health in New York State is the Commissioner of Health, and it's Antonia Novello for us. She administers the Health Department Rules and Regulations through Part 800. That's where that comes from. She has all the, she has the ability to shut hospitals down, shut virtually anything to do with health care, approve, disapprove. So she has the ultimate authority on that.
      From her, the segment of the Health Department that we are directly under is certainly the EMS Bureau, the New York State Department of Health EMS Bureau. And they are responsible for providing the financial and staff support to the state EMS Council and the Regional EMS Councils. So in essence they act for the Commissioner of Health and then act to support all of the actions of the State EMS Council and actually the Regional Councils. And so they coordinate contracts as well with EMS agencies from around the state for the development of local EMS. They also enter into national contracts, federal government contracts and grants.
     So they approve all the certification courses and assist in development of the curriculi. State Council really has that responsibility, but they take that information and all the work that the State EMS Council does and then turns it into working documents that all of us use. They also approve and work with EMS plans that are supported by state aid. So the monies that flow to counties, certain counties get monies to administer EMS that way. They do the examination process as most of you would know. And then do all of the administration of the state aid for EMS training. So we all know if you belong to an EMS agency in the State of New York that your training virtually is free, other than your textbooks, everything is free. They do maintain the prehospital data from the PCRs. We had 1998 data from them, we're hoping to get more recent data shortly. But I don't know what that means.

AL LEWIS: They are always five years behind.

CHAIR RAJSKY: And it's hard to work five years behind with data. They also are involved with the trauma program in New York State. There is a State Trauma Advisory Committee which falls under the department. And they also have the trauma registry which collects thousands and thousands of trauma cases for looking at improvement in trauma.
      Talked about managing the federal grants, Emergency Medical Services For Children grant is under that EMS Bureau. And one of the big things, obviously the certifications, ambulance certifications, first response, ALS agencies, they do all of that issuing of those certificates. And also maintain that they do the spot inspections for those agencies.
      Next down, if you will, down the pyramid or parallel to the, in this chain would be SEMAC, the State Emergency Medical Advisory Committee, 29 members, 21 which are positions, one from each REMAC, and then additional physician from New York City, there is a pediatrician, a trauma surgeon, and a psychiatrist and eight non-physician non-voting members. So in that only the physicians can vote. And they set, their mission is to set statewide minimum standards for medical control, for treatment and transportation and triage protocols. They also do the regulating of the medical devices. Up until now that would be AEDs, but we know we can get those over the counter now. So we don't do that any more. But certainly the medical devices, drugs, all comes under the auspices, what medications can be used comes under the Medical Advisory Committee.
      With any of those issues they're the ones that issue advisories. So if there is a new treatment modality, they issue and you will get the SEMAC advisory, and that's what, that's where it's coming from. And then they also review and approve protocols from each region. So each regional REMAC has to submit their protocols, treatment protocols to SEMAC for approval.
      Next to that is the New York State EMS Council. Again 31 members, and that includes one person representative from each of the Regional Councils, and then there is a representative actually from the general public, representatives from voluntary ambulance services, ALS first response services, actually the professional ambulance association, and a whole host of others. But at least there is at least one person from each region. There is physicians, nurses. The advocate, it's interesting the representative from the general public Harriett Weber just passed away maybe six months or eight months ago, and Harriett was an elderly woman who served many many years on Council and was the patient advocate. And it was very interesting to go to meetings with her and get that perspective. I think that was one of the very healthy things that State Council did. So that's the membership of the State Emergency Medical Service Council. So they actually have quite a bit of power in New York State. So they do the establishing the minimum standards for ambulance services, for the certification of ambulances, approve, set the standards again for Advanced Life Support and then provision of prehospital emergency medical care. They are also responsible for doing public education and development of statewide EMS system. They approve the training curriculums, the examination process, actual what's on the exams and then certification from first responders through paramedic. Another job they do is certainly they have the ability to amend, modify or reverse the determinations of need in the CON process. So if there is a Regional Council that approves or disapproves and there is reaction to it, it can get appealed to the State Emergency Medical Services Council.
      At the regional level then we have the REMACs, so the Regional Emergency Medical Advisory Committees, basically the same make up if you will, at the state, same kind of issues they deal with, but in Article 30, is defined as five or more physicians and representatives from the Regional Council, hospitals and basic and advanced life support providers. So our local one is STREMAC, Southern Tier Regional Emergency Medical Advisory committee.
      So they are responsible regionwide developing policy, procedures, triage treatment and protocols for the region, and they also approve, may approve physicians to provide on-line medical control. It was last month it was approved credentialing process for physicians. So ours can certainly do that.
      Their issues are other things, coordinate development of regional medical control systems, and then participate in the quality improvement process regionwide. So they look at regionwide problems as they occur. And that's the voting membership. Those are the physicians involved. Actually a good cross reference of physicians from Dr. Robshaw from Hornell area through I guess who is the farthest east, I guess Dr. O'Connor, Dr. Huffner from the eastern end of the county. Dr. Sharaff from Schuyler. And Dr. Seaman, Dr. Enders from the Corning region. And then the non-voting members are there as well.
      So our Council, that's who we are, the Regional Emergency Medical Services Council, we're STREMS, can have 15 to 30 members. The important part in law is one-third of our membership here has to be representatives of ambulance services. So you have to be designated, one-third has to be from ambulance services, and then the rest are interested parties, hospitals, physicians, nurses, street providers, other interested parties, and the application process is always open. So under law these are the things that we can do, acquire property to do what we do. Make and alter our bylaws, so we can run the operation. Enter into contracts with other entities to do our business. And then recommend training courses, training course sponsors within the region. Certainly developing an EMS plan, training plan that allows that no student that wants to receive training has to travel more than an hour anywhere. And that was, that's kind of, that was a state goal. And the REMSCOs have adopted that as well. They also approve the Regional Medical Advisory Committee members, so the physicians on the REMAC also always come here for approval.
      Certainly are the overseers if you will to coordinate emergency medical services within a geographic region. Each region is just a little bit different in terms of how many counties are involved, and the size of those. Certainly New York City, the REMSCO of New York City is rather large, as opposed to, as a contrast to STREMS I am sure.
      One of our major obligations is the making of determination of need for new services. Either new ambulance service, service that's looking to get into a new territory. And also looking at adding like ALS first response units. The other things they can do is grant exemptions to the basic EMT rule, where every ambulance in New York State has to have an EMT. The Council can grant a waiver if, if an ambulance service can't staff an ambulance 24 hours seven days a week, we can grant a temporary exemption up to two years for that.
      And part of our job is to give focus technical assistance to volunteers and proprietary ambulances, municipal ambulances, and how best to serve their communities, so Schuyler Chemung Steuben. Our committee, executive committee, training committee, we do have a sponsors committee as a subset of training, that's each of the sponsors get together and set kind of policy, regionwide policies, so we kind of all operate together. Systems committee, public relations and then quality improvement.
      That is the whole bunch, and that's actually up to date as of today.
      The other entity regionwide, in each region are called program agencies. And so the REMAC really doesn't get any money from anywhere, the councils, the regional councils gets a little bit of money from New York State, but certainly not enough to carry out the mission. So program agencies are another entity, regional entity that contract, are independent companies that contract with regional councils, REMACs, Department of Health and they may have other contracts as well. But they carry out the duties, responsibilities of the Council. So our Council, if we adopt a new policy tonight, it would be the program agency who would do that, who would do the printing, do the final work on that, do all the mailings, all of that. Our program agency is EMSTAR, that's the new term. It had been for years STREMS Inc. or STREMS Incorporated. And what had happened is, and the corporation who really just does what the Council and the REMACs tell them to, were taking hits financially and kind of getting, taking blame for things that really they weren't involved with, or not responsible for I guess. So we tried to put this new name in to try to delineate the difference between STREMS Council and the program agency. So that's the deal with that.
      And so through contract with New York State is, we have, we do have some responsibilities of kind of not overseeing but helping facilitate the Council do its mission, ensuring that every citizen or passerby within the region gets good quality emergency care. They also staff as I said the REMAC and the REMSCO. So Judy, Judy is here as a staff member of EMSTAR, not as a Council member.
      Our particular one does, also does prehospital care courses, so we actually do ACLS, PALS, CPR, we do the instructor courses for New York State, that's a direct contract with New York State for that. There we have it.
      So in addition to the State and the Council and REMAC, we also do, we also have contracts with the six regional hospitals, the three county governments, and over the past have provided regional AED training, recertification, disaster trailers, two in Steuben County, one in Chemung, one in Schuyler, we have given educational grants when a squad was about to fold and said they couldn't possibly send or do EMS any more, that organization stepped in and awarded some grants and provided instructor to keep them up and running. And as of late I guess was the 12 lead education program. REMAC introduced the new protocol which required a significant eight-hour educational component, which EMSTAR did. So it enacted, made sure every advanced provider in the region did get the training. And in fact that did occur and as of last week at the REMAC, we have realized that every CC and paramedic in the region has had that education.
      So if we look at it that way, that's what we just went through. So I hope that was helpful. If there is questions I would certainly entertain them. If not, we will move the agenda.
      Reports from committees, STREMAC, SEMAC and State Council.

DR. HUFFNER: As I had promised at the last meeting, the summaries for the September and the May meeting were included in your folders. One is this color, the other one is yellow in color, they are always entertaining, we have already spoken about the highlights of those meetings, I am not going to spend any more time on it.
      You also have in your packet a set of STREMAC meeting minutes from October 12, this past Tuesday, which is the last time the STREMAC has met since we met. There are a few things that I wanted to point out to you, and there are three items that require action by the Council.
     In your packet also in a white sheet you will have the AED, ALS permits that need action by the Council. The first is the Erway Ambulance ALS renewal permit that was approved by the STREMAC. It now comes to the Council for issuance. We jointly issued those renewal permits, because it is a renewal permit according to the ALS policies and procedure, it comes only back to the STREMAC for evaluation. Attached to the white sheets actually is the standard form that is evaluated by the STREMAC for Erway Ambulance which there is an attestation by the area QI coordinator that there was participation in QI meetings, that by the service medical director that providers adhered to meet educational criterias as required, and that the service carries and utilizes all appropriate and proper equipment adequately maintained, and the ambulance's CEO attests that for the previous 12 months they have and will continue to carry and utilize appropriate and proper equipment adequately maintained.
      I will make a motion that that permit, renewal permit for ALS provision be issued.

MARY ANN TEETER: So moved.

CHAIR RAJSKY: Motion on the floor, seconded. Discussion? Seeing none, all those in favor signify by saying aye. Opposed? Abstentions? Carried. (CARRIED, UNANIMOUS.)

DR. HUFFNER: The second item requiring action by the Council is the matter of the AED renewal application for Elmira Fire Department. That also is consistent with the AED policies and procedures of the region, and that also comes as a renewal, therefore only through the STREMAC. And then is evaluated there and then brought here for consideration of issuance of a renewal permit. You have a copy of the application that accompanied the documents and all the other documentation that was required. And I will make a motion that the Elmira Fire Department's AED permit be renewed.

PAUL CARD: Second.

CHAIR RAJSKY: Motion made and seconded. Discussion? Seeing none, all those in favor signify by saying aye. Opposed? Abstentions? Carried. (CARRIED, UNANIMOUS.)

DR. HUFFNER: The third is the Addison Volunteer Fire Department Ambulance Corps AED renewal application. This application was also reviewed by the STREMAC. One of the documents, pieces of documentation that was, that is required is a narrative that describes the service's compliance with Section 5 of the STREMAC's, of the region's policies and procedures for providing AED care. That document was provided, it was however unsigned inadvertently. We have had discussions with the appropriate personnel and that document is on the way. In fact Judy did we get it in the office today or not? I don't think we did yet. But it's coming.
      So I would make a motion that the AED renewal application for Addison Volunteer Fire Department Ambulance Corps be, that the application be approved and that their permit be renewed pending receipt of that signed Part documentation. Simply a signature from the CEO and it's an oversight.

MARYANN SWEELY: Second.

CHAIR RAJSKY: Motion made and seconded. Discussion? Seeing none, all those in favor signify by saying aye. Opposed? Abstentions? Carried. (CARRIED, UNANIMOUS.)

DR. HUFFNER: The other items that I did want to bring to the Council's attention deal with some very important issues. One has to do with a stroke center designation. Draft protocols are being worked on at the state concerning stroke center implementation. There were materials that were mailed out to the hospital as well as drafts of the stroke BLS stroke protocol were distributed and discussed at the STREMAC. We're not going to bring them ahead at the STREMAC until the state takes a final stance, if you will and approves one.
      As you recall, may know that our ALS protocols already has a stroke, we already have a stroke protocol and it enables us to send patients to what we defined as the most appropriate hospitals. So we do sort of have a little band-aid protocol that may need to be revised pending what the state BLS protocol has in place.
      Other things that we should take note, is that we, the STREMAC received a letter from Rural/Metro concerning the cessation of the Wayland Base ALS First Response Medic 73, if you will, decrease in service created by the cessation of this service is and will remain a concern to the STREMAC, I am sure to the Council as well. We at the STREMAC decided that we would ask the Council Systems committee to evaluate the situation and possibly come up with some recommendations about how we might improve both ALS and BLS service in northeastern part of Steuben County.
      Draft document entitled credentialing of paramedics and critical care technicians was distributed and discussed. It is a blue document that is in your handout. It was not written by me. It was not written by me.

JR MILLER: With a bold faced, underlined.

DR. HUFFNER: I believe that the STREMAC, now I know that the STREMAC is very excited about this document coming forward, if you will, a new technical advisory group that was appointed after they had shown such great promise in coming up with this document. That technical advisory group which is working on the credentialing of paramedics and critical care techs in the region was chaired by Jim Kintz of Erway Ambulance and representation participation included all the ALS services, that is critical care and paramedic based services, not ILS at this time. They participated in the development of this document.
      STREMAC would encourage this to be distributed regionwide. That in fact would hope that all critical care tech and paramedics get a hold of it to read and see what is being considered.
      Mr. Kintz, that's Jim Kintz was appointed chair of that technical advisory group. And that they are to report back at their next meeting, at our next STREMAC meeting concerning any input that they might have received from the region. I think it's imperative that people at this table take this back to their services for comment by individual providers, by services, by hospitals, so that everyone can have input into this process.
      Again for the third time, I did not write this.

JUDY BLAIR: Dr. Huffner, I will put this on the website tomorrow.

DR. HUFFNER: That would be great, Judy.

JUDY BLAIR: So if you want someone to look at it. Tell them to go look for it, it will be there.

DON DUVALL: Did you write this?

DR. HUFFNER: Thank you for asking, Donny, no. That was Mr. Kintz, James Kintz wrote that document with representatives of the ALS services, that's the critical care level and paramedic level service and higher. No, I did not write this. Thank you for asking though. I hope that's clear.

AL LEWIS: Clear down here we got it.

DR. HUFFNER: I believe that concludes the issues that I wanted to raise up here, other than the back of the STREMAC minutes. Another technical advisory group was actually appointed, and I am pleased to announce that that group is also working hard on inter-facility transport protocols. That chairman is Mr. Duvall. I also did not write these minutes, and they are also working very hard and diligently on inter-facility transfer protocols, among many other things.
     There are several issues that they have been charged with doing and they are making good progress on that. But we will include with the STREMAC minutes from now on formal reports from those technical advisory groups, that the chairs prepare and bring to the next, to each of the STREMAC meetings.

JIM KINTZ: I will report whatever you write, Dr. Huffner.

DR. HUFFNER: Dr. Huffner is not writing them. But those technical advisory reports will be included in the STREMAC meeting minutes, so everyone is kept abreast of what's going on. I believe that's the end of my report unless anyone has any questions.

CHAIR RAJSKY: Questions for Dr. Huffner?

RON KINTZ: Since the last meeting, has the problem been resolved, or a problem with the Hornell Fire Department?

DR. HUFFNER: I wrote to Mayor Hogan and Chief Kelly, the question that I be informed of when in fact Hornell Fire Department would be on-line, utilizing 12 lead EKGs. I got a letter back from the mayor, saying that as soon as they got those pieces of equipment that they would be utilized. I don't know the status and maybe Mr. Crist could comment on whether or not 12 lead EKGs are being performed by providers at Hornell Ambulance. I know they are all trained and ready to go. But I don't know physically if they are there yet or not.

FRED CRIST: But I was told not to tell you. But yes, we do have our four 12 lead EKGs. We have been doing 12 lead, we had a loaner unit, and they have been done. They are doing well.

DR. HUFFNER: Thank you. That's excellent news to hear. Please pass my --

FRED CRIST: You pass it, I am out of the loop.

DR. HUFFNER: To the mayor and to the fire chief. So there we have, they are complying.

CHAIR RAJSKY: Anything else for Dr. Huffner? Seeing none we will move on. Training has not met. Quality Improvement has not met. Public relations has met, and met several times and has some exciting news.

MARY ANN TEETER: It is.

CHAIR RAJSKY: Mary Ann Teeter.

MARY ANN TEETER: Our last meeting was October 5, and the focus of that meeting primarily was regarding the EMS conference this weekend. How many here are going? Let's see a show of hands. We have approximately and probably a little bit more by Saturday a hundred registrants, so we are very pleased with that response. And it looks like it is going to be a good day whether the weather is good or not.
      The other thing I know there was also an article in the Star Gazette, in a little column there, also announcing it. And I think there is going to be some more media attention as well. I think the TV crews are going to be coming up to Corning Community College. So we're going to get a lot of PR out of this which seems really really positive. The other items.

DR. HUFFNER: Make that good public relation.

MARY ANN TEETER: Of course, always. I told you you go through me.

DR. HUFFNER: That's right from now on.

MARY ANN TEETER: The other items that we discussed was the award nomination process, that whole process we took apart and looked at and we're revising that to make it more user friendly.
      And then the last thing, it's going to be a short report, we discussed the awards banquet which will be next May. And I have to look at the calendar, but I want to say it's May 13. We have chosen the Corning Country Club as the site and it's our 30th anniversary for STREMS. So we're hoping to make it -- it won't be as wild as the 25th, but we're hoping to make it as much fun. And I think that's it.
      Excuse me, I will give you these. The Gold Stars of Life. And I see that there is some dates that go back, are these just late entries, Judy?

JUDY BLAIR: Yes.

MARY ANN TEETER: So I will read those and then I am going to let my partner here pick out the winner.
      First is Kathy Lunney from Corning Hospital, and nominated by Bunny. I wish to nominate Kathy Lunney for the Gold Stars of Life recognition. On June 14, 2004 Kathy took time from her busy schedule at Corning Hospital to organize a debriefing for Wellsburg Fire Department. Kathy responded to a call for an urgent need to organize a critical incident stress response from Tri-county CISM team. With several team members obligated to their employment and several out of town, Kathy managed to assemble a team and respond to this need. Hats off to her and Michelle Meyer from Steuben Mental Health and Tri-county team member also.
      The next is Tina Goodwin from Cohocton Ambulance, nominated by Maryann Sweely. Tina Goodwin has stepped up to the plate during a very difficult transitional period in which we lost a close friend and CIC Mr. Yonkin. Tina stepped into his class, took over the reins during a very difficult period, she conducted herself professionally and with compassion. Tina has consistently proven herself to be a knowledgeable and effective CIC. Thank you Tina for being there when our EMS community needed you.
      Wellsburg Fire Department, unknown nominator. Special thanks and congrats to the Wellsburg Fire Department for a job well done on the cardiac arrest save on Lower Maple Ave. on 7/10/04. Your assistance with treatment as well as your help with the family during the cardiac arrest was vital to the save. Mike, Dickie, Larry, Les, you guys are great, thanks for the quick response and professionalism. It's always a pleasure to work with you guys.
      Next is Mary Ann Klee and George Welch, from St. Joe's, nominated by Bunny. I wish to nominate Mary Ann Klee and George Welch, chaplains at St. Joseph's Hospital and Tri-county CISM team members for their many hours of response as Critical Incident Stress Debriefers during the week of June 13. They both responded in many different ways to the needs of family and responders to the drowning of an 11 year old child. Their action certainly helped all who they came in contact with.
      Winnie Romeril from Rural/Metro nominated by Woodhull Ambulance. During a recent accident involving a tractor trailer, Winnie arrived with Rural/Metro, offering medical support as well as emotional support. After informing Winnie of the stress debriefing, Winnie arrived in Woodhull to continue offering her support. We appreciate the role Winnie played in this unfortunate accident.
      Next is Renee Saltsman from Pulteney Ambulance, nominated by Carole Travis, Bath Ambulance. On 9/17/04 Renee was driving down I-86 and came upon an MVA that had just happened. She had only been an EMT for seven months but her training kicked in. She immediately started CPR on a young female who was critical with extensive trauma. She never stopped CPR until I took over as the responding EMS crew. She then stayed to help load patients and asked if she should ride along for extra help - which we gladly accepted. Renee remained calm and level-headed throughout the entire experience and should be very proud of her own actions. Thank you, Renee, for that day and for volunteering your time and life-saving measures on that day, and hopefully many more in your very bright future.
      That's all of the nominees. Let me open the secret Ziploc.

PAUL CARD: Is there any way I can pick them all?

MARY ANN TEETER: I know, I know. Okay go ahead.

PAUL CARD: Renee Saltsman.

MARY ANN TEETER: Renee Saltsman. I am sure we will make sure she gets her Gold Star pin.

JUDY BLAIR: She will be at the conference on Saturday.

MARY ANN TEETER: Great, perfect. Thank you.

CHAIR RAJSKY: Anything else, Mary Ann?

MARY ANN TEETER: I think that's it.

CHAIR RAJSKY: Systems committee? Donny. You want to.

DON DUVALL: Systems committee actually did not meet this month because all of the county EMO directors are out of town on conferences.
      As you recall the only item that really has progressed from last month was the credentialing work group that Systems initially supported has been moved forward as a TAG for the REMAC. So we're happy about that.

CHAIR RAJSKY: Thanks, Don. Executive committee met prior to this meeting tonight. And approved some new alternates for Mike Sprague, Carol Lucas, from Woodhull Ambulance and Tim Marshall from Steuben County EMO; for Bill Kennedy, Shirley Churches from Schuyler EMO and Chip Wood from Tyrone Ambulance. For Rick Churches, Ron Hoffman from Odessa Fire, and Nicole Hoffman from Odessa Fire. And Fred Crist, for Fred Crist, a new alternate Steve Foster. So those were all approved.

CAROL LUCAS: It's Jasper Ambulance for me. May I make a correction.

CHAIR RAJSKY: So noted. Thanks. Recommended membership renewals, we have several people that need to renew so I announce those at this meeting, and then we officially vote for them next meeting in November. In the meantime between this meeting and the following meeting, we ask them if they would like to serve another term.
      Those are Steve Bennett, Kathy Brimmer Hanville, Fred Crist, Ron Kintz, Bernadette Josbeno-Oakes, Dr. Steve Manganaro, Michael Smith and Richard Sullivan. Those folks are all up for renewal. We will put them before the body tonight, and in the next, in the coming month we will ask them for, ask them if they would like to continue.
      Also next month is election of officers, chair and vice chair. And in the past the nominating committee -- or the executive committee acts as the nominating committee. And the nomination or motion from that group was to place, continue the same two officers, myself as chair and Bernadette Oakes as vice chair.
      There were memberships discussed, there is actually still two openings from Steuben County, all of the Schuyler seats have been filled, as well as Chemung County. And we did have one membership for, application for membership from Steuben and we tabled that until next meeting. So that's the executive committee report.
      Other business to come before Council this evening? If I could I would like to introduce Ross Riley from the New York State Police who would like to just take a minute or two to talk about a new program that he is involved with with the troopers. Ross?

TROOPER RILEY: Thank you for giving me the time to come speak to your Council. As Bob said my name a Ross Riley, I am a trooper with the State Police. And partly I am here to represent the Mobile Response Team, it's the MRTs, it's the SWAT team for the State Police. A lot of people don't even realize we have a SWAT team. And that's the way that they wanted it for many years. They wanted us to be a secret, dressed in black, kicking in doors and stuff like that. We spend a lot of time up in the cities of Rochester, Buffalo, we do, we handle all the warrants when they think there is going to be a problem, they call us to make the arrest. We carry a lot of extra fire power and equipment that our guys on the road don't carry. When they run into something they don't think they can handle they call us to help us out. Part of things we do we do hostage rescue, we train a lot with the military teams and with the FBI, we do barricade subjects, they call us out, they call us out for high angle rescue, we have a rope rescue team.
      Like I said before, we were kind of a little secret in the State Police but I am trying to change that and I am trying to get us a little more high visibility, high profile, especially after September 11.
      We provide dignitary protection services for Governor Pataki and for visiting dignitaries. We work very closely with the Secret Service. There is only 40 of us in the whole state. It's pretty competitive to get on the team. We have tryouts every couple of years. And once you get on the team you have to maintain your spot.
      I am a paramedic also. I worked for TLC up in Cortland when I was in college. And I think that kind of helped me kind of get on to the team because they didn't have any medical operators on the team.
      I am here tonight, I am actually on the road all this month, my wife isn't too happy about it. I am going to all 18 different Regional EMS Councils in New York State and I am introducing the Mobile Response Team of the State Police. What we're looking to do is get recognition from the New York State Department of Health, Bureau of EMS as a Basic Life First Response agencies. Of the 40 of us we have 27 basic EMTs, two paramedics, we do a lot of inner perimeter stuff. We do a lot of things where you really couldn't take basic EMT or a paramedic from Rural/Metro or from Bath Ambulance and bring them inside the crime scene tape, perhaps for an active shooter situation, like a Columbine High School deal, they would call us to that. A sniper situation such as in the DC area a couple years ago. They would call us to that.
      Like I said we have all the body armor, we have all the fire power to deal with these things. And we can have the ability to take care of people inside the perimeter of these situations.
      So what I am doing is I would like, I have the packet, I have the application packet for the BLS FR, and I would like to get a letter of endorsement from your distinguished Council here if I could. We're not looking to become part of your 911 system, we're not looking to take any work away from anybody, and we're not looking to invade anybody's territory. We are just kind of pretty much we're looking to do our own thing. Also if your system gets totally taxed out in the event of a mass casualty incident, or perhaps a search, a very large search where you are looking for somebody, plane crash, whatever, we're very very easy to get a hold of. You can call us, one phone call we can give you a yes or no. And I can have between 20 to 30 guys here within two hours. And a state the size of New York, that's pretty good. Just yesterday I was down in New York City, before that I was up in Massena, three days ago I was in Buffalo. It's like I said, I don't really, we don't work out of any specific barracks, I work out of my truck out in the parking lot. My wife's a trooper, thank god. She is pretty understanding. Because it's pretty tough.
      But that's pretty much it. If it's a law enforcement emergency, the state, the local troopers in your area, they are going to call us, like I said. If it's something, an event where your system becomes totally taxed, all assets are tied up, we can be reacted, when we come we show up with a lot of our assets, we have a Huey up in Albany, it's special operation, it's ready to repel, it's rigged, we can have that in an hour and a half, two hours, anywhere within the geographic areas of New York State.
      I had a great video, poor prior planning on my behalf -- I didn't have a VCR and TV set up -- shows you some of the stuff we do. But that's it.
      Does anybody have any questions for me?

MARY ANN TEETER: When there is a prison situation, would you respond to that as well since we have two maximum securities here?

TROOPER RILEY: After Attica in 1972, we haven't been invited back to any prisons. However, you remember in Elmira they had an escape a couple years ago, anything outside the wall. We were on that one. We were on the two deputies in Pennsylvania just over Tioga County that got killed. We were out there. I was in the woods for about three days looking for that guy.
      But to answer your question, we do work with the Department of Corrections, on the outside. They have their own teams that deal with anything that goes on inside the wall.

MARY ANN TEETER: That's what I meant.

TROOPER RILEY: However we do provide, we're all snipers, we provide riflemen to assist them and other -- a lot of counties that don't have a SWAT team or a lot small towns or cities that don't have SWAT, they will call us in for instance to help them out and we do that a lot. We have done a lot of work, like I said in Rochester PD, Buffalo PD, Albany PD. Yes, sir.

DR. HUFFNER: I am fascinated as to why you need to go around and get support of the Regional EMS Councils to become a BLS First Response agency. I would think that the Department of Health, EMS Bureau would welcome you with open arms, and this wouldn't be necessary.

TROOPER RILEY: I am glad you asked that, sir. It's not that easy. I thought it would be pretty easy. But I am finding out that they throw so much red tape up at you they almost try to discourage you. As you know for BLS FR you don't really need to have a certificate of need for BLS FR. However for our situation, as I said, we are not going to be part of your 911 system, we are kind of going to do our own thing. The same way, like Corning, Corning Glass Works I am sure they have a medical team on-site that they do their thing within side their confines. They took, part of the BLS FR application packet says to get a letter of endorsement if you can from your Regional EMS Council saying the Council understands what you are trying to do, that they support what you are trying to do and that if you need any help they are going to be available for us to tap into them for any sort of administrative help or whatever. Because being though we operate anywheres within the geographic counties of New York State, I am on the road this month, I am trying to do this. I don't want to go in this okay, we're like, I am sure most of you are all familiar with the Troopers, how they operate, I am trying to get rid of all that, and I am trying to build a peace bridge between us and the fire people and the EMS people. I am trying to go through the steps and jump through the hoops and go through the process just like any other fire department or ambulance squad just starting up would. I am going through step by step. I have the packet.
      And this has been very well received too pretty much. I had one problem with somebody down in Westchester County, she told me that we had no business doing this, we were way overstepping our bounds, they have no need. And she was a very offended that I even sent her a letter. But almost every, everybody else especially up in the north country like in the Adirondack areas were very well received.

RON KINTZ: I would like to make a motion if our chairman is ready, I would like to make a motion to authorize them to sign whatever is necessary, what you want our support for.

TROOPER RILEY: That was fast.

CHAIR RAJSKY: Motion on the floor.

DR. HUFFNER: I would second that. And I would --

CHAIR RAJSKY: Discussion.

DR. HUFFNER: I will make a friendly amendment: That the chairman write the letter to include comments that, from our perspective in our region, we welcome the opportunity to, we welcome the addition of an additional First Response agency such as has been described. And just the opposite from my perspective, it certainly fills a huge void, addressing issues when the scene clearly is not safe, when we clearly say to our providers, do not enter the scene, this fills a huge void that in fact not only will serve patients caught in the middle of this, but maybe injured colleagues in an unsafe scene. So I would like that to be included in with that, the letter of support for the New York State Troopers SWAT team's First Response, BLS First Response, NRT.

DICK SULLIVAN: I would suggest to the lady downstate that you have her phone number, so when you have one of those situations call her up.

DON DUVALL: My question is, it's an intriguing concept first off. And you had mentioned once or twice that you're looking to going to do your own thing.
      My question is do you have a plan or an intention to provide support and maybe educational offerings to develop an interface between your First Response team and civilian agencies across the state? And I think certainly to bring you on board, that's something that I would like to see. I am curious as to whether you could make that happen in the form of some sort of continuing education offerings or some sort of advertisement as to how we're going to work together, how we would work together in the situation, so that we're not both off doing our own little thing, we're doing the same thing together.

TROOPER RILEY: Absolutely, in fact I was in Bob's refresher class a couple years ago, and they asked me to speak for a couple minutes. It turned into about a two hour discussion. I mean I was the only cop in that class, there was about 25 students. And they had just never gotten close to a state trooper before, other than you know here's a flare. So you know, I would be more than glad. After September 11, prior to September 11 we were sort of like volunteer firemen, we worked the road and we had pagers and we would get called out in the event of something. After September 11, we become so much more busy, there is a lot of work, we do a lot of hazmat stuff actually with the clan labs, the meth labs that these people are cooking up, they stealing hydro ammonia, we used to call the DEA up from Virginia. We have so many of them now they have trained us how to go in disassemble them, take them apart and into evidence.
      We do a lot of work with EMS people. I give my business card to Mr. Rajsky. Any time you need a presentation for continuing medical education, we would be more than glad to come out and give one. In fact the meeting I just went to Finger Lakes EMS Council last week, and they want to put together a school violence school at Keuka College up on top of Keuka Lake, they want to do an active shooter scenario, involving role players, fire/EMS people and they want to use us as a SWAT team. And they want to set a perimeter up and they want to see how we would go in and do a rescue and how we would bring somebody out and turn them over to the ambulance people there. So any time, we would be more than glad to sit down, if you need a presentation at your, back at your fire hall, no problem at all. I haven't seen the road in about three or four years. Just they have kind of thrown a lot of different stuff at us, like I said dignitary protection, clan labs, our narcotics people realize, they used to do their own warrants, after they got banged up a little bit, they realized it was better to let somebody else that has helmets and body armor go do that stuff.

DON DUVALL: So do you have policies in place for interaction with civilian authorities now?

TROOPER RILEY: Yes, I have drafted a SOPs. That's part of my application packet that I am going to forward up to Department of Health, Bureau of EMS once I receive the letters from the different REMSCOs. I have, as far as doing PCRs I have that. I am going by the New York State wide EMT, AEMT protocols. Also we have a medical director, we have a surgeon with the Division of State Police, his name is Dr. John McGurdy, he has a practice down in Peekskill. He is really a pro pro, he is a buff, he is very into SWAT and things like that. But he is a sworn member of the Division of State Police also. We have actually had him out to a couple large scale incidents, the last Woodstock festival they had, we were, went out and kind of got everybody calmed down. In fact they put us on fire trucks to protect the firemen. Dr. McGurdy was out at that one, he was medical control right there. Granted we are a basic, although I am a paramedic, this is Basic Life Support, First Response. We do have a doctor on board to oversee our program.

DON DUVALL: You will share those, you could share that SOP with us?

TROOPER RILEY: Yes, definitely.

DR. HUFFNER: My thought was I might not necessarily like to see a SOP as much as a pamphlet that says here come -- I don't want to say the men in black, but whatever you guys are.

TROOPER RILEY: We have been called that.

DR. HUFFNER: Her comes MRT, whatever it is, a pamphlet identifying not who you are but what you are. So every First Response agencies in our region, every EMS agency could at least be aware of the situation, that these guys might be come and what they could potentially do. Because there is a real need to obviously close the interface in some simple handout or a flyer or something that we would, we would be happy I think from our perspective, we would be happy to direct it to all the EMS providers in the region, so that they know what you are and what you could do.

TROOPER RILEY: I am working on that. And like I said I do have a great video to show you. If I ever do come out to your, to do a presentation, do some sort of training with our agency, I will bring that, I will bring a couple of my goons with me, the guys I work with, the smallest one, we have a former Miami Dolphin, huge, everybody's like knuckle dragging. Anybody else? Thank you very much for your time.

CHAIR RAJSKY: Any other discussion on the motion? There is a motion on floor. Any further discussion? Seeing none, all those in favor signify by saying aye. Opposed? Abstentions? Carried. (CARRIED, UNANIMOUS.)

CHAIR RAJSKY: Great.

TROOPER RILEY: Thank you very much.

CHAIR RAJSKY: Anything else to come before Council this evening?

DR. HUFFNER: Move to adjourn.

FRED CRIST: Second.

CHAIR RAJSKY: Second. Thank you. (MEETING ADJOURNED 8:10 P.M.)

C E R T I F I C A T I O N
I hereby certify that the proceedings and evidence are contained fully and accurately in the notes taken by me on the above cause and that this is a correct transcript of the same to the best of my ability.
ELIZABETH R. BRUCIE