Northwest Georgia Region 1 Emergency Medical Services Council. Villanow, GA. January 26, 2012 DRAFT OF MINUTES

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1 Northwest Georgia Region 1 Emergency Medical Services Council Villanow, GA January 26, 2012 DRAFT OF MINUTES Paul Arnold welcomed the Council to Walker County and thanked Grilling Time for providing the meal and for Custom Works Ambulance for sponsoring the meeting. Bud Owens gave the invocation. A meal was served. The roll call was taken by David Foster and a quorum was determined to be present. The chair declared the meeting open. New members of the council were recognized: Claude Craig (Whitfield County) Randy Lacey (Polk County) Tommy Lawson (Dade County) Larry Simpson (Chattooga County) Kevin Ballew (Murray County) The first order of business was approval of the minutes of the previous meeting in October, A motion was made to approve the minutes as circulated by Jim Cutcher, seconded by Danny West and were approved as circulated. David Foster gave a report on the status of the Council. He reported that there were 5 new appointments but several counties have not submitted nominations at this time. The Executive Committee report was given by the chair. The committee met immediately preceding the council meeting and considered the proposed bylaws changes and the progress toward the council becoming a 501C3 non profit corporation. These and other issues discussed are covered in other agenda items. Dr. Jill Mabley gave the Office of EMS and Trauma report as well as the Regional Medical Director report in the absence of Dr. McDougal. Dr. Mabley reported on 8 issues. First, the Centers for Disease Control (CDC) issued amended trauma triage protocols which determine which patients should be transported directly to a trauma center. The guidelines contain 4 elements: o Physiological parameters CDC added the need for ventilatory support o Anatomic parameters some grammar changes were made for clarity o Mechanism parameters Vehicle roof intrusion was added for motor vehicle crashes o Special Consideration parameters Head Injuries in a patient taking anticoagulants or aspirin was added in addition to ground level falls by older adults

2 Second, the State Stroke Committee produced a standard stroke evaluation scale to be used by EMS services in Georgia. Questions have been asked about whether this scale can be modified for local EMS service use. Dr. Mabley answered that it may be modified and is a guideline not a standard. She added than many hospitals are now requesting additional paperwork be completed on stroke patients delivered to their facility. She reported that these requests are not mandated by the State Office of EMS. Third, there have been questions about the new fingerprint background check requirements. She stated that this is not a requirement for existing licensed EMS personnel but only newly licensed personnel or those who are upgrading to another level. Hospitals are also requiring background checks prior to student beginning clinical rotations but the state background checks cannot be shared with these facilities by the state according to the Federal Bureau of Investigation. Fourth, Tracy Al Belar has resigned as the EMSC program director. Kelly Buddenhagen has provided assistance to the program until another director may be appointed. Dr. Mabley reports that the EMSC program may take a 20% cut and this may prevent the position from being filled. The next meeting of EMSC will be at Georgia Public Safety Training Center in Forsyth, Georgia on February 21, 2012 and the meeting after that will occur at the CHANGES Conference in Atlanta which occurs on April 4 7, Fifth, the next EMSMDAC meeting will occur at the CHANGES Conference in Atlanta on Tuesday April 3, Sixth, advanced airway issues will be discussed. Seventh, Destination choice presently is decided by the patient or his family with two exceptions: the local medical director normal transport distance policy and medical necessity which dictates transport to the closest appropriate hospital. The designation of specialty centers such as trauma centers, stroke centers and STEMI centers has caused reexamination of the issue. Dr. Mabley asks the council members to e mail any comments on this issue to her at jamabley@dhr.state.ga.us Finally, the proposal for a trial study for RSI by Thomas County EMS will again be discussed for approval by a subcommittee chaired by Dr. McDougal. Lonnie Oliver asked about the use of RSI to control patients under the influence of new synthetic drugs. Dr. Mabley replied that the treatment of these new drugs should follow toxidromes and not be tailored to each specific drug. The EMSAC report was given by Bud Owens. He reported that all issues discussed have been addressed in Dr. Mabley s report. He reported that the 2012 meeting schedule was been released as follows: February 28, May 22, August 28, November 27. He encouraged attendance at the 2012 Georgia EMS Legislative reception on February 7 and the EMS Breakfast and Recognition Ceremony on February 8. RSVP is required by January 27, 2012.

3 David Foster addressed the issue of EMS personnel license renewal for the cycle ending on June 30, Each level must complete additional training available on the Office of EMS website by June 30, 2012 which will address upgrading to the new National Standards for each level. Larry Owens voiced concerns about this requirement. His concerns were about the lack of notification of each licensed EMS provider since all do not work for a licensed service and the timing of the changes in the middle of a relicensure cycle. David Foster reported that it is the individual licensed EMS provider responsibility to keep up with the changes in his/her license. Attempts during the last cycle to notify each person failed because a large amount of these mailed notices were returned because the provider did not notify the office of new addresses. This caused a large expenditure of funds that the office does not have this year. David Foster has e mailed these notices by his very large e mail blast mail in an attempt to inform providers of this requirement. [ It has also been posted on the regional website] He encouraged that each person contact as many of these persons as possible to alert them about this requirement. David Foster also added information on other new requirements. She stated that the new rules and regulations are in effect and will soon be posted on the Office of EMS website. As a part of the new rules, each licensed first responder service must put Medical First Responder on both sides of each vehicle in 3 inch letters. David Foster asked each new council member to give contact information to David Loftin before the end of the meeting. David Foster added to the EMSC report given by Dr. Mabley to include information on the delivery of Braslow Tapes to services. These may be available soon. Paul Arnold asked if newly licensed EMS personnel must complete the update modules and whether they must complete re licensure procedures. David Foster answered that if the personnel completed a course which began after August 2011 they would not have to do either because the courses included the new material. They would not have to relicense if initially licensed within a year of the end of the two year license period (July 1, 2011). David Foster gave the training report and gave the following statistics: 187 approved con ed courses 2264 attended these courses 1938 contact hours only 10 outstanding rosters remaining Robert Early reported on a new EMS grant by GEMA/Homeland Security through the Area 6 All Hazards Council. The priority of these grants has been determined to be interoperability of communications systems but other items will be considered. The deadline of the application is February 15, 2012 at 2:00 p.m. A standardized form must be submitted as well as information on a thumb drive. The submissions will be considered by the Area 6 All Hazards Council. Randy Pierson gave the Trauma Commission report. The call center in Forsyth funded by the Georgia Trauma Commission has been taking calls since January 1, 2012 and 145 AVL systems have been installed in ambulances. Phase 1 3 have been completed in the program and no additional AVL systems are available at this time. 17 ambulance grants have been approved and changes are being considered to the uncompensated care program.

4 Randy Pierson gave the GAEMS report. The contract for training and funding First Responder training programs has been approved. Grant funding is available for sixty (60) Medical First Responder training programs. Some grants have been received and are incomplete and additional funding for this program is being considered. In addition, grant funding is being considered for the Georgia Extrication School with an emphasis on heavy rescue. David Foster added that there are 14 EMS Personnel Upgrade modules for paramedic not 10 as printed on the form. The ASPER calendar for grant funded training courses is available and all personnel are encouraged to attend these programs which are free with lodging and travel allowances for those who attend. The 2012 grant funds will pay for 19 medical first responder training programs and 32 trauma courses (ITLS or PHTLS). Services are encouraged to apply to host one or more of these programs at their location. Last year the Georgia lawmakers approved HB 247 to provide background checks for EMS personnel involving fingerprint identification and transmission to the Georgia Office of EMS and Trauma. The legislature also increased uncompensated care for EMS Services. [Please visit US/Search.aspx to monitor legislation.] The Georgia Office of Rural Health has funded a leadership training program and the program was created by Georgia Southern University. Since the program was funded by the Office of Rural Health most of the slots for the program will be designated for rural service participants. However, there are 5 slots for non rural service participants funded by GAEMS. The program will include on line homework and 4 classes at Georgia Southern University and Georgia Public Safety Training Center. Application must be made to attend by February 28, The GAEMS funded conference dates for 2012 have been released as follows: CHANGES Conference April 2 5 Awards Banquet May 17 EMS Educator/Savannah Conference September Please visit the GAEMS Website for more information on all of the above information including grants and conferences at ems.com/ Dr. Mabley added that ASPER will fund an EMAG conference in Savannah with an EMS track this year. Funding is available to pay for expenses of those attending in the EMS community with 5 slots dedicated for non rural service participants and the rest for rural service participants. The opening speaker will present a program on response to the April tornados in Alabama. Contact Dr. Mabley for more details at jamabley@dhr.state.ga.us Paul Arnold gave the Awards Committee Report. Grilling Time was selected as the food vendor for the 2012 Region 1 Awards Banquet. Southeastern Emergency Equipment and Tommy Sanders will be sponsoring this event at the Catoosa County Colonade on March 22, Each service is encouraged to bring a door prize which costs less than $50 to the event. Another flat screen television will be given as a door prize this year. Randy Pierson gave a report on the progress toward converting the EMS Council to a 501C3 non profit corporation under old business. He stated that $1000 is needed to fund the paperwork and processing needed to establish the corporation. The discussion has been centered on how to raise this money which included asking each service or each council member to donate an equal amount between $32 and $65. Thirteen people volunteered to donate $100 to fund the establishment of the 501C3 Corporation. Thanks for your generosity. If you did not have a chance to sign the sheet indicating that you intend to contribute, please contact Randy Pierson at rpierson@floyd.org Mr. Pierson stated that the process will take from 9 to 12 months to complete.

5 Eric Irish gave the nominating committee report under new business. The committee was composed of Darryl Payne, Scott Radeker and Eric Irish and they formed a recommended slate of officers and members from nominations received. The Executive Committee traditionally has 2 of the 8 members replaced each year (the elected chair and vice chair are automatically members of this committee and are part of the 8 members) Two members of the Executive Committee either did not respond within the time limit or indicated that they no longer wished to serve so the recommendation of the nominating committee was to replace Lonnie Oliver and Robert Early. Their recommendations were Rick Cobb (Whitfield County) and Carlton Firestone (Haralson County). The chair and vice chair both indicated that they wished to stay in their offices and no other persons indicated an interest in serving so the nomination committee recommended that Randy Pierson continue to serve as chairman and Lana Duff continue to serve as vice chairman. The nominating committee received 9 applications for the three atlarge positions. One of the positions according to the bylaws will serve a one year term to create staggered membership. There was no recommendation on who will serve the one year term and therefore will be the decision of the chairman. The recommendation of the nominating committee for the three at large members was: Randy Pierson (present chairman of the council) Jim Cutcher (former Region 1 EMS Training Coordinator) Tommy Sanders (Southeastern Emergency Equipment) The Executive committee discussed the method of voting on these offices at their meeting immediately prior to this meeting. A motion was made to accept the nominating committee committee s recommendations by Bryan Walker and seconded by Curtis Vincent. Larry Ballew asked if there would be nominations from the floor. Randy Pierson stated that only the motion for acceptance of the nominating committee recommendation is on the floor and should be considered and he called the question. The vote was 22 for and 2 opposed. The motion passed to accept the nominating committee recommendation for at large positions. The recommendation for the executive committee members was considered and the vote to accept was 25 for and 0 against. The recommendation for the chair was considered, nominations were taken from the floor (there were none) and the vote was 31 for and 0 against. The recommendation for vice chair was considered and nominations were taken from the floor (none were received). The vote was 31 in favor and 0 opposed. The chair indicated that he wished to retain all representatives for EMSAC, EMS C and the Trauma Commission. The next order of new business is the first reading of the revised bylaws. The Regional Trauma Advisory Committee steering committee met and developed the revised bylaws draft. The committee is also charged to recommend membership of this RTAC. The RTAC is advisory to the Council and the chair is required to be a council member. The membership of RTAC is 15 or more persons representing different types of categories involved in the provision of trauma care. The council bylaws revision also includes housekeeping to correct grammatical errors and other issues. David Foster discussed each of the changes highlighted in red on the draft with the council. Dr. Jill Mabley addressed a grammatical mistake on page 3 in the following sentence: The District Health Director voting membership of the Region 1 Council shall vote on three (3) additional at large members The District Health Director in conjunction with the Council Chair and the Region 1 EMS Program Director shall appoint three members from District 1.1 and/or 1.2 Public Health to include at least one person from Public Health Emergency Preparedness and one (1) from Epidemiology in order to assure that the Council will include at least one member from each of the

6 following categories while maintaining the two thirds required majority for County Commission representatives. It was decided to add In addition to the 3 at large members to the beginning of the second sentence to avoid confusion as follows: The District Health Director voting membership of the Region 1 Council shall vote on three (3) additional at large members. In addition to the 3 at large members the District Health Director in conjunction with the Council Chair and the Region 1 EMS Program Director shall appoint three members from District 1.1 and/or 1.2 Public Health to include at least one person from Public Health Emergency Preparedness and one (1) from Epidemiology in order to assure that the Council will include at least one member from each of the following categories while maintaining the two thirds required majority for County Commission representatives. Mr. Foster indicated that there was a discussion in the Executive Committee about a change in the required quorum to do business on page 6 in Section 3. The RTAC Steering Committee recommended the quorum be changed from 40% to 33% in order to be consistent with other regions. However, the Executive Committee voted to change the quorum to 50% in the draft bylaws. The draft should then include the sentence as follows: A quorum shall be required to conduct business and shall consist of at least fifty (50%) of the voting members of the Council, committee or task force. There was a discussion on whether to have a first and second vote on the bylaws change or simply a first reading and a vote after the second reading. It was decided that the proper procedure was to have a first reading at this meeting and a second reading with a vote at a special called meeting on February 22 at 10:00 a.m. at the Trinity Baptist Church in Calhoun. A concern was voiced that the called meeting will not meet the 30 day requirement on page 7, Article VIII, Section 1 of the present bylaws. The meeting will be rescheduled. Three council members )Lonnie Oliver, Kevin New an Alex Case) presented information on the narrow band requirement for radios by the FCC. A webinar will be presented on this subject on February 28, 2012 at 12:00 p.m. at Registration for this webinar is required and can be completed at the following weblink: Once you submit your registration, you will be added to the attendee list. A confirmation will be sent to the account used for your registration and it will contain the webinar access information. That should be sent to you no later than 12 noon on Tuesday February 28th. Larry Ballew questioned the deadline for conversion of narrow band technology on EMS radios. The radio equipment purchased after 1996 probably include this technology but radios purchased before this year will have to be replaced. Jim Cutcher asked if this was a state or federal requirement. The requirement is a federal requirement. The FCC website at has a countdown clock for the requirement and APCO also has information on this requirement. See also

7 The chair encouraged all to attend the EMS Day at the Capitol on Tuesday February 7 and Wednesday February 8. The next regular meeting date of the council will be April 26, 2012 at Floyd Medical Center EMS Headquarters located on Riverside Parkway in Rome. The July 26, 2012 meeting will hosted by Gilmer County EMS in Ellijay, Georgia. Guests in attendance were recognized and Walker County Fire and Emergency Services was thanked for their sponsorship of this meeting. A motion was made to adjourn by Bud Owens, seconded by Curtis Vincent and passed. The meeting was adjourned. Respectfully recorded C. David Loftin, BS, EMT P Recording Secretary