Region I Emergency Medical Services Council Meeting Sheridan County EMS, Hoxie, Kansas June 15, 2011 David Stithem, Region Chair, called the June 15, 2011 meeting of the Region I EMS Council to order at 19:00. Jason Fawver, AHA, Steve Sutton, Kansas Board of EMS Executive Director, and Chad Churchwell, Kirby Gillespie, Michael Gillespie and Roy Litfin from Quinter EMS were welcomed. The minutes of the April 7, 2011 meeting were presented as posted on the web site and emailed. Mickie Helberg moved for approval. Jayne Holle provided motion second. Motion passed. The financial report was presented. Kerry McCue moved for approval of the financial report as written. Brandon Payne provided motion second. Motion passed. Old Business: KDHE funding: We have previously discussed the dollars received for 4 mobile radios. We did put in a request for additional funds if more money became available. We were funded an additional $24,000 and now have 12 radios to distribute. Invoices have to be submitted by the end of the month. Radios will be assigned at the August meeting. Placement is required to be accompanied by a form returned to KDOT listing the location and serial number. A user agreement must be on file with KDOT. To date, all counties have a user agreement on file with the exception of Wallace County and Goodland Regional Medical Center. The cost is approximately $3,030 per radio. The radios are programmed with the state template. Council appointments must be up to date to receive a radio. Those desiring to be considered need to be present at the August meeting. Please respond to Gary Winter with the following information: 1) Is your county utilizing 800 MHz communication? 2) Are you interested in receiving a handheld 800 MHz radio? We will have $10,000 in the next grant cycle. As there is more time to consider needs, Gary Winter, Jayne Holle, Kerry McCue, and Letitia Keenan will serve as a committee to determine needs and bring back a proposal. Please submit your needs to a committee member. New Business STEMI: Mission LifeLine. Jason Fawver presented the historical development of the Kansas Mission LifeLine initiative. The vast difference in resources and availability of treatment across the state was identified at the state STEMI Summit in Hutchinson last May. Each service can impact care by first providing education to the public. We can assist the hospital to cut time to recognition. The goal is to provide a door to balloon (DTB) time < 90 minutes, which is difficult in our area. The American Heart is collaborating with EMS systems. Some internet sites to check are: http://www.americanheart.org/presenter.jhtml?identifier=3061195 https://www.acep.org/content.aspx?redir=3&id=43678 http://www.heart.org/heartorg/healthcareprofessional/mission-lifeline-home- Page_UCM_305495_SubHomePage.jsp 1
The next STEMI meeting is September 21, 2011 in Hoxie. Details will follow as developed. We are asking EMS to get the word out. If you need additional information, contact Jason Fawver: jasonfawver@haysmed.com. Elections: Nominations for the Chair position were opened. Aden Schillig nominated David Stithem. Aden Schillig moved nominations cease. Kerry McCue provided motion second. Motion passed. Vote for David Stithem for Chair passed. Nominations for the position of Vice Chair were opened. Jayne Holle nominated Kerry McCue. Ken Tharman moved nominations cease and to cast a unanimous ballot for Kerry McCue. Aden Schillig provided motion second. Motion passed. Nominations for the position of Secretary were opened. Jayne Holle nominated Deb Kaufman. Letitia Keenan moved nominations cease and we cast a unanimous ballot for Deb Kaufman. Kenneth Gatlin provided motion second. Motion passed. Members at Large - Kerry McCue nominated Jayne Holle for member at large. Mickie Helberg moved nominations cease and to cast a unanimous ballot for Jayne Holle. Aden Schillig provided motion second. Motion passed. Scott Reese nominated Brandon Payne for the second Member at Large. Kerry McCue moved nominations cease and an unanimous ballot be cast. Motion seconded by Letitia Keenan. Motion passed. Educator Workshop: Scott Reese, Jayne Holle, and Letitia Keenan will form a committee to research a program and will bring back information regarding options for instructor, date, time, and proposed location. The Train-the-Trainer did meet regulatory requirements for an education workshop. There is KRAF funding available for expenses. Region I Coordinator Position: The annual evaluation was distributed. They were returned and tallied. The resulting figure fell in the very good range. There were many positive comments. No negative comments were received. ACT: Kerry McCue reported the ACT committee met May 24, 2011 to discuss the Level IV trauma hospital designation. We are urged to support our local hospitals in attaining that goal. NWRTC General Membership Meeting: Deb Kaufman reported the trauma council met Wednesday, May 4, 2011. Rosanne Rutkowski, Kansas Trauma Program Director, provided the presentation on the program`s achievements, current projects, and future goals. Dee Vernberg, Trauma Program Epidemiologist, provided findings from trauma registry data for the NW region. Her presentation described characteristics of the NW Trauma Region and outlined the two primary ways trauma registry can be used to enhance system development (primary prevention and Performance Improvement). Dr. Gordon Ewy, Professor of Cardiology-Director of Saver Heart Center at the University of Arizona College of Medicine, Tucson, Arizona, provided the presentation on the science and successes of chest compression CPR only. See: www.medicine.arizona.edu/sarver-cpr Dr. Charles Schultz, Trauma Medical Director, and Cammie Townley, Trauma Program Coordinator, Hays Medical Center, provided the presentation on the progress of Hays Medical Center achieving level III trauma center designation. 2
Karla Hosick, Trauma Nurse Coordinator, Good Samaritan Hospital, Kearney, Nebraska, provided information on EMS documentation and loop closure. The Council was reminded providing the hospitals with their run times is important. 2011 Kansas Rural Health Options Project (KRHOP) Trauma education funding announcement grant awards: PHTLS - Goodland Regional-NW Kansas EMS, TNCC - Sheridan County Health Complex and Goodland Regional Medical Center, RTTDC - Cheyenne County Hospital ITV trauma education started in February 2010. It continues with monthly presentation on the 4 th Tuesday of the month at 12:00 noon. There were 709 participants in 2010. The Region I EMS Council received funding from the NWRTC for EMS initial course scholarships. The recipients of the scholarships are: Logan County EMS-4 scholarships, Phillips County EMS-7 scholarships, Trego County EMS-4 scholarships. The services in the Region are also actively working on the transition courses. Cheryl Goetz reported May is Trauma Awareness Month. The focus this year is fall prevention. She is also researching the opportunity to participate in the KDOT SAFE Teen Driving Program Complete minutes are available at http://www.kstrauma.org/nw_council.htm Northwest Kansas Homeland Security Meeting May 9, 2011. The Region will fund the narrow banding and cable fixed infrastructure (towers) for MOCOM in the Region. FY11 Projects were adjusted per award criteria. Bylaws are being reviewed. We have a public works position open on the Council as well as a KEMA position and two members at large. Jason Moses announced we will be receiving a letter from Blue Ring regarding 800 MHz rebanding. http://www.kansastag.gov/kshls.asp?pageid=255 is the website to review the entire minutes. EDTF: They will meet tomorrow in Salina. The educator proposal has been worked on by a group from each Region. It has come back to the EDTF with proposed changes. EDTF will discuss it tomorrow and then it will hopefully be ready to be presented back to the Board. It would take statutory and regulatory changes to implement. EDTF will also discuss the bridge course from the EMR to the EMT. Steve Sutton reported on the statute changes concerning the transition deadlines. There is now additional time to transition. The National Registry has accepted a paramedic continuing education refresher course as a transition course from Kansas when documented on the CE certificate. Kerry McCue reported 6 people from Kansas attended the National EMS on the Hill. They met with congressional members regarding reimbursement, death benefits for line of duty deaths, provision of public safety and first responders with an additional 10 MHz, and fuel prices. It was felt it was a successful trip. Board Committee Reports: Planning and Operations: Jim Reed gave a report on inspections. He has conducted 95 so far this year. Staffing issues are the most common. He thinks a lot of services are getting close to having staffing 3
problems. The education audits are not going well. He provided a letter with the results of those audits. These results are available on-line if interested. Deb Kaufman requested a report from KEMSA regarding the recent leadership workshop. Chris Way reported on the successful workshop. KEMSA was thanked for their efforts. Dave Cromwell discussed the medical director survey he has been working on. Several changes were suggested. Dave Cromwell will make the changes and resend it to the committee by Tuesday, with responses back to Dave by Friday. Note: the Survey did go out. If you did not get the survey, please contact Dave Cromwell and provide your correct email address. Operational regulations 109-1-1 through 109-2-13 have been to the DOA, been sent to the AGs office, changes have been made, sent back to the DOA and are now back at the AGs office. This will need to happen at least one more time due to 109-2-11. The new statute made changes to who can ride on a helicopter (staffing). The Board no longer has a say in this. KanAAMS supported the original language. The committee recommended pulling the roto-wing from the regulation, going forward with the language for fixed wing, and creating 109-2-13 as a new regulation just for roto-wing. Executive: HB 2182, which contains EMS language, was signed by the Governor on May 25th. Dave Cromwell is working on identifying the response groups who will need to have protocols. The MAC is looking into state-wide protocols as is being presented as a national model of EMS. With the response groups needing protocols and protocol approval, the state medical director position was also discussed. Funding for that position will would currently be problematic. Steve Sutton discussed an on-line medial director`s course previously funded by KDHE. Kansas specific information could be added to the course. It is still being discussed. Steve Sutton and Dr. Hornung have been discussing how the information will flow between the Board and MAC. Education: The next EDTF will be June 16 th at the KHP facility in Salina Instructors wishing to allow individuals to attend new scope of practice initial courses for transition training must make application for the course to be issued a transition course number to be used on certifications of completion of transition training. Instructors allowing individuals not enrolled for initial training to complete transition training through this method must submit copies of rosters showing those who attended for transition training only. There have been approximately 500 transition courses approved so far. The office is getting 6 10 applications per day. Many minor issues have been found in the CE Program audits, however 4 issues were substantial and those were addressed. A new education Audit Policy & Procedure (available online) was discussed. The committee moved to adopt the policy using 2 or more board members to hear appeals at a designated time and place. 4
A non-renew survey was conducted and charts were presented using the information. The SW Kansas Skills Exam contract renewal has been signed. It could still be renewed one more year. The new EMR & EMT check sheets have been tested in a few exam sites. Chy Miller spoke on Hutchinson Community College`s thoughts on the new sheets. He wants to use the National Registry skills sheets. The committee discussed having the staff work on comparison between the BEMS version and the registry version. The committee moved to use the National Registry sheets beginning July 1 for EMR and EMT. This was later tabled. The AEMT information was provided to the committee. It will be on the web site soon. The power point presentation still needs some photos to be complete. There was no public comment on 109-8-2, which addresses scheduling of AEMT, MICT and paramedic examinations. Chy Miller questioned what board-approved examiners means. This may change. Camille Nohe feels the criteria needs to be in writing. The committee moved for conceptual approval of the regulation. It will now go to the DOA. The following regulations will go out for public hearing on June 21: o 109-5-5 Retroactive Approval of Continuing Education Courses o 109-9-1 Instructor Coordinator Certification o 109-9-4 Instructor Coordinator Initial Course of Instruction o 109-10-3 Late Enrollment o 109-10-5 Revoked o 109-15-1 Reinstating Attendant Certification after Expiration o 109-15-2 Recognition of Non-Kansas Credentials The following regulations received conceptual approval to move forward: o 109-5-1c Continuing Education for EMT-I, EMT-D, EMT-I/D and AEMT o 109-5-3 Continuing Education Approval for Long Term Providers o 109-7-1 Schedule of Fees o 109-10-1c Approved AEMT Education Standards o 109-10-2 Long Term Accreditation for Training Programs Conducting Initial Courses of Instruction o 109-11-4a AEMT Course Approval o 109-13-1 Training Officers Steve Sutton needs an adult education theory class to regain his IC. He will audit and/or teach the adult education theory portion of Barton County`s IC class and submit mock course paperwork. The National Registry will accept normal refresher CE as the paramedic transition if identified on documentation. The committee moved to approve the AEMT Transition. Investigations: Involved allegations against a TO. A continuing education audit found missing records. He also was a program manager and service director. He resigned prior to the audit. He continued to issue certificates after the program provider had been revoked. He has since volunteered to surrender his TO. The committee accepted the voluntary surrendering of his TO. 5
An application with a felony for possession of stolen property. He was released from probation in July of 2010. The committee moved to allow certification. An IC did not submit enrollment forms to BEMS. Three letters were sent. An investigation uncovered a pretty impressive body of problems. On March 25th she volunteered to surrender her IC, but has not yet done so. She was contacted on May 25 th and stated she has decided not to do so. She has moved out of state. An order temporarily suspending her IC was issued on March 16 th. The committee moved to issue a summary proceeding order to revoke her IC. On committee member asked it this should be turned over to a prosecutor. Involved criminal felony charges against an attendant for two counts of rape. An emergency order of suspension was previously issued. The KBI is investigating. The committee will keep the emergency order in place until the case is concluded. Involved an IC who has now surrendered his IC certification. The committee moved to accept the surrender of his certification. Sarah Hansen with the Kansas Association of Addiction Professionals (KAAP) gave a presentation to the committee on their Impaired Professional Program. Full Board-June 3, 2011 The Board approved the minutes from May 9 th teleconference and April Board meeting. The Planning Committee recommended looking at legislation to regain control of staffing for helicopters. The motion passed. The Education Committee`s recommendation to use two or more Board members at a time and place specified for the Education Audit Hearings passed. The Education Committee looked at the National Registry check sheets over night and decided to hold off until the August Board meeting. Carman Allen will work with the registry and examiners to review both. This passed. The recommendation for conceptual approval of 109-8-2 passed. The recommendation for conceptual approval of the 7 regulations previously discussed passed. Steve Sutton will set up, coordinate and develop the adult education theory portion of Barton County`s IC course to gain reinstatement. This passed. The AEMT transition, version 2-1, dated May 29, 2011 passed. Steve Sutton reported that Joe Moreland received two awards from NEMSIS for his work with KEMSIS. Steve Sutton has received applications for the Deputy Director position and is taking applications internally for Marcus Herrera`s position. Once filled, they will advertise for the position of the person replacing him. Dorothy Hughs, Legislative Research Analyst, was introduced. Steve Sutton thanked Representative Vern Swanson and Senator Jay Emler for their work on SB216. JR Behan recognized Camille Nohe, who is retiring the following week. She was given a roll call certificate from the Board. The meeting was adjourned. There were two investigation hearings scheduled following the Board meeting. 6
Correspondence/Announcements EDI Update and ASK Workshop: Deb Kaufman reported on the 2011 EDI Update. The HIPAA 5010 will apply to all electronic healthcare transactions. She gave examples of changes. ICD-10 cannot be implemented until 5010 is completed. ICD-10 will also apply to paper claims. It is suggested we pay attention to this change now. It will require greater specificity of our medical record documentation. It is suggested we identify problem areas now and work to correct them. EMS providers are urged to attend updates and training. There will be ICD-10 Workshops October 11 in Topeka, October 12 in Salina, and October 13 in Wichita. We will look into scheduling an informational presentation at the August Region I meeting. There are many informational sites. Among these are the following: https://www.cms.gov/icd10/13_2010_icd10pcs.asp http://www.wedi.org/ Gary Winter read a thank you letter from Nancy Schmidt. She thanked the Council for the memorial sent in her mother`s memory. The memorial was given to the Andbe Nursing Home in Norton for the purchase of a lift. Kerry McCue moved for adjournment. Brandon Payne provided motion second. Motion passed. Respectfully submitted, Deb Kaufman, Secretary (These minutes are pending Council approval.) 7