X. OLD BUSINESS 1. Presentation by Tim Taylor and Doug Berry of Beaumont One. 2. Presentation by Denise Landis of Survival Flight, U of M, Ann Arbor

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REGULAR MEETING AGENDA MONROE COUNTY EMERGENCY MEDICAL AUTHORITY MONROE COUNTY BOARD OF COMMISSIONERS CHAMBERS WEDNESDAY, SEPTEMBER 21, 2016 6:00 P.M. 125 E. SECOND STREET MONROE, MICHIGAN 48161 (734) 240-7003 I. CALL TO ORDER II. III. IV. ROLL CALL PLEDGE OF ALLEGIANCE OATH OF OFFICE Jerry Welch V. APPROVAL OF AGENDA VI. VII. VIII. IX. APPROVAL OF MINUTES (07/27/16 Regular Meeting) PUBLIC COMMENT LOCAL GOVERNMENT MEMBERS COMMENTS COMMUNICATIONS 1. Board Action - None 2. Information Expiring member terms X. OLD BUSINESS 1. Presentation by Tim Taylor and Doug Berry of Beaumont One 2. Presentation by Denise Landis of Survival Flight, U of M, Ann Arbor 3. Update from MCA XI. XII. XIII. NEW BUSINESS COMMITTEE CHAIRPERSON S AND MEMBER S REPORT 1. July and August 2016, Operation Reports PUBLIC COMMENT XIV. OTHER ITEMS FROM MEMBERS XV. NEXT MEETING November 16, 2016 XVI. ADJOURNMENT The County of Monroe will provide necessary auxiliary aids and services, such as signers for the learning impaired and audiotapes of printed materials being considered at the meeting to individuals with disabilities at the meeting upon one week s notice to the County of Monroe. Individuals with disabilities requiring auxiliary aids or services should contact the County of Monroe by writing or calling the following: Human Resources 125 East Second Street, Monroe, MI 48161 Voice (734) 240-7295 and TDD (734) 240-7300

Page 1 I. CALL TO ORDER At a Regular Meeting of the Monroe County Emergency Medical Authority held in the Board Chambers in the City of Monroe on Wednesday,, the meeting was called to order by Peter Navarre, Chairman at 6:03 p.m. II. ROLL CALL Roll call by Deputy Clerk as follows: Present: James Bennett, David Brown, Michael Demski, Glenda Kennon, Peter Navarre and William Urbanski. Absent: Robin Miller (excused) A quorum being present the board proceeded to conduct business. Chairman Navarre presented an application for a new member, Jerry Welch, and explained why Mr. Welch would be a good fit for the Monroe County Emergency Medical Authority. Mr. Welch was introduced and spoke briefly about his qualifications. Motion made by David Brown, supported by Glenda Kennon to recommend to the full Board of Commissioners that Jerry Welch be appointed to the Monroe County Emergency Medical Authority to fill the vacancy left by Mike Carder. Term to expire 2017. Motion carried. III. APPROVAL OF AGENDA Motion by Glenda Kennon to approve the agenda as presented. Supported by Michael Demski. Motion carried. IV. APPROVAL OF MINUTES (03/16/16 Regular Meeting and 05/18/16 Regular Meeting) Motion by William Urbanski, supported by David Brown to approve the minutes for the March 16, 2016 meeting and May 18, 2016 meeting as presented and waiving the reading thereof. Motion carried.

Page 2 V. PUBLIC COMMENT Dale Berry, President of Monroe Community Ambulance spoke: Fiscal year just finished, financially doing well Operationally doing well, been busy Traffic and the heat of the summer have been a challenge Staffing in the entire industry in shortage; MCA is pretty stable Senior paramedic on each ambulance 56 hour schedule EMT or entry level paramedic; 64 hour schedule; reducing to 60 hours in September Going to High Schools to talk about EMS as a career Paying for tuition for many people; paramedic tuition can be pretty expensive If you hire on as an EMT at MCA they will pay for paramedic school Mercy Memorial moving to Promedica transition has gone well Dirk Borton, COO of Monroe Community Ambulance spoke: They are running five 24-hour ALS and two 12 hour BLS ambulances Maintaining M-F BLS ambulances; hospital to hospital transports New ambulance in August; 11 ALS and 1 BLS New safety 6 point harness restraints on the jump seat (bench seats) New restraint system for cots Newer/Safer restraint system for patient as well Added Pedia-Mate system like a car seat for pediatric patients Assisted Frenchtown for annual Sterling State Park fireworks Getting ready for the Monroe County Fair Assisted Promedica Monroe in their successful accreditation of their primary stroke center Participating with Fermi drills First 911 camp in Monroe Township in June teaching kids about EMS Spoke with Ash Township Board about possibly adding on to the fire station to accommodate the EMS folks who are currently sharing with the firefighters VI. VII. LOCAL GOVERNMENT MEMBERS COMMENTS- None COMMUNICATIONS 1. Board Action See section II 2. Information Potential new member applicant See section II

Page 3 VIII. OLD BUSINESS 1. Discussion regarding Beaumont Air Ambulance One Tim Taylor, Flight Paramedic, Beaumont One spoke and apologized for lack of communication for the past several months but they were getting compliant in order to be able to fly in Monroe County. They have done a radio test with Central Dispatch so they are now compliant with their communications system and he wanted to let the Emergency Medical Authority know. They are in partnership with Trenton Southshore and Cleveland Clinic Each air ambulance unit flies with a nurse paramedic/critical care paramedic and pilot on board They are different in that they carry FFP and packed red blood cells on every flight PHI Air Medical is their parent company Peter Navarre asked how many flights would they expect; Minimal flights in Monroe County; probably less than 10 per year Have not worked a lot with MCA because the need for scene response is not as great as it once was. There are a lot of responders in this area. They service a lot in St. Clair County and in the thumb area of Michigan Dale Berry, MCA, spoke and wants to make the Emergency Medical Authority aware of controversy in the helicopter business in general. Some medical helicopter transports are billing $30-40,000 for a transport. The patient is billed and whatever the patient s insurance does not cover gets billed to the patient. Sometimes this could be $20,000. Some helicopter services participating with insurers and some don t; if they do they will accept reasonable and customary which may be only $6,000. Helicopter companies have taken people to court over these bills. States try to regulate these charges but the court has told them they don t have any authority; it s FAA that has the authority. Mr. Berry will try to get some articles about this issue. Companies that provide the helicopter service set the prices. Mr. Berry suggested that perhaps helicopter services could come to a meeting and you can ask them what their billing policy is and what charitable care policy is?

Page 4 Mr. Taylor of Beaumont One was asked what their charges are and he was not privy to that. He will be happy to bring in corporate reps to come in and talk about what they charge and what their policy is for charitable care. Michael Demski and David Brown added that this is good information and it would be good to know what the policies are and they should have a chance to review the Air Ambulance services and their rates. Michael Demski would like Beaumont to come to the next meeting of the Emergency Medical Authority and present on their services and to answer the questions regarding billing and charitable care practices. 2. Annual Report for Air Ambulance Services in Monroe County Discussion regarding the various Air Ambulance services coming in to present and address the billing/charitable care policies. Clerk will coordinate these presentations. IX. NEW BUSINESS 1. Updated Report MCA See Section V. X. COMMITTEE CHAIRPERSON S AND MEMBER S REPORT 1. May (16) and June (16) Operations Report May 2016 92.6% Compliance Charlie/Delta/Echo Calls 652 Total Cancelled Enroute 54 Total Cancelled At Scene 89 Total Transported 509 Reponses 10/15 Minutes or less 519 Exceptions Requested 35 Long Responses without exceptions 44 Responses Over 25 Minutes 0 Mutual aid Given 41 Mutual Aid Received 59 57.9% transported to ProMedica Monroe Regional Hospital. Bedford Township, City of Monroe and Frenchtown Township had the highest volume of calls: 96,150, and 104 respectively.

Page 5 June 2016 91.4% Compliance Charlie/Delta/Echo Calls 614 Total Cancelled Enroute 68 Total Cancelled At Scene 99 Total Transported 447 Reponses 10/15 Minutes or less 477 Exceptions Requested 22 Long Responses without exceptions 47 Responses Over 25 Minutes 0 Mutual aid Given 44 Mutual Aid Received 48 59.5% transported to ProMedica Monroe Regional Hospital. Frenchtown Township, Bedford Township, and City of Monroe had the highest volume of calls; 104, 95, and 116 respectively. Michael Demski asked about Charlie/Delta/Echo calls. Clerk advised that per Marc Gramlich, Director, Central Dispatch, They use Priority 1 and 2 only. They don t use Charlie/Delta/Echo calls anymore. Discussion continued. Dale Berry explained more about the calls that come in. There is a Card-X code with 33 categories; MCA s card matches Monroe County Central Dispatch. Discussion continued. He will dig into this more and come back. He can and will make the report more helpful. Motion by David Brown, supported by Glenda Kennon to accept and place on file the report for May (16) and June (16). Motion carried. XI. PUBLIC COMMENT None XII. OTHER ITEMS FROM MEMBERS James Bennett-- asked about the 30 minute wait time for Priority 3 calls. Discussion continued regarding Priority 3 calls and shoot times. He will put the data together and bring it to the next meeting.

Page 6 Michael Demski Pass Glenda Kennon Thanks for the discussion on the reports. Helped clarify things for her. William Urbanski Pass David Brown Compliment crew on the Priority 3 run at Curtis Air Center; Jason and Brett did a fantastic job and were very courteous; Appreciates the service he got. Peter Navarre--Pass XIII. NEXT MEETING September 21, 2016 at 6:00 p.m. XIV. ADJOURNMENT Motion by David Brown to adjourn, supported by William Urbanski. Meeting adjourned at 7:30 p.m. with no further business.