State of Georgia
Department of Human Resources * Division of
Public Health
OFFICE OF
EMERGENCY MEDICAL SERVICES
EMERGENCY MEDICAL SERVICES ADVISORY
COUNCIL
QUARTERLY MEETING
TUESDAY, AUGUST 13, 2002
JEKYLL INN CONFERENCE CENTER - JEKYLL ISLAND,
GEORGIA
The regular quarterly
meeting of the Emergency Medical Services Advisory Council was called to order
in the Rockefeller Room of the Jekyll Inn Conference Center at Jekyll Island at
0915 hours by Chair Stanley Payne. Mr.
Payne welcomed the members to the meeting.
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MEMBERS PRESENT |
MEMBERS ABSENT |
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Pat Atkins Ernie Doss Danny Edwards Tim Genest Ben Hinson Chief Jack Krakeel Allen McCullough Lee Mitchell Suzanne K. Nieman Lee Oliver Stanley Payne Tom Schneider Courtney Terwilliger R. Keith Wages Dave Wall |
Steve Adams David Arrington Jennie Banks Don Cargile Linda Hamby Dr. John Harvey Zachery Holmes Isiah Lineberry Scott Masters Mark Walker |
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OTHERS PRESENT |
REPRESENTING |
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R. David Bean W. Marty Billings Wayne Buford Sam R. Cunningham Ej Dailey Daisy Gantt Shane Hill Doug Hooten David Loftin Russ McGee Earl H. McGrotha Lawanna Mercer-Cobb Mickey Moore Renee Morgan B. Jack Mundy Dr. J. Pat O’Neal Terrell Partain Joe Robinson Shirley Starling Chris W. Threlkeld Robert D. Vick, Sr. Billy Watson |
Georgia Office of EMS Northeast Georgia Region
10 EMS Department of Technical
and Adult Education West Central Georgia
Region 7 EMS Georgia Office of EMS Georgia Office of EMS Putnam County EMS Rural Metro Ambulance
Service Northwest Georgia Region
1 EMS West Georgia Region 4
EMS North Georgia Region 2
EMS East Central Georgia
Region 6 EMS Department of Technical
and Adult Education Georgia Office of EMS North Georgia Region 2
EMS Georgia Office of EMS Hart County EMS Mid Georgia Ambulance
Service Southeast Georgia Region
9 EMS Central Georgia Region 5
EMS Southwest Georgia Region
8 EMS West Georgia Region 4
EMS |
QUORUM
The Bylaws require that
50% (13) of the voting members be present to constitute a quorum. Mr. Payne noted that fifteen (15) voting
members (60%) were present at the call to order.
WELCOME AND INTRODUCTIONS
Mr. Payne asked Mr.
Schneider to open the meeting with an invocation, then he welcomed those
present and asked each to introduce themselves.
APPROVAL OF THE MINUTES OF THE MAY 7,2002 MEETING
Copies of the minutes of the May meeting were distributed to EMSAC members prior to this date. Additional copies were available for those who did not bring theirs.
MOTION 0802-01: The meetings of the May 7, 2002, meeting be approved as presented.
ACTION: The motion was CONFIRMED
as presented.
EMSAC MEMBERSHIP AND APPOINTMENTS
Mr. Payne noted that EMSAC
members’ appointments are for the period 07/01/2002 to 06/30/2004. He noted that the packet of information
distributed to members contained a copy of the Bylaws.
BYLAWS AND RULES GOVERNING EMSAC
Mr. Payne reviewed some of
the requirements of the Bylaws, particularly those related to attendance. Mr. Hinson asked the status of the Bylaws
revision that was completed several years ago.
Mr. Bean stated that the Board of Human Resources did not approve the
revision. He suggested that EMSAC
review the proposal again prior to resubmitting it to the Board.
MOTION 0802-02: EMSAC review the Bylaws proposal that was approved by EMSAC
and at the next meeting decide whether to send it to the Department with a
request for approval.
MOTION BY: Mr. Hinson
SECOND BY: Mr. Wall
DISCUSSION: Mr. Bean noted that the Bylaws proposal when
developed included a pre-rules change set of Bylaws and a post-rules change set
of Bylaws.
ACTION: The motion PASSED
unanimously as presented.
EMSAC ELECTION PROCEDURES
Mr. Payne discussed the
elections procedures as defined by the Bylaws.
MOTION 0802-03: The Chair appoint a Nominating Committee to present a slate
of officers thirty (30) days prior to the next meeting.
MOTION BY: Mr. Terwilliger
SECOND BY: Mr. Atkins
DISCUSSION: Mr. Hinson noted that the current Bylaws are in
conflict with current state laws regarding open meetings. The motion was amended to require the slate
of officers to be submitted electronically to members thirty (30) days prior to
the next meeting.
ACTION: The motion PASSED
unanimously as presented.
Mr. Payne appointed Mr.
Wages, Mr. Terwilliger, Ms. Nieman, Mr. Atkins, and Mr. Mitchell to the Nominating
Committee. It will be chaired by Mr.
Wages. Mr. Bean asked that the
committee report by October 1, 2002.
REPORTS
EMS MEDICAL DIRECTORS
ADVISORY COUNCIL: Dr. O’Neal provided the
report.
He stated that EMSMDAC would meet later this date. The primary action expected to take place is a recommendation on how disciplinary actions are handled. Also to be discussed is the use of Amiodarone and the maintenance of previously administered paralytic drugs on patients who are intubated at the hospital. Mr. Hinson expressed appreciation to Dr. O’Neal for accepting the position of State EMS Medical Director. He also cautioned the medical directors to be careful in setting standards for critical care transport because doing so can have an adverse effect on reimbursement. Dr. O’Neal said the reimbursement issue is very important, but the job of EMSMDAC is concern with the clinical outcome of patients and not reimbursement issues. Mr. Krakeel said the state does need to define “critical care interfacility transport” so that EMS providers will not have to guess if they qualify for additional reimbursement. He suggested that EMSAC appoint a task force to address the issue. Mr. Payne said EMTALA also addresses who can transport patients from hospitals and the level of care required. A general discussion ensued regarding interpretation of the CMS rule with no conclusions reached.
TRAUMA – Dr. O’Neal stated that
the state is moving forward with the development of a statewide trauma
system. The needs assessment was
completed in May. Recommendations are
forthcoming and will be delivered to the soon-to-be-appointed State Trauma
Committee. The design process will take
place over a twelve-month period of time, at the conclusion of which, two
nationally known consultants will be brought in the review the
recommendations. Attorney Wayne Reece
has been instrumental with the political process regarding trauma over the past
few months and is interesting in expanding those activities. Dr. O’Neal also reported that $754,000.00
was allocated by the General Assembly for trauma. That will be distributed among the fifteen (15) currently
designated trauma centers. Ms. Gantt
reported that as of July 1, 2002, all trauma centers in Georgia began using the
TRACS trauma registry. Training has
been provided on the system and a coding class will be offered in
December. By providing the training for
the trauma nurse coordinators, the state will be able to compare data from the
different centers. Mr. Bean provided a
brief history of the collection of trauma data in Georgia and how the system
evolved from the use of two systems (Cales’ TRAUMA! Registry and ACS’ TRACS
Registry) to just TRACS. Ms. Morgan
reported that monies allocated to trauma centers will be disbursed on a
quarterly basis after receiving their data.
She also provided information on the status of those centers requesting
an upgrade in their level of designation.
There are additional facilities across the state exploring
designation. The registry must be in
place with data being collected prior to the site visit. Dr. O’Neal said the data drives the trauma
improvement process. Georgia has a
horrible record (65 fatalities / 100,000) in terms of trauma statistics. It is much worse than the national level (56
fatalities / 100,000). Data is also
important in reimbursement issues. An
investment in a trauma system is expensive, but can result in as much as a 500%
return. Funding is not likely unless
the state can show that improvements are being made in the system. Ms. Nieman indicated that the education of
county commissioners regarding trauma systems is vital. She emphasized the importance of data in
helping county commissions making budget allocations at the local level and she
encouraged the use of as much information as possible.
INFORMATION SYSTEMS AND
DATA MANAGEMENT – Mr. Bean provided the report.
JOHN DORLING: Mr. Dorling has accepted a position as Bioterrorism Preparedness Coordinator in District 4 and will be leaving the State Office at the end of August.
PREHOSPITAL CARE REPORT DATA: Mr. Krakeel asked if the State Office of EMS has ever produced an annual report utilizing the Prehospital Care Report data submitted to the office. Mr. Bean said that one has not yet been produced under his administration. He noted that compliance is spotty and variances occur among the Regional EMS Offices regarding the completeness of the data (i.e. all documents submitted, trouble with hardware, etc.). Mr. Bean said he is not happy with the current situation and is exploring the options. Mr. Krakeel said it would appear to be much simpler and much less resource intensive if the State Office would develop a very simple minimum data set for the providers to report. Mr. Hinson said the State Office should develop a product, showing EMS providers exactly what would be provided to them with the data, then identifying the data that is needed. Mr. Bean said an annual report is a quantification of what is going on. A product that meets every providers needs is a fictitious item.
MOTION 0802-04: EMSAC create a task force of individuals to define the product of data reporting to the state.
MOTION BY: Mr. Krakeel
SECOND BY: Mr. Hinson
DISCUSSION: Mr. Bean asked that the Data Task Force not be ignored in the process. Also, on the national level, what is likely to occur is a defining of the data elements, rather than the creation of a uniform data set.
ACTION: The motion PASSED with no opposition.
Mr. Payne appointed Mr. Krakeel as the chair of the task force. Other members include Mr. Arrington, Mr. Cargile, Mr. Doss, Mr. Roberts and Mr. Hinson. The next meeting of the Data Task Force is September 10 in Meriwether County.
Mr. McCullough asked if an annual report is produced, would it address only data from Patient Care Reports or would it include other items such as the number of medics recertified, the number of ambulances registered, etc. Mr. Bean said the motion only addressed Patient Care Reports, but he is reviewing the Iowa EMS Report and considers it to be a model.
DEPUTY DIRECTOR: Mr. Bean announced that Ej Dailey has been appointed to the
position of Deputy Director of the State Office of EMS.
GRANTS – Ms. Dailey discussed
current grant activities underway in the Office of EMS.
AED GRANT: The grant will provide approximately 100 AEDs.
EMS-C GRANT: The State Office of EMS will likely apply for a three year
extension of funding for the EMS for Children program.
RURAL HEALTH: A county will be identified that provides service to
an adjoining county. If accepted,
funding will be available for specific needs.
CDC GRANT: This grant is for $23.2 million and deals with Public Health
system preparedness for bioterrorism.
HRSA GRANT: This $3.4 million grant rests with the Office of EMS and requires
the agency to undertake an assessment of hospitals, EMS providers, community
health centers, and state facilities preparedness. Assessment tools are being developed now.
STATE OFFICE EMS
POSITIONS: New positions are being advertised or will
be shortly. Among the eight positions
are Bioterrorism Preparedness Coordinator, Bioterrorism Training, and Program
Associate.
TRAINING AND CERTIFICATION –
RECERTIFICATION: Mr. Bean said the majority of the recertification data forms have
been scanned. An internet portal access
effort has begun with the state so that in the future, medics should be able to
recertify on-line.
ACCREDITATION: A process of
accreditation of educational institutions is being studied.
EMS FOR CHILDREN – Ms. Dailey provided the
report.
PROGRAM GUIDE: Ms. Dailey distributed the Program Guide for 2002 – 2003. She stated that EMS-C used pediatric patient
data extensively over the past few years.
LICENSING ISSUES – Mr. Bean provided a
brief report.
EMT-BASIC STUDY COMMITTEE REPORT
Information regarding the EMT-B Study Committee was included in the packets to the EMSAC members. Mr. Bean reviewed the recommendations. Mr. Bean said the report will be submitted publicly and the State Office will welcome comments with rationale from individuals and organizations across the state. EMSAC’s opinion will be especially valuable.
MOTION 0802-05: EMSAC adopt the report of the majority opinion of the
EMT-Basic Study Committee and recommend its implementation to the State Office
of EMS.
MOTION BY: Mr. Hinson
SECOND BY: Mr. Krakeel
DISCUSSION: Mr. Oliver asked why the committee reversed its
opinion in April on utilizing two EMT-Bs on the ambulance. Mr. Genest said it was determined that to do
otherwise would essentially require ALS staffing on all vehicles. Mr. Wages provided additional explanation,
addressing in particular, the use of hybrid curriculum.
ACTION: The motion PASSED with no
objections and one abstention.
Mr. Bean said he
anticipates a decision by the end of the year.
If the recommendation received is accepted, the Rules will have to be
changed. Mr. Krakeel urged that the
decision be made as soon as possible, stating that he did not see the need to
wait for any changes with the Rules.
Mr. Hinson said it should not have to jump through every hoop possible,
but there should be ample opportunity for comment. Mr. Edwards said a large percentage of providers in southwest
Georgia do not support the recommendation.
Mr. Wall commented for the record that at least two groups of fire
service providers (Atlanta Metro Fire Chiefs Association and the Georgia Fire
Chiefs Association) have gone on record in support of the recommendation. Mr. McCullough indicated that the West
Georgia Region 4 EMS Council has also gone on record in support of the recommendation.
Mr. Oliver expressed concerns regarding training. EMT-Bs will be allowed perform some airway maneuvers that EMT-Is
currently cannot. Mr. Bean clarified that while the Rules may not need revision
in order to enact the recommended policy change, a review of the rules is
important to insure no barriers to implementation exist. Further, Mr. Bean made
it clear the decision on this issue is not bound by the same schedule and
procedure as a regulatory change.
RULES AND REGULATIONS REVISION
REPORT
The Rules and Regulations
Committee was chaired by Mr. Cunningham.
The report of the committee was submitted to the State Office on July 1,
2002. The draft was reviewed and modified
by the Regional EMS Coordinators at their meeting in mid-July. A revised draft will be distributed to
EMSAC, the Office of Legal Services, and others in the near future by the State
Office of EMS.
EMSAC MEMBERSHIP EXPANSION
Mr. Atkins requested that
the Commissioner be approached and requested to appoint liaison representatives
from the Georgia Association of EMTs, the EMS Directors Association of Georgia,
and the Georgia Hospital Association.
Mr. Wall also mentioned the Georgia Hospital Association.
MOTION 0802-06: EMSAC recommends that the State EMS Director request a waiver
from the DHR Commissioner to allow the appointment of four additional voting
members, representing the Georgia Association of EMTs (GAEMT), the EMS
Directors Association of Georgia (EMSDAG), the Georgia Hospital Association
(GHA), and the Georgia Municipal Association (GMA).
MOTION BY: Mr. Atkins
SECOND BY: Mr. Oliver
DISCUSSION: Mr. Buford asked if consideration could be given to
the appointment of a member of the Educator’s Division of the Georgia
Association of EMTs. Mr. Krakeel noted
that the objective of the motion can be met without the motion. Mr. Bean assured the group that he would
submit the names of the presidents of the two associations, along with the
names of representatives from the Georgia Hospital Association, the Georgia
Municipal Association, and the Educators Division of GAEMT to the Commissioner.
ACTION: The motion was WITHDRAWN.
NEXT MEETING
The next meeting of EMSAC
will be held in conjunction with the TIME Conference at Albany during the week
of November 11. The exact date and time
will be announced later.
ADJOURNMENT
There being no further business, Mr. Payne declared the meeting adjourned at 1215 hours.
_____________________________________
R. DAVID BEAN
State EMS Director
RDB:src
cc: EMSAC Members
Mike Smith, Director - DHR
DPH Environmental Health and Injury Prevention Branch
Regional EMS Coordinators
Regional EMS Medical
Directors
Lead District Health
Directors
State Office of State EMS
Staff
R. David Bean, EMT-P
Charles F. Benson, Jr.
Ej Dailey, EMT-P
John Dorling, EMT-P
Paul Ownby, EMT-P
Daisy Gantt, RN
Renee Morgan, EMT-P
Other Interested Parties
Minutes Scribed by Sam R. Cunningham