Western Mass Emergency
Medical Services Committee, Inc.
Meeting:
Regional Council
Date: January 10, 2001
Place: Dakin, Conference Room A, CDH, Northampton
Presiding: Robert Hopkins, President
Called
to Order: 10:09 am
Adjourned: 11:50 am
Attendance:
Minutes: The minutes from November need to correctly reflect that the meeting was held in the Dakin Conference Room A, not the Living Room of McCallum. A motion was made to accept minutes as corrected. This was seconded and approved unanimously.
Physicians
Council Report:
Discussion –
Dr.
Dinneen reports that there was discussion regarding the Initial P/B Waiver from
Deerfield Rescue Ambulance. The Physicians Council recommends that this
application be approved. Also discussed was the P/B Waiver Renewal from
Easthampton Fire Department. This application is also recommended for approval
from Regional Council. There was also a discussion about the impact in our
region for the requirement that within three years ALS services will need to be
providing coverage 24/7 ideally with P/P coverage. The members viewed a template Memorandum of Agreement for Aspirin
use by Basic and Intermediates. It will be sent to all hospitals and they can
either use it or something else to meet the MOA requirement from OEMS. The
members reviewed the Region One medication list and re-iterated that the
optional medications selected for Region One are required for all Paramedic
services. There was also a brief
overview of Flo-Lan, a pulmonary vasodilator continuous infusion running via a
central line that some lung transplant patients at home have. Lastly, there was
a sharing of information in regard to ambulance restocking issues.
Action – Regional Council to vote on the
Deerfield Rescue Ambulance and Easthampton Fire Department P/B Waivers.
Executive
Directors Report:
Discussion –
The Department of Public Health (DPH) has posted the date for the Public Hearing on Proposed Regulation Changes. There will two dates; the first will be here in Northampton at 11 a.m. on Monday February 4, 2002 at the DPH Regional Health Office at 23 Service Center Road (by the Salvation Army) and the second date is Thursday February 7, 2002 in Jamaica Plain. Information in regards to the proposed changes can be found on our website (wmems.org) as well as on the OEMS website (http://www.state.ma.us/dph/oems). Ms. Moriarty strongly encouraged everyone to look at them. Some of the regulations being addressed are: Service Zone Planning, New First Responder Regulations, a change to the Responsibility to Dispatch Treat and Transport, and a revised reporting requirement.
OEMS
has sent out to ALS services a controlled substance survey. Ms. Moriarty
believes that this is an attempt by OEMS to gather information so they can put
pressure on the State FDA to change the regulations so that services can
purchase directly needed medications from places other than hospitals.
OEMS
has also sent out the new ALS Equipment list to all ALS services. The one item
noted was that as of November 1, 2003 all Paramedic Services will be required
to have 12 Lead EKG capabilities.
Action – The office to put a summary of the
Regulation changes on the wmems website.
Treasurers
Report:
Discussion –
Ms.
Cushman reported that there is $68,499.95 in the checking account, $680.90 in
the savings, $6,224.10 in the scholarship account and $4897.50 in the EMS
victim/worker relief fund. Mr. Hayden
donated $.05 to make it an even $68,500.
The office has filled out the paperwork necessary to re-instate a
non-profit bulk mail permit. Finally, the accountant is in the process of
filing our taxes and we now require a full audit instead of a review because of
the increase in our funding.
Action – Donation to be put in
checking account (thank you Mr. Hayden)
Awards
Committee:
Discussion –
Ms.
Hover reports that 16 applications were submitted with all approved. There were 5 save awards and 9 meritorious.
The committee spent some time discussing the impact of the proposed HIPPA
regulations regarding patient confidentiality and how it might affect our
entire award process. The committee
will do some more research and see what changes should possibly be made to our
submission process. Ms. Hover also wants to remind everyone of the March 1,
2002 deadline for award submissions.
Action – Office to send out
letters to award recipients.
Communications
Committee:
Discussion –
Mr.
Brian Andrews reported that the committee has met and they have various
projects and issues ongoing. A letter has been sent to OEMS/DPH requesting
either some funding assistance or alternatives to the Internet access
requirement for the hospital diversion notification (as of today he has not had
a response). Springfield CMED does not have Internet access or a funding
mechanism for that and currently they are the contact point for several
services. A question was raised by Mr. David Keefe in regards to compliance
with the regulation for computer access to the diversion website. Ms. Moriarty
stated that you do not have to be on-line 24/7 to be in compliance, you just
have to have Internet access capabilities.
Mr. Andrews stated that one of the alternatives he listed in his letter
to OEMS was the current system that we have in place for Region One and he was
wondering if OEMS would allow that to meet the diversion requirement.
A
letter was sent to Franklin County offering support in their endeavor to fix
the 340 radio that has been down for many months.
The
Hampden East Project is moving slowly at the moment due to a technical issue
regarding an inferior piece of equipment. Mr. Andrews and Mr. Cote are working
with the National Grid to solve the problem.
The
committee is continuing on developing a regional EMS resource book.
Finally,
a newsletter has been published and will be sent out to all services.
Hopefully, more people will become involved with this committee.
Action
– Ms. Moriarty suggested that the users group from Springfield CMED contact
the City of Springfield and let them know that they pay fees and want CMED to
provide the Internet access for the diversion website.
PIER
Committee:
Mr.
Clapp reported that the first meeting of the PIER committee will be held on Wednesday
February 20, 2002 at 7 pm in the Living Room of the McCallum Building at Cooley
Dickinson Hospital here in Northampton.
A notice will go out to all services and he is looking forward to getting
this committee up and running. This committee will meet regularly the 3rd
Wednesday of every month.
Action – The office to send out
notices.
MCI
Committee:
Discussion –
Captain
Keefe they have met twice and have had fairly good attendance. At the last
meeting copies of the Hampshire, Franklin and Hampden Counties MCI plans were
handed out. There was discussion about the State MCI plan and it appears that
at the State level they are preparing a template for regions to use when
developing their regional plans. Mr.
Zlogar gave a presentation about the Hampshire County LEPC/UMASS collaborative
project developing a CD to be used for Hazmat, MCI type events. There was also a discussion about long range
plans for this committee. All meetings
are held the 4th Wednesday of the month at 7 pm.
Action – None
Training Committee:
Discussion –
This
committee did not meet this month. The next Training Committee will be in
February at 9:30 a.m.
Action – None
Trauma
Committee Report:
Discussion –
There
have been two very successful meetings. This committee is in the process of
creating their goals. Ms. Cushman is still looking for representation from the
hospitals and ambulance services. It is important for us to pose our questions
and voice our concerns in order to influence the building of the state trauma
system plan. Now is the time use our collective knowledge to make a difference
in trauma care in our region and as it unfolds across the state. All meetings are held the 2nd
Wednesday of the month at 8:45 am.
Action – None
County
Committee Reports:
Discussion –
Mr. Brian Andrews would like to introduce and welcome Tracy DiSilva. Ms. DiSilva is the new Trauma Program Manager at Berkshire Medical Center, very familiar with pre-hospital care and is very active with the Region Trauma Committee as well as various committees in Berkshire County
Action – Welcome to Ms. DiSilva!
FYI:
Action: The office to
update the website.
EMS
Worker/Victim Relief Fund:
Discussion –
The
office is still in the process of contacting the two funds that were suggested.
The Executive Committee wanted to determine which one would contribute the
funds collected directly to the EMS victims/workers and not spend too much on
overhead expenses. Once the office is able to determine who is closest to 100%
then we will send our money to them.
Action – The office to contact
the two funds and make a determination.
Update
on State Diversion:
Discussion-
Ms.
Moriarty reported that she had received draft #3 of a universal definition fro
diversion document from DPH. There are ongoing discussions at the State level
and diversion is an agenda item fro the State Executive Committee meeting next
week. There will also be a meeting of the Region Diversion task force next
Thursday, January 17, 2002 at 9 am at AMR in Springfield.
Deerfield
Rescue Ambulance Initial P/B Waiver:
Discussion –
With
the recommendation from Physicians Council, a motion was made to approve the
Deerfield Rescue Ambulance Initial P/B Waiver to be issued conterminously with
their paramedic license. This motion was seconded and approved unanimously with
1 abstention, Mr. Stump.
Action – Ms. Josefski to send a
letter to OEMS regarding this approval.
Easthampton
Fire Department P/B Waiver Renewal:
Discussion –
With
the recommendation from Physicians Council, a motion was made to approve the
Easthampton Fire P/B Waiver Renewal. This motion was seconded and approved
unanimously with 2 abstentions, Mr. Eline and Mr. David Keefe.
Action – Ms. Josefski to send a
letter to OEMS regarding this approval.
Annual
Meeting:
The
annual meeting is scheduled for Thursday night April 11th, 2002 at 5
pm. We have reserved the Delaney House. A reminder that the deadline for the
Eaton Freeman nominations and the Regional Save, Meritorious and Recognition
Awards is March 1st, 2002. Any nominations received
after that date will be forwarded for next years EMS week awards.
Proposed
Regulation Changes:
Mr.
Brian Andrews highlighted some of the issues in the 105 CMR 170 and 171
proposed regulation changes. He recommends that everyone get a copy and go
through the changes line by line. There is a summary of changes available from
OEMS but it only highlights certain issues. It will be important fro us to put
in writing our concerns and be prepared for the public hearing.
170.345 (C)(1) “EMS personnel at the scene who are
not transporting will have to generate a report for every patient contact and
deliver a copy of their report to the transporting ambulance service or shall
make sure delivery procedures are followed…”
Many questions were raised: does this involve any
first responder? Mass State Police? Is it part of the patients’ record that
needs to be at the hospital? What about patients not transported? How are they
to physically get the report to the ambulance? Time frame?
170.350 (B)(1) “Each
licensed service shall file written report with the department within 5 days of
other serious incidents ……” It appears that wants us to report
on ourselves, what if the issue is found during a QA/QI? There was a lengthy
discussion about discoverability and possible violation of 5th
amendment rights. Ms. Moriarty stated that DPH already has in place very
specific guidelines and reporting mechanisms for “sentinel events” which occur
in hospitals. Perhaps they should follow a similar format fro prehospital. Is
this self-incrimination? A suggestion was made to have our lawyer look at these
changes.
170.350 (C) “ Each ambulance
service shall file a written report with the Department within 72 hours of all
instances in which an ambulance and its EMTs are delayed 30 minutes or longer….
transfer patient care responsibility to facility personnel at an equal or
higher level…” How are we to document
turnover time…no current reliable time mechanism? It appears that DPH wants us
to report on the hospitals. What is the reason for this regulation? What is DPH
trying to accomplish?
170.355 (B) (2) & (3) “
…ambulance is not available for immediate dispatch…” The
current regulation states ambulance will not be available for dispatch within 5
minutes then the back up ambulance is dispatched. This regulation will affect
our volunteer ambulance services. Not all services are scheduling volunteers,
not all EMTs have radios and in the hill towns occasionally you can’t reach
dispatch via radio. The other option is to spend time phoning dispatch instead
of walking out the door to respond.
Mr. David Keefe raised the question of who is actually writing these regulations? Ms. Moriarty responded that the DPH lawyer, Ms. Silva Cameron, is the person who is actually putting the words on paper. OEMS put together interest groups that met and were part of the development of the new regulations, such as Service Zone Planning and EFR. The OEMS office based on issues that have arisen over the years made the current regulation changes, such as dispatch and reporting requirements. Mr. David Keefe requested that someone from the OEMS office come out to our region and explain their rational for some of these changes. Mr. Clapp stated that there appears to be a clash between the regulations and reality of implementation.
Action: Ms. Moriarty to ask Ms. Goyette and/or
her staff to attend one of our meetings to
explain the process of how the regulations were developed. The
office to send out Public Hearing Notices to all ambulance, fire and police
services
Hospital
Fair Exchange Policy:
Ms.
Bycenski asked if there was a template available of a hospital/ambulance
exchange policy. There is a Federal requirement that the policy be posted in
each hospital that exchanges supplies with ambulance services. There was a
motion made that WMEMS put together a fair exchange policy template for use by
those hospitals that exchange with ambulance services. Motion passed
unanimously.
Discussion-
Mr.
Johnson was wondering if there is any plan to have another Region sponsored
legislative event. Discussion followed and a motion was made to have the office
check with the legislators and determine at date to have another opportunity to
share with our legislators the issues of EMS.
Motion passed unanimously.
Action- The office to check with
legislators about determining a date.
Conflict
of Interest:
Discussion –
Ms.
Cushman reminded the chairman that at the beginning of each meeting he should
make a statement that anyone in attendance who has a conflict of interest in
any voting matter needs to make it known to the president. The president can
then make a decision as to whether or not the member needs to abstain from
voting.
Action- Conflict of Interest
Statement to be added to each meeting agenda.
FYI:
Mr.
David Keefe suggested having a gubernatorial candidate as a guest speaker for
this years annual meeting. Suggestion was made to be careful about seeming
apolitical.
Action – Executive committee to
take under advisement.
FYI:
Mr. Brian Keefe announced that Agawam Fire Department just appointed 5 new FF/Paramedics which now brings their total to 19 FF/Paramedics. They are also able to staff a second paramedic ambulance in Feeding Hills. This is quite an accomplishment for a service that started 7 years ago with just a few paramedics. Congratulations to Agawam!
Next
Meeting:
Discussion –
The
next meeting will be held on February 14, 2002 at 10:00 am. This meeting will be held in Dakin,
Conference Room A.
Adjourn: A motion was made to adjourn at 11:50 am. This motion was
seconded and approved unanimously.
Dawn
Josefski, Recorder