1 MONTEREY COUNTY EMERGENCY MEDICAL CARE COMMITTEE Agenda Wednesday ...

60 Pages·2017·1.61 MB·English

MONTEREY COUNTY EMERGENCY MEDICAL CARE COMMITTEE

Agenda
Wednesday, September 13, 2017
1030 to 1200
Monterey County EMS Agency (Cinnamon Room N-1000)
1441 Schilling Place, Salinas, CA 93901

I. CALL TO ORDER/INTRODUCTIONS
II. PUBLIC COMMENT
Any member of the public may address the Committee for a period not to exceed three
minutes on any issue not on the Committee’s agenda. The EMCC will listen to all
communications but may not take any action.
III. APPROVAL OF PAST EMCC MEETING MINUTES
A. July 12, 2017 EMCC Meeting Minutes
IV. EMS 20/30: EMS SYSTEM ASSESSMENT, STRATEGIC PLANNING, AND RFP
PROCESS
A. Status Update by Fitch and Associates, Consultants
B. Revision to Emergency Medical Services System Ordinance, Susan Blitch,
Deputy County Counsel
V. REPORTS
A. Medical Advisory Subcommittee (MAC): July 12, 2017 Draft Meeting Minutes
B. EMS Operations Subcommittee (EMS Ops): July 12, 2017 Draft Meeting Minutes
C. Emergency Medical Services (EMS) Agency
• Oral Report
VI. OLD BUSINESS
A. EMS Data System (11/15)
B. Addition of Alternates and AMR Representative to EMCC (11/16)
C. EMS System Providers QI Program Development (11/16)
D. Contract Compliance Working Group (1/17)
E. TB and Infectious Disease Reporting (7/17)
F. Transfer from Inspironix to FirstWatch (7/17)
VII. NEW BUSINESS
A. 2017-2018 Policy Development Cycle
B. Law Enforcement Use of Narcan

1
VIII. NEXT MEETING AND ANOUCEMENTS
A. The next regularly scheduled EMCC meeting will be held on Wednesday,
November 8, 2017 at 10:30 a.m. in the Cinnamon Room (N-1000) at 1441
Schilling Place, Salinas.

IX. ADJOURNMENT

Attachments:

1. July 12, 2017 EMCC Meeting Minutes
2. Staff Report: Revision to EMS System Ordinance
3. July 12, 2017 Medical Advisory Subcommittee (MAC) Draft Meeting Minutes
4. July 12, 2017 EMS Operations Subcommittee (EMS Ops): Draft Meeting Minutes
5. Staff Report: EMS Data System
6. Staff Report: Addition of Alternates and AMR Representatives to EMCC
7. Staff Report: EMS System Providers QI Program Development
8. Staff Report: Contract Compliance Working Group
9. Staff Report: TB and Infectious Disease Reporting
10. Staff Report: Transition from Inspironix to FirstWatch
11. Staff Report: 2017-2018 Policy Development Cycle
12. Staff Report: Law Enforcement Use of Narcan

Notices

ALTERNATE AGENDA FORMATS: If requested, the agenda shall be made available in
appropriate alternative formats to persons with a disability, as required by Section 202 of the
Americans with Disabilities Act of 1990 (42 USC Sec. 12132), and the federal rules and
regulations adopted in implementation thereof. Individuals with a disability requiring a
modification or accommodation, including auxiliary aids or services, in order to participate in the
public meeting may make these requests to the EMS Director at least 3 days prior to the
Emergency Medical Care Committee Meeting.

CONSENT CALENDAR: These matters include routine reporting of subcommittees and are
usually approved by majority vote.

TO ADDRESS THE COMMITTEE ON A MATTER ON THE AGENDA: When the agenda
item is called, raise your hand and wait for recognition by the Committee Chair. In order that all
interested parties have an opportunity to speak, please be brief and limit your comments to the
specific subject under discussion. Time limitations shall be at the discretion of the Chair, with
equal time allocated to opposing sides of an issue insofar as possible. Allocated time may not be
reserved or granted to others, except as permitted by the Chair.

TO ADDRESS THE ON A MATTER NOT ON THE AGENDA: When the agenda item for
public comment is called, raise your hand and wait for recognition by the Committee Chair.
Public comments shall not pertain to matters on the agenda. Time limitations shall be at the
2
discretion of the Chair, with equal time allocated to opposing sides of an issue insofar as
possible. Allocated time may not be reserved or granted to others, except as permitted by the
Chair.

DOCUMENT DISTRIBUTION: Documents related to agenda items that are distributed to the
Committee less than 72 hours prior to the meeting shall be available for public inspection at the
EMS Agency Office, 1441 Schilling Place, Salinas, California. Documents distributed to the
Committee at the meeting by EMS Agency staff will be available at the meeting.
3
Monterey County EMS
Emergency Medical Care Committee (EMCC)

Meeting Minutes
July 12, 2017

Emergency Medical Services Agency
1441 Schilling Place, North Bldg.
Salinas, California 93901
1030 to 1230 Hours

Item Discussion Deliverable/Action
I. Welcome and Introductions Martha Karstens, Vice Chair, called the meeting to order at • Meeting called to order and role
1030. EMCC members and guests introduced themselves. The taken. A quorum was present.
following committee members and EMS Agency personnel were
present.

Members Representing Present Absent
Martha Karstens BLS Fire X
Edmond Rodriguez ALS Fire X
Paul Tomasi Law Enforcement X
Carla A Spencer Hosp. X
Administrators
Cindy Williams EMT/Paramedic X

Layne Long City Managers X

Nick Chiulos County Parks Dept. X

Harry Robins Citizen X

Jodi Schaffer Citizen X

Harold Wolgamott Citizen X

1
Dr. Sean Emergency X
McRoberts Physicians
Gerry Malais Ex Officio Member X
EMS Agency Staff
Michael Petrie EMS Director X
Dr. Jim Stubblefield EMS Med Director X

Steve Brooks EMS Analyst X

Fred Claridge EMS Analyst X

Teresa Rios MA III X

Laura Wallin Health Program X

Coordinator

Patrick Anderson Epidemiologist II X

Guests

Tammera Badano AMR X

Larissa Bradford CALSTAR X

Doug Petrick AMR X
George Nunez CAL FIRE X
Scott Houchin Salinas Fire X
Eric Ulwelling MCRFD X
Kevin Oakley Law Enforcement X
Jay Fitch Fitch & Associates X
Robert Fuller Fitch & Associates X

II. Public Comment None. • As noted.
III. Approval of Past EMCC
Meeting Minutes
A. January 11, 2017 A. The EMCC meeting minutes for January 11, 2017 were • January 11, 2017 EMCC meeting
approved, as presented. M/S/C H. Robins/H. Wolgamott minutes approved as presented.
M/S/C H. Robins/H. Wolgamott
B. March 8, 2017 B. The March 8, 2017 EMCC meeting was cancelled.
2
(meeting cancelled) • As noted.

C. May 17, 2017 C. The May 17, 2017 EMCC meeting was cancelled. • As noted.
(meeting cancelled)
IV. EMS 20/30: EMS System
Assessment, Strategic
Planning, and RFP Process

A. Briefing by Fitch and A. Michael Petrie introduced Jay Fitch and Robert Fuller, • EMS Agency will schedule
Associates members of Fitch and Associates, who have been interviews with Fitch and
contracted by the EMS Agency to assess the Monterey Associates with EMCC member,
County’s EMS system, assist in strategic planning and and EMS Stakeholders between
redesign, and development of RFP for 911 emergency now and October. Five community
ambulance services. Jay Fitch provided an overview of the meetings will also be scheduled in
three phases of the project and the timeline to complete it. October.

V. Reports
A. Medical Advisory A. Dr. Stubblefield provided a brief report, summarizing the • A copy of draft minutes was
Subcommittee (MAC): February 8, 2017 MAC meeting. Copies of draft minutes included with agenda packet for
February 8, 2017 Draft were included with agenda packet for reference. reference.
Meeting Minutes

B. EMS Operations B. Fred Claridge provided a brief report, summarizing the • A copy of draft minutes was
Subcommittee (EMS February 8, 2017 EMS Operations Subcommittee meeting. included with agenda packet for
Ops): February 8, 2017 Copies of draft minutes were included with agenda packet reference.
and March 8, 2017 – for reference.
Draft Meeting Minutes

C. Emergency Medical C. Michael Petrie reported that the EMS Agency hired a • Stakeholders should expect to see
Services (EMS) Agency temporary website assistant to assist the agency with significant improvements to the
improving the website. website soon.
VI. Old Business
A. EMS Data System (11/15)
3
A. Fred Claridge provided background information and a report • EMS Agency and EMS Stakeholders
on the status of the EMS Data System. He stated that the to continue to implement ESO
EMS Agency has been working with agencies to get Solutions data system.
agreements in place for this system. He pointed out that
the administrative part is the most challenging part but said
the training phase should move quickly. ESO, the vendor,
provided a presentation to the working group in May, which
provided the working group an opportunity to see how the
system works. Fred added that the system’s analytics are
much more robust than what we can do now and is able to
combine different report formats. Martha Karstens
expressed a concern regarding the system’s social security
number field. Fred clarified that entering a social security
number is not necessary to make the system work.

Similarly in June, the Health Department Privacy Compliance
Officer provided a presentation to the working group
regarding protected health information (PHI).
B. EMCC Bylaws Review
and Revision (11/16) B. Michael Petrie reported that the amendment to the EMCC • EMS Agency, with help from EMCC
Bylaws to create an alternate for each member and to allow representatives, to solicit
the 911 EOA ambulance provider to be represented will be alternates for each EMCC position
approved the Board of Supervisors at the end of July. Upon and to submit nominations to the
Board approval, agencies that nominate an EMCC Board of Supervisors for approval.
representative should nominate an alternate. Nominations
for alternates will need Board of Supervisors for
appointment.
C. EMS System Providers QI
Program Development C. Laura Wallin provided a report on the status of the Quality • ALS service providers are to submit
(11/16) Improvement (QI) Program. The EMS Agency has their revised QI Plans the EMS
conducted several trainings on how to write a QI plan and Agency by November 1, 2017.
understanding the difference between a QI Plan and a QI
Program. A training is scheduled for Thursday, July 14th.
4
Laura added that individual assistance is available to
agencies upon request to the EMS Agency.

D. EMS Plan Revision
(1/17) D. Michael Petrie informed the committee that the 2016 EMS • EMS Agency to begin to develop
Plan was approved by the EMS Authority on April 10, 2017. next revision of EMS Plan.
This is a plan LEMSAs are required to submit to the EMS
Authority annually. The EMS Agency will start working on
the 2017 plan revisions soon.
E. Contract Compliance
Working Group E. A report on the Contract Compliance Working Group • EMS Agency, AMR and FirstWatch
meeting held on June 14, 2017 was provided. to review and adjudicate AMR’s
• AMR Response Time response time performance data
Measurement, Analysis, • Fred Claridge reported that the EMS Agency has invested a from March 2017 forward. EMS
and Reporting lot of time reviewing AMR’s response time measurement Agency to continue to work with
and reporting processes. A comparison was done to ensure AMR on breach of contract issues.
both AMR and Inpironix measurement and reporting
processes were accurate. Slight differences that can
significantly affect the results were identified. The EMS
Agency continues to work with AMR for consistency in data
system reporting.
• AMR Contractual
Compliance (1/17) • Patrick Anderson distributed a handout of countywide data
in priority format for the months of September 2016
through January 2017. Patrick explained that there are a
lot of nuances that impact compliance (e.g., not being able
to round up). He is working with AMR on some
discrepancies on a few records. Patrick reported that he is
also working on getting the correct fields in the new CAD.
He said both AMR and the EMS Agency will be using First
Watch (AMR’s vendor) to handle data instead of Inspironix.
Gerry Malais raised the question of the EMS Agency using
AMR’s vendor to analyze data. Fred Claridge explained that
5
First Watch works with large systems and that just because
they work with AMR, it does not mean they would work to
their benefit. Besides, the EMS Agency will still review the
data. Michael Petrie added that First Watch would not be
able to manipulate the data without the agency knowing
about it.
• AMR Breach of Contract
Notice and Response • Michael Petrie updated the Committee on the AMR Breach
(5/17) of Contract. Michael summarized the Notice of Breach of
Agreement sent to AMR and AMR’s response to the EMS
Agency expressing its disagreement with the EMS Agency’s
interpretations. Michael stated that the EMS Agency
continues to work with AMR on these issues.
VII. New Business
A. Reappointment of EMCC A. Michael Petrie reported that members whose term was • EMCC members to advise the EMS
Members with Terms ending June 30, 2017 have been reappointed by the Board Agency of completion of oath of
Expiring June 30, 2017 of Supervisors for two years. He also reminded members of office and ethics training.
the need to advise the EMS Agency when they complete
their oath of office and ethics training.

B. Election of 2017-2018 B. Michael Petrie reminded the Committee that each year as • Martha Karstens was elected as
EMCC Officers of July 1t, the new EMCC Chair and Vice Chair are to be Chair and Jodi Schafer was elected
elected by the Committee in compliance with the EMCC as Vice-Chair. M/S/C H. Robins/ H.
Bylaws. Martha Karstens was nominated as the new Wolgamott
Chairperson, and Jodi Schaffer was nominated for the Vice
Chairperson. M/S/C H. Robins/ H. Wolgamott

C. CSA-74: Operations C. Teresa Rios discussed changes to the CSA-74 reimbursable
Subcommittee equipment funding program at length. Michael Petrie
Recommendation for commented that funding costs will be retroactive dating
Reimbursable Equipment back to last Fiscal Year 2015-2016. Discussion ensued
regarding burdensome paperwork to provide the EMS
6
Agency the needed supporting documents to support
expenditure of CSA 74 funds. Both Michael Petrie and
Teresa Rios emphasized the EMS Agency’s responsibility to
ensure agencies expense funds in allowable expenses and
follow Generally Accepted Accounting Principles (GAAP).
Committee members expressed concern that the addition
of the communications costs as proposed by EMS staff
report was beyond the intended use of CSA 74 funds stated
in the 2011 MOU and therefore did not support the changes
as recommended in the EMS Agency staff report. The EMS
Agency noted that this allocation had been reviewed by
County Counsel and approved by the Operations
Subcommittee.

The EMCC reviewed the section of the MOU related to the
use of CSA 74 funds.

Following the review and discussion of the MOU, the
committee entertained the following motions:

C-1. Motion to endorse the following changes (bullet points 1- • Motion to endorse changes to the
4) to the CSA 74 allowable equipment/service costs. This CSA- 74 allowable
motion failed. M/S/F H. Robins/J. Schaffer equipment/service costs as
outlined. M/S/F H. Robins/J.
1. Costs to purchase equipment on the current version Schaffer
of the EMS Agency’s minimum equipment list,
commensurate with the organization’s scope of
practice. For example, only paramedic service providers
could be reimbursed for equipment used only by
paramedics. The current minimum stock policy is Policy
4010: Minimum Stock: ALS Units.

7