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If folks have an interest in the ambulances standards the link below will take you to a 7 video series on ambulance history, Standards review and crash testing. Excellent series that will take about an hour to watch all 7.
Steven Isaacson, BA EFO CEMSO
Kootenai County Fire & Rescue
EMS Administration Office
DT: November 9, 2018
TO: Idaho Fire Chiefs Association
RF: November 2018 EMSAC Update
FM: Steven Isaacson, President of EMS Section for IFCA
The quarterly EMS Advisory Committee (EMSAC) met in Boise on November 7th 2018. Here is brief recap of cogent points discussed. It is important to note the minor restructuring of EMSAC. Committee work process was initiated with additional committees added by the new Chairman of EMSAC, Chief Chris Way. The committees are where the detailed work flow is completed with reporting and approval provided by the EMSAC as a whole. With this in mind a review of major committee action is appropriate following some general comments or actions:
EMS Bureau Update:
· EMSAC is requesting trending data on EMS personnel in Idaho. The Bureau reports on the numbers of EMT, EMT-A, Paramedic each meeting but we are requesting the use charts to allow a visual to track trends in staffing. It will be interesting to monitor this trend and I will request the slides from Bureau to share in future updates.
· Investigations: Significant discussion within the EMSAC reference the noted increase in investigations. 15 new investigation cases opened in 2018. Since the August meeting 4 (four) new Agency cases have opened with 1 (one) case a Narcotics Diversion case. There are currently 5 open cases that have Law Enforcement investigations in progress as well. These are significant occurrences and should be a warning to all service providers. Know the DEA requirements for security of controlled substances. Work with your local Medical Director to be vigilant in safety, security and oversight of Controlled Substances.
o From this report EMSAC acted by requesting the Training Sub-Committee work with Administrative Sub-Committee and Idaho Emergency Physicians Committee to develop a statewide training on Controlled Substances security and oversight. More as this develops.
· Dr. Hill (SMR): Presented a paper on Spinal Motion Restriction (SMR) advised the group the value of consideration. Discussion of a Ketamine consensus guidelines coming soon. Finally, requested the EMSAC Support wound packing in the nationally recognized “Stop the Bleed” curriculum being taught to civilians in Idaho and around the country. Problem, EMS Providers do not have “Wound Packing” in our scope of practice. Chairman Way stated he would discuss with Dr. Sande who Chairs the Physicians Committee. This will be discussed at the Friday meeting with the goal to discuss and set forth a plan in the near future for Idaho Scope of Practice changes to allow.
Grant Committee: Steve Isaacson Chair
FY 2020 Grant cycle changes:
· Changes to Application:
o Confirmation email language: On page 1 you will read that an email confirmation will be sent to whoever sent the grant application. If you do not receive the confirmation, we do not guarantee the EMS Bureau received the Grant application.
o Language change on number of providers and volunteers: Page 3. Read carefully to provide the most accurate information. We attempted to clarify the simplify the request.
o Added: Page 3: Verification of call volume: Need to provide data via spreadsheet or CAD download to verify call numbers.
o Added: Page 3: “Fire District” for title as they may now per State Law Title vehicles
o Added page 4: Funding Sources portion of application was streamlined to decrease confusion
o Added: Grant History award to Page 6: Need to provide departments grants awards for past 5 years.
o Added: Title and age/condition of the vehicle being replaced
o Changed: Price Caps page 15: Application will outline the changes to the FY 2019 Grant Price Caps. Some mentioned below in repeat of August Grants Committee changes.
o Verbiage on Ambulance Standards: The Grant application will have a statement encouraging ambulances purchased with Grant Funding be built to the latest version of the NFPA Ambulance Standard or the CAAS Ambulance Safety Standard.
· History of vehicle awards: Sliding scale from 1-5 with recent recipients receiving 1 point (Previous Year) to 5 points (5+ years since award).
· Response type: Sliding scale based on percentage of prehospital responses getting more points
· Fiscal Base: Looking at public funds including general funds, not just special taxing district revenues.
· Local Government Endorsements: Only 1 endorsement is required to get 5 points.
· Narrative: Committee reviewers score narrative and that score goes from a current maximum of 5 points to a maximum of 10 points with the FY 2020 Grant cycle. Puts additional emphasis on the need for clarity and completeness in Grant narrative.
· Tactical / ballistic equipment and scene lighting equipment will be moved to the ineligible list as the committee is working to keep true to the Idaho Rule in Title 56 Chapter 1018B that outlines the EMS funding purpose.
· AED pricing cap was raised to $1,700.00. Literally a rounding to nearest whole number.
· Extrication equipment cap was dropped from $10,000.00 to $7,500.00
· Added Power Cot Retro Kit with Cap of $2,500.00
· Added a Power cot/Load Kit and capped it at $25,000.
FY 2020 Grant Cycle Dates: Moved from previous years forward 1 month!
· Application available on or before January 1, 2019
· Submission deadline: Through April 1, 2019
· Evaluation period: April 2 – June 1, 2019
· Award notification: July 1, 2019
· Disbursements: September 1, 2019
· Return of unused funds: June 1, 2019
FY 2019 Grant Overview:
· $1.4 Million in defined funds: Slit 50/50 Vehicle and Equipment
· 72 applications received in total:
o 19 Vehicle applications / 7 awards provided
§ Ambulances: 15 requested / 5 awarded
§ Non-transport vehicle: 4 requested / 2 awarded
o 68 Equipment applications / 62 awarded
§ 12 Powered Load Systems awarded: Largest component of the equipment grant budget.
Administrative Committee: Chris Way Chair
· TSE: Designation criteria for EMS providers is being considered. The final criteria will be approved by the TSE Committee at the September meeting with a target of spring 2019 to begin the application process for EMS Agencies (Transport and QRU) to apply for TSE verification. Continued discussion and thoughts toward how we could encourage EMS participation, we discussed the potential of providing Grant points for applicants that apply for the State EMS grant and have the TSE designation for their EMS agency.
o Process might be:
§ Application by Agency through iGEMS
§ Approval by the Administrative Sub-Committee
§ EMSAC Committee as the whole approval
§ TSE Council awarded
§ 3-year Designation period
o NOTE: This would require a Rule Change and thus legislative action. More on this as it moves forward.
· Longevity or tenure awards: This was again discussed as being a high priority fir the EMS Chief Denny and the Chairman of EMSAC Chris Way. We will develop options for Bureau to consider and hope for funding mechanisms to be worked out for purchase of awards before February EMSAC meeting.
Reminder: The Committee agreed upon a 10, 20, 30 and 40+ year award or tenure for Idaho EMS Certification designation. Idaho EMS providers with consistent service reaching these defined levels will be thanked through certificate, lapel Pin or Coin and personal public thanks by EMS Chief Denny. This new initiative was well received by the EMSAC and will be considered by Chief Denny as he looks at funding opportunities to pursue this initiative.
· Ambulance Standards: The Committee is proposing that new ambulances bought for service and licensure in Idaho be built to the latest national safety standard from either NPFA or CAAS.
Toward this goal: The Bureau of EMS and the EMSAC Committee hosted an Ambulance Standard and testing review workshop on November 8th, 2018 in Meridian, ID. Jim Green, researcher from the National Institute of Occupational Safety and Health (NIOSH) provided an overview on the standards (CAAS, KKK and NFPA) and provided graphic video demonstration and discussion on his recent research and NIOSH testing on ambulance safety. This was an informative day of education, discussion and hands on in demo ambulances brought by vendors to help with the discussion. It is clear that ambulance safety has taken great strides in the past 5 years. EMSAC looks forward to continuing the discussion and leading Idaho EMS in safety discussions through review of current national ambulance safety standards.
IMPORTANT NOTE: In a 2001 – 2011 NHTSA (National Highway Traffic Safety Administration) study of ambulance crashes…. 84% of those technicians involved in the accident… IN THE AMBULANCE… were not seat belted. We are fighting a “Culture war” for the safety of our staff.
· Regional Preparedness: The Administrative Sub-Committee is looking into how we collect accurate data on available transporting ambulance availability State-wide. The goal is to build an active living data bank of resources and how to access them in the event of a Regional deployment need. IMPORTANT NOTE: Working with currently in place agreements within the Emergency Management and fire service structures.
Communication Committee: Dr. Martin Mangan Chair
· On-Line Newsletter: The Committee is proposing an online newsletter for all EMS licensed members in Idaho for opening communications within the providers in Idaho. EMSAC fully supported the proposal and the Committee will continue to build on this idea and bring back additional information as they build out the idea. Purposed purely to increase communication within the EMS Committee in Idaho.
Data and Quality Committee: Randy Howell Chair
· Data: Working on statewide reporting and consistency of data. This very difficult process being worked on by the committee. The committee is looking at processes to help blend state data into a single data base for clarity of the data. The committee is looking at what exact points of data will be beneficial to all to see and compare your department against the state values. This very dynamic group is led by Chief Howell from Boise Fire and has a very diverse team with multiple interests and insights in data.
Education Committee: Bill Arsenault Chair
o This committee is working to make the State EMS Providers aware of the training opportunities in Idaho. Toward this goal, the committee discussed the IFETp Facebook page. This is a Facebook page dedicated to announcing training opportunities, Job postings and significant announcements that effect Idaho EMS providers.
o Drivers simulation lab: A mobile Drivers simulation lab on a trailer is available to Idaho EMS Conferences and training requests. This is a significant training opportunity in mobile format that includes fire apparatus and ambulance driving scenarios with real life driving
Clinical Integration Committee: Dr. Brittani Hill and Mark Babson Co-Chairs
· New committee chairs will work together to review committee objectives, learn what was being accomplished and move forward with a duel leadership model. One of the items from previous months report listed below will be reviewed by the committee in the future and resolved. No ac
o Clinical Integration Form: The Committee is developing a form for online access to complete when the integration of standby and transportation is required for clear delineation of roles and responsibilities and plans for integration. The Committee is working to make the form rapid to access and easy to complete.
· No action items this month as the committee leadership is setting plan for future.
Kootenai County Fire and Rescue