PRESENT: S. Bennett, M. Buth, P. Card, M. Cowan, F. Crist, J. Larson (for D. Crowley), D. DuVall, P. Gressel, A. Lewis, Dr. Huffner, A. Jones, B. Oakes, R. Kintz, K. Lunney, R. Rajsky, Dr. Manganaro, Dr. Seaman, M. Smith, J. Drake (for W. Shutter), M. Sprague, D. Sullivan, M. Sweely, T. Symonds, M. Teeter. STAFF PRESENT: J. Blair.
ABSENT: J. Chrabaszcz, M. Colegrove, R. Kimball.
GUESTS: T. Murphy, A. Mallow, C. Oakes
STENOGRAPHER: B. Brucie
CHAIR RAJSKY: Let's call the Southern Tier Regional EMS Council to order for January 2001. Happy New Year to everyone. And did we have introduction of guests this evening? Anyone we would like to introduce.
STEVE BENNETT: Jill Drake is Wendy's alternate.
CHAIR RAJSKY: Okay. Anyone else?
JIM LARSON: I am Jim Larson for Dave Crowley's alternate. And one of our fire fighters in the back.
CHAIR RAJSKY: Approval of the minutes, our last meeting was in November. Attached for the first time we have our comprehensive list of what actually went on word for word. So that was in the packet that went out to you. Any changes, corrections for that document?
DR. HUFFNER: There are several places where we speak about a Dr. Seamer, the first is on page 12 line 9, that should actually be Dr. Seaman. So wherever it says Dr. Seamer make it Dr. Seaman. Also on page 20 line 5, I am talking to Bernie, it's actually Bunny not Bernie. Bernie. I will make a move to approve with the corrections identified.
RON KINTZ: Second.
CHAIR RAJSKY: Motion made and seconded. Any other discussion? Seeing none, all those in favor. Opposed? Abstentions? Carried. Great. All right. Committee reports. Systems committee. Mr. Lewis?
ALAN LEWIS: I am first, lucky am I. We met on January 10th which was just a couple days ago. We talked about public access defibrillations policy and procedure for handling those. And we do have a rough draft of it which we will share with you at the next meeting.
We also approved several PAD projects. There are numerous programs in our counties. I was going to read a list for you.
CHAIR RAJSKY: I think everyone is familiar with public access where an agency, a group of people, a person can get a document from the health department, signed by a health care practitioner and be trained, and virtually start a public access, a automatic defibrillation program. I think the biggest one for us in this area would be Corning Incorporated. Many many machines in place on all their aircraft and all their plants. It's a wonderful deal.
ALAN LEWIS: I would like to read off to you just the ones that are out there that have been approved. Corning Consumer Products, Corning Community College, Steuben County Sheriffs, Corning Family YMCA, Corning Country Club, Bruce Baxter DMD, Corning Inc. again, Schuyler County Sheriff, Greg Schultz, DMD. Again, Painted Post Fire Department, Addison Central School, Watson Homestead, Painted Post Presbyterian Church, Sementilli and Sementilli, dentist group in Corning, Grace United Methodist Church, Addison Police Department, BOCES, Wildwood and Canisteo Central School. So there is numerous ones out there that have been approved.
Now we accept the information, file it in our files and send it to the state, that's all we have a right to do with those PAD programs. So we just keep them on file. And point out that if there are deficiencies, in each of the applications, but still refer them to the state and the state deals directly with the PAD applicant from there on out. So that's what's going on with that.
First responder, minimum standards was discussed next. And we have asked all of the fire coordinators to go back to their respective departments, take a look at the standards and if there are suggested changes, bring them to the next Systems meeting.
The restocking issue of variable medical goods and medications was again discussed. That's still an open issue. We're hoping that this area remains intact as far as all of our hospitals are concerned in restocking for ambulances and first response units.
Committee goals, I believe you all have our committee goals in front of you. We reviewed those. There is eight committee goals that we have elected to take on for this year. If you have interest on working on any of those specific goals, you are welcome to come to our meetings, they are open. That's pretty much it.
Mr. Smith gave us a report on, an update on Southport Fire Department. And that's the end of my report.
CHAIR RAJSKY: Thank you. Questions for Mr. Lewis? Seeing none, let's move on to STREMAC. Dr. Huffner?
DR. HUFFNER: You will recall at the last meeting it doesn't happen very often I had no report because STREMAC had not met last time we met. Unfortunately since the last time we met the STREMAC has met three times; and in your packet you have three sets of minutes, one is orange, one is green, one is yellow and I am going to march through these very briefly.
There are several things that are going to require action by the council. The first item to come before the council comes to the November meeting, it's actually the purple sheet of paper that's also in your packet. It's a Southern Tier, it's a STREMAC policy concerning the administration of nebulized albuterol by emergency medical technicians basic.
In the past we had discussed this issue at the STREMAC, and initially had some resistance. Essentially if we were to do this regionwide it would require again another set, obviously another protocol, training program, that type of thing. And initially thought that we would not want to do this, given that there is not particular known to be a significant need for this. We approached actually Mr. Davis to talk about how he might proceed in terms of sending out feelers, seeing if there were any services out there that would be interested, seeing if there was any overwhelming support for this. I had mentioned this at the previous council meeting I believe, not the one in November but the one before that.
Long and short of it is we had a little bit of a change of heart. We decided from STREMAC's perspective that we would in fact develop a policy that as you can see would allow the administration of nebulized albuterol by basic EMTs but do it service by service. If a service wanted to do this, they would have to meet essentially the four items in the policy. And they are that the administration of nebulized albuterol by basic EMT must occur in a service in which all the basic EMTs are trained and authorized to provide this treatment.
An administration protocol, training plan, QI skills maintenance plan for this must also be approved. A physician service medical agreement, medical director agreement acknowledging and accepting responsibility for the provision of off-line medical care, control for the service and providers administering the nebulized albuterol must be approved by the STREMAC and justification of the need providing this.
Just sort of off the hand looking at PCRs and things we didn't see a particular huge need for this but there may in fact be a service that's interested in. They may have an asthmatic or something that is within their catch in. They might want to be able to do this. And we saw no reason why we should present an impediment to this. At the same time we didn't think it was necessary for us to say okay every basic EMT in the region needs to do this. So it's sort of a compromise, the best of both worlds. If there are services out there that are interested in doing this we would be happy to accommodate it.
But at this time we are not going to mandate that it be done by every single EMT in the region. Again not an unreasonable amount of training and skills maintenance, additional course work, hours, again, being ever sensitive to our volunteers and their, again ever-increasing amount of training that they need to do. Essentially that's why we took this position. Yes.
ALLEN DAVIS: Just a quick question on your fourth requirement, could you expound on that just slightly? What do you mean by, I know what you mean but are there any specifics you are looking for?
DR. HUFFNER: The bottom line is we thought if a service and the service medical director came to us and said we want to do this because we want, we have a patient that we believe we can help in our region or we have -- I mean do it for a reason, not just for the fun of it I guess is the bottom line. We have had four cases of asthma in the last whatever. I mean any justifiable reason for doing it I guess is what we are saying, rather than let's just do this for the sake of doing it.
The bottom line is we don't want to be looked at as forcing the basic EMTs to do this if they don't want to. If there is not a need, and if there isn't obviously support from within the service to do it. We did however firmly believe that if a service was going, if a service was going to do this, just like we have the same saying if you are going to do ALS you are going to do it 24/7. If you are going to provide nebulized albuterol you are going to do that 24/7 and that's why that is there.
So this has been approved by the STREMAC, usually we like to bring all our policies to the council to get approval. Just because it is always nice to have the council approve our policies. And I guess I will make the motion that we approve the STREMAC's policy 001 basic emergency medical technician and nebulized albuterol administration.
ALLEN DAVIS: I will second that.
CHAIR RAJSKY: Second been made. Further discussion on the matter, further discussion? Seeing none, all those in favor signify by saying aye. Opposed? Abstentions? Carried. [Nebulized Albuterol protocol approved.]
DR. HUFFNER: The next item actually comes from the December 12 meeting minutes, it has to do with the emergency medical dispatch protocol, these are the protocols that are used in the 911 centers to provide instructions of what to do while you wait. It also, those protocols also provide the level of response by county of what type of service needs to be sent, whether it be first responders, basic life support or advanced life support.
Those protocols are being revised because the vendor who provides us with the, if you will the generic ones came out with a new version in late September. Essentially we have not yet begun that process. It's not an easy process. We will be setting a meeting date very soon to begin that process. And when those are viable, obviously the STREMAC will act on them.
Now again we don't, there is no statutory requirement that protocols come before council but tradition is they always come for your approval. And you will at least be able to see a completed set of cards. Again remember it's those big box of cards that come on the big plastic things, so it's not like I can give you a hard paper copy to take with you. We are not allowed to duplicate them. We only have so many copies of them. So that it's somewhat difficult to work with them just structurally because they can't be duplicated.
But I wanted to at least remind you that that's going to be happening in this first half of 2001. Some time, sooner hopefully rather than later.
The other thing that comes from that December meeting was the presentation of the first draft of credentialing on-line medical control physicians in the Southern Tier. That document's included in your packet, it's hite, it's actually sort of gray I guess. It's got, looks like this.
This is the document that we have developed as a first draft document that the STREMAC needs to be working on for a number of reasons. Not the least of which is the fact that one of the deliverables for the program agencies is that we need to provide some methodology for credentialing on-line medical control physicians. So this document is being distributed to all you tonight, in the hopes that you, I guess don't have anything else better to do, you might sit down and read it. It's a framework to consider, and again it's specific for physicians at this time. But the framework certainly could eventually apply to other levels of providers. It is provided again only in draft form and we will be working on that. And it will likely come back in a second version. If anyone has any comments or thoughts on it, I certainly would welcome them back as we develop our next draft of that document.
The next item, and I am going to hold all the AED applications to the end, just in case you think I am skipping anything. The next item that I wanted to just highlight has to do with the January meeting, that was January 9th. The STREMAC has been having problems with attendance of its membership. You will note that our stationary shows that we actually have seven physician members. The law requires that we have a minimum of five.
In our agreement with the council, we're able to retain certain rules of governance and operations as they apply to things like how frequently we meet, and meeting attendance and items associated with that. Because of this, we did a review of our attendance and found that some of our physicians were not certainly meeting the attendance requirements.
And we have decided to change a couple things. All consistent with our agreements so that there is no need to change the agreement. But that we have decided to go to an every other month meeting schedule. We will be meeting, we obviously met in January, you can expect us to meet in March and then every other month onward.
Two of our physicians have been placed on a probationary period, and they will be essentially, I guess assessed is the best way to do it at the end of that for consideration of further action. It's a little bit of kind of shooting ourselves in the foot. We certainly don't want to lose any of our physician membership because we need representation from all parts of the region. But at the same time we need to try to create, coddle or somehow get new blood in to the system as well.
So I'm bringing this up here only to encourage you all to go back to your services, your hospitals and if you have a physician out there, that's out there, and interested, certainly encourage them to come to the STREMAC meetings. All physician medical directors are ex officio members. Again they are public meetings, anyone can come. If any of your physician medical directors want to get the information from the STREMAC in terms of being on mailing lists and stuff, we would be more than happy to accommodate them.
But we would welcome more participation rather than less. More physicians on there, the better off it is. We have identified one other physician that we are going to try to at least return him to the fold. He was here maybe three or four years ago, was a very good full player and, we hope we can convince Andy Michel to come back and participate on the STREMAC.
That's it really for the minutes in terms of my report. There are several AED permits, applications that have made their way through the Systems committee and have been forwarded on to the STREMAC and that we acted on at either, it's the blue sheets of paper now. The blue sheets of paper in your packet. Addison was acted on in January, actually the other three, Golden Glow, Thurston and Pulteney were acted on in the November meeting. Included in your packet are the cover sheets of essentially we believe we all decided that we would forward the, essentially the completed application to the council once the Systems committee found them complete and, the STREMAC found the application complying with the requirements of the AED policies and procedures, that we would only bring forth the cover sheets of the applications to save a tree now and then.
So I guess I will make the motion that the AED permits for the Golden Glow, Thurston fire, Pulteney volunteer ambulance and Addison volunteer fire department ambulance corporation all be issued at this time.
MEMBER: Second.
CHAIR RAJSKY: Discussion? Seeing none, all those in favor signify by saying aye. Opposed? Abstentions? Carried.
DR. HUFFNER: MaryAnn is asking a question about Addison's, there is a question, there is a circle around the total number of providers, this is the last page of that blue packet. The total number of providers is listed as 34 yet they only have, I think listed nine certified members. That was researched and in fact there is 35 members of the corps, I guess, they say that they are members, but actually don't do anything or they don't practice. The bottom line is they actually have nine people who actually provide the service, which again we have never used those numbers as a determining factor, yea or nay. It was questioned and answered. Just didn't take it off the cover sheet. That's the end of my report unless anyone has any questions.
CHAIR RAJSKY: Anything for Dr. Huffner?
Seeing none, we will move on to the executive committee. We have actually had two executive committees since we met last. One in December, at that meeting we discussed kind of at length general goals and objectives for council and each committee, and a global discussion occurred actually through STREMS, the corporation and the council, and that was that the concept of credentialing. And I think we finally have some resolution, and Dr. Huffner brought forth the first portion of credentialing if you will. That concept, we have bounced on the fence for years now I guess. And need to either embrace that concept or dismiss it. So Systems committee actually is going to do some more research for that. Ask other regions that do credentialing, I think we are going to get away from the word credentialing, going to say skills maintenance as a softer more gentler, kinder way of to view that. That was major topic of that meeting that evening.
We met just prior to this meeting again to discuss specifically the issue with Southport fire department, their not being able to provide emergency services currently. Initially to talk about that, and then to try to come up with some kind of information packet, dog and pony show, call it what you may, for squads that council members may hear about, we hear about through the newspaper, that they are in trouble, trying to help them.
And I guess I am a little remiss in not maybe being as proactive certainly in the Southport issue as maybe I should have and maybe involving the council. So we met just prior to this meeting and we did, the executive committee did come up with a resolution that we'll present here. So that resolution was:
JUDY BLAIR: To approve the concept of a public forum to recommend possible remedies or solutions for the unfortunate situation of a lack of EMS response of the Southport fire department, and make someone be in charge and develop and implement it.
CHAIR RAJSKY: So that came before the executive committee, and they approved it. I would certainly open that up for discussion of this body, the entire body and I guess maybe reaffirm that position. So if anybody would like to speak for that or?
DR. HUFFNER: I made the motion so I thought I should at least explain myself. Certainly we're all aware that there has been a considerable amount of press paid to this unfortunate situation. And I think as a council, we have an obligation to respond in some way.
And I think the idea of some type of a public forum, some type of a public information session that can make not only the people in the town of Southport, but the region aware that there are options, and that, not only to remedy the solution but that we're concerned. We as a council are concerned that fire departments and EMS, and all EMS agencies are struggling, struggling because of decreasing numbers, struggling with their own abilities to provide, if you will the public safety, the public safety net that's needed to provide EMS.
We know that any successful, sound EMS system is built on the foundation of basic life support and BLS response. And once we start chipping away at that foundation, our system isn't, is threatened. And we as a council I think have an obligation to respond.
Again I will be the first one to admit I sat down and wrote down my first letter to the editor and thought no that's probably not the best way to respond. I think we need to have some organized presentation given officially with the, if you will, with the full authority of the council saying we're concerned, go out, educate, bring people in, get people involved, and respond to this situation. It's not only in Southport. We have already heard rumblings in other parts of the system, and certainly we know that it's rampant throughout the state and really throughout the nation.
And I think that as a council we're, it's really a duty for us to respond in a very public way, involve the press, involve people so that everyone knows that we're concerned, that here's some options. Think about it.
And we need to do something about it.
CHAIR RAJSKY: Our mission statement just to go back to that reads as follows: STREMS Council continuously strive to ensure that every person in the counties of Chemung, Schuyler and Steuben will have access to high quality out-of-hospital emergency care specific to that particular emergency situation delivered in accordance with expected level of treatment and receive it in a timely fashion.
So I think Dr. Huffner is right when we say we have some obligation certainly in this case and in future cases to make sure that occurs. Further discussion? Mike Sprague?
MIKE SPRAGUE: I guess I would heartily welcome any support that we could get from the council in this endeavor. Our county -- and Mike and I were on TV about a week ago talking about this very issue. My county is launching some sort of a public information campaign, because we are experiencing great difficulties.
I have got a copy of the meeting that was held last week, and I would be happy to share copies of that meeting and some of it boiled down to three major factors that are effecting the numbers, and the response of the EMTs that we have out there, the medical people, which includes training and recertification, required numbers of hours of training, the frequency of training, frequency of recertification, protocols, not allowing the best use of the rural resources that we have. We only have one or two EMS rigs, we have to be very careful where we place those and how we send them. And depending on the EMTs to help us make those decisions and the need for all agencies to come up with back-up plans for coverage in the event that they cannot respond. Recognition that it's not appropriate by the corps to leave this up to the dispatch agencies to try to figure out how to fill the gaps. And this has happened, a couple of our corps have taken an innovative approach and designed their own mutual aid, that seems to be working. That's a very positive sign. I have got copies here I would be happy to share with the group.
We are taking a multi-prong approach to this thing with, I have got some TV spots, I have got two EMS videos and a general fire service video, FASNY is assisting us with 1-800 fire line. We are going to put up some signs, I am going to buy them for $9.95 each, if I can get DOT to put them up.
Every night we have a tractor trailer incident we will just plant one next to the tractor trailer incident until they take the haz-mat stuff away, which is about three months later.
I certainly would welcome any assistance we could get. One of the things I have found is the local TV station needs to have a different format of video than I have available. And it may actually cost me money, if there was any financial support that we could get to do this I would greatly appreciate it.
In addition my legislature has taken the steps and will be at the end of this month, and that's one of the things I want you guys to be aware of, that there probably will be more press in regards to this because they're going to pass a resolution in regards to volunteer incentives, to the tune at this point I think it's 10 percent for property tax assessment. It's the sales tax on a purchased vehicle for the emergency responder, we're asking for repeal of the registration fees and taxes associated with that. We're looking at a income tax incentive of $2,000 plus mileage to training, and the jury duty exemption to be reinstated which was taken away some time ago. We're trying to do everything we can to try to help the situation out. We certainly again endorse your motion as long as it encompasses the whole region.
CHAIR RAJSKY: I think the intent of that is I think there is an immediate need at Southport and then the plan would be to develop it further to where it could be whatever plan comes about would be put on the road. So I think that's going to be the new public relations committee's first big project.
MIKE SPRAGUE: I share the need with Southport, I guess the only comment I would have with that is Southport is providing a first response agencies, without the first response agency there is still an ambulance service underlying. In our situation if the fire department does not or the ambulance department does not have enough personnel, there is no ambulance.
CHAIR RAJSKY: Don?
DON DUVALL: I agree with Dr. Huffner certainly and Mike. And I guess what I would like to see is rather than one person being in charge of or responsible, maybe the organization of a task force to focus on problems as they arise and maybe try and deal with aspects one at a time and just continually work at improving it.
Mike spoke about training concerns, cost issues, location issues. Those are a lot of different angles for one person or a couple of people to pursue. So maybe the organization or the appointment of a task force would be a little more appropriate and maybe a little more helpful to answer problems region wide. If nothing more than to be a clearinghouse to provide answers for questions that people may have and not know where to go to ask.
And there are some creative things that maybe we could do with respect to recruitment retention. And I run the CPR program at Schuyler, and every CPR student gets a 60 second commercial on why they should be a volunteer somewhere. And we try to refer those people. You know it's just kind of a small thing but it helps, every little bit helps. So I would like to see a task force.
CHAIR RAJSKY: Richard Sullivan.
RICHARD SULLIVAN: I have commented on the paper and, if you have noticed, unfortunately, either Mike or somebody told them to call me, but it is a serious problem. I think one of the things that Dr. Huffner is working on which is going to help, especially in Horseheads, we had, I guess at the highest number we had was 28 EMS providers in the department. And one of the things that's happening is we get so many calls that the ambulance is already on scene or pulls up with us or right behind us. And that's our biggest problem. We still have the amount of people, well we have 12 that are still certified and we just started asking how many people would take a first responder class if we could do one at the station and try to make it accommodating for them. I think we got like 10 people signed up, which is a good sign.
But just as an example, the month of December we had 87 EMS calls in Horseheads and 60 of them the ambulance beat us there. Well how many people leave work and leave whatever they are doing over and over again to find you are not needed. Now today we had five and I was late tonight, but I canceled everybody because I pulled up with the ambulance. But it was icy out there so I helped them wait until they got the patient on board. But simple things like that. And I think there is a solution to it.
I guess the bad part is what Dr. Huffner is trying to do as far as cutting down the amount of EMS calls. I don't know how you can write common sense down in protocols. Because if you take and look at a list and I have in the past and was part of some of that committee, when you set in a room like this and look down through a list and say when should the fire department go and when should they not go, you all of the sudden pick a lot of cases.
Now one of those interviews I made the comment, she wanted to know when the service started getting tasked with a lot more calls, and I said well I think it was when 911 came about, because now there is only one number to call, where years ago if you wanted the fire department you called them or if you wanted the ambulance, you know. Then I went through and started looking at numbers, and basically when we got the defibrillator program is when our numbers started going up. So it's kind of like we're out there for one reason and yet we're complaining about it. It's really a tough thing.
And I don't know what really, what the answer is as far as other than maybe with a 911 centers communicating with the ambulance service when a call comes in to find out what their ETA is to get on the scene. Because if they have, especially in the day time in Chemung County, there is four ambulances stationed around at various places. If an ambulance can get there within a reasonable length of time, you know why do you need the fire department I guess, unless it's a full arrest or something severe. But even then you don't mind going when your help is needed. So that's what's caused our problem in Horseheads more than anything. So I don't know, Doctor, do you want to alleviate what?
DR. HUFFNER: When I speak of the emergency medical dispatch protocols, those protocols we are going to attempt to manipulate them in some way to decrease just those situations that Dicky is talking about. It's got to be very disheartening to get out of bed at 2:00 in the morning to respond and then have essentially the ambulance pull away and you have gotten out of bed and done everything for nothing. Now there is certainly going to be, those aren't going to go completely away.
But we believe that we can come up with some type of a recipe, because remember our EMT protocols are county specific, they are county specific. We believe that we can come up with some type of a, I guess the best way to put it is a recipe to at least decrease some of these unnecessary calls, and at the same time we will reemphasize why we believe like a full arrest, everybody has got to go or whatever the class of patient is that we believe everybody has got to go to. That's going to be as conscious a medical decision though as the dosage of Lidocaine for V-tack, it's not going to be done without some head scratching and some decision making, because we are going to take the medical responsibility of saying this is how we are going to do it. And we are doing it for a good reason. Not because we are, we're doing it because we are concerned about the system. We can't sacrifice, if you will, the nicety of saying everybody go all the time and I don't have to worry about it, and not live up to the ramifications of that.
Essentially we're seeing it, burn out. People can't do this any more. And unfortunately in our three county system, our public is pretty much spoiled. They come to expect the high quality EMS assistance. They have had it for many many many years and, it's not enjoyed like this in the rest of the state. It's of the high quality that it is, because of that basic first response by the basic life support providers. But also because of the cooperation between EMS, between the fire departments and between public safety. We have got unprecedented levels of cooperation. I know we all have our moments of conflict, but it's nothing like it is anywhere else in the state. We really are spoiled. And I think we need to pay attention to these, if you will, maybe they are little chips and little cracks, but we have to pay attention to them and we have to do something if we are going to enjoy it the same way as we have for these last 40, 30 years whatever it's been going. We need to put a little bit of time and energy and worry in to the next 25 years to make sure that it's of the same quality and caliber that was --
JIM LARSON: Doctor, just when you do the EMD, from Elmira we generally have the manpower and want to respond. So protocols that are written more for the outside part of Chemung County don't always have to include us on that part of that response. A lot of times with both us and Erway responding may free up more time if we're called on the minor ones, they are free to respond to some of the other ones. Possibly free them up for more calls throughout the county. But we are probably one of the few agencies that are willing to take anything we can get.
DR. HUFFNER: We will certainly consider that.
TERI SYMONDS: I just have a comment. It says frequency of training. Are we offering less, less courses to people in their area, because St. James is doing the same amount they always have. I guess I just need some clarification. Is it the number of hours perhaps rather than the number of courses?
MIKE SPRAGUE: A combination of a couple things and, Fred, hop in if I quote this wrong. They were looking at the number of times that it is repeated, in other words if you have basic EMT course and certain people can't make it, they want to get in to another one but it has to wait a while before the next one comes up. On the flip side it was also the frequency of the recurrence of recertification and that type of training, it was both ways. I was trying to boil it down in to some sort of a nut shell basically.
FRED CRIST: What they are saying is you have taken the basic course ones, you have taken a recertification course, you take a recertification course, you take a recertification course. Why? Why not update on things that have changed, and as long as they do X number of extrications or demonstrate that they do that, why do they have to keep going back and repeating the same thing over and over and over again?
MARYANN SWEELY: I think that's a good point. But I think you need to have two different avenues for them to travel, one the EMS workers that do not, that are not out there and active, they need to get in to a more structured program. And the recertification process now is very very flexible. You can go for years and then still come in to a recert class, and you know this Fred, and test out in the beginning and not have to take any classes until the end, when you take the written, once passed the practical. So the flexibility I think is there.
I hear your other suggestion which I think is good and I think that goes along with the credentialing line that we're looking at and, we're exploring. It's an ongoing thing, it's the executive as well as the council is exploring. And that's looking at credentialing, though the active people like you don't have to get stuck if you would in to a more structured recertification process, but rather just attend updates, current updates, things like this.
Let me give you an example, okay, of a different discipline that we were just in today. And that's instructor trainer for cardiopulmonary resuscitation. We had to sit for six hours today in a course just, just updating us on the new things that are occurring. Now that doesn't recertify us, we have to go back and go through the provider course just like the rest of you do, and recertify that way on skills that we have been doing for a hundred years. So but, I hear you. And I agree, I think there needs to be two avenues for the individuals in it practicing actively and the ladies and gentlemen that are not and need more structure.
CHAIR RAJSKY: Further discussion about, I believe there is a motion on the floor, am I correct?
MARYANN SWEELY: I just have one more comment and that's regarding the availability of classes. I am sure this would be echoed with the other corps sponsors in the room here, the need just has to be identified. And no we can't put on a course for two or three people. But yes, we can put on a course for ten or 12 people. And we're more than willing to do that providing we have the base of instructors and we are building on that as we go. So just identify the need. If the need can't be addressed in Schuyler County or Chemung County then call Steuben and we all know that. We share our pool of instructors and resources.
CHAIR RAJSKY: Further discussion? We have a motion on the floor, right? Motion was what Judy read.
JUDY BLAIR: It did come as a second motion from the executive committee.
CHAIR RAJSKY: Judy just read that again.
JUDY BLAIR: To approve the concept of a public forum to recommend possible remedies or solutions for the unfortunate situation of a lack of EMS response in the Southport fire department and make someone be in charge of development and implementation.
CHAIR RAJSKY: Okay.
DR. HUFFNER: I would take, Mr. Duvall's recommendation of maybe a task force or something to help the person that's going to be in charge to work along with that as a friendly amendment. So maybe we could expand that to, that you would be working with like two or three other people to help whoever that chairman is going to be of that group. That's what you meant, right, Donny, to have a group work on it. I think that's more heads, you can get three or four people to work on it, that would be great. So I will take it as a friendly amendment.
CHAIR RAJSKY: All right. Is that acceptable to everyone? Further discussion? Well friendly amendment, it's coming from committee.
JUDY BLAIR: Bunny seconded the first motion.
CHAIR RAJSKY: We can defeat the first motion and put a new motion on the floor if you would like.
DR. HUFFNER: Okay. You can't withdraw the committee's motion. Let's defeat the motion that's on the floor, then reenter it with a friendly amendment.
JUDY BLAIR: Pass this one.
DR. HUFFNER: Hold off on your friendly amendment, Donny. You don't accept his friendly amendment any more.
CHAIR RAJSKY: It wasn't seconded so it doesn't count. We will vote on the motion that's on the floor. Without the friendly amendment. So all those in favor of the motion on the floor signify by saying aye. Opposed? Abstentions? Okay. Carried.
DON DUVALL: I would move to amend the recently adopted resolution to create a committee or task force of three or four people to assist the person in charge with developing and implementing strategies to do what Dr. Huffner said.
DR. HUFFNER: I would second that. Let's name Rajsky the head of the organization or is he going to name himself?
JUDY BLAIR: He has the right to do that.
CHAIR RAJSKY: Okay. So another motion on the floor, motion is made and seconded. Discussion about this motion? Seeing, hearing none, all those in favor signify by saying aye. Opposed? Abstentions? That too is carried.
RON KINTZ: I don't know if you are prepared for another friendly motion. But it sort of bothered me seeing this is being done for Southport, I think it is done for situations such as what Southport is going through. And this is going to be used throughout the three counties whatever we develop.
DON DUVALL: I will second that.
CHAIR RAJSKY: I think that's a motion second to develop a regionwide task force.
RON KINTZ: The word Southport was in the original motion.
MIKE SPRAGUE: Take that nasty word out of there.
BERNADETTE J-OAKES: But it's already passed.
CHAIR RAJSKY: Development of a regionwide task force?
DR. HUFFNER: How about we just say what we really mean on that first motion is that we're doing it for Southport but we are going to use it in lots of other places wherever we are going to use it. Is that what we mean? They brought it so we know what's going on. Shouldn't use the word Southport in the first motion. Bottom line is we want to take whatever program we develop and when we go to Southport we are not going to throw it away, we are going to use it in other places and that's really what the intention is. The same dog and pony show, we can take it up to Steuben County or Horseheads or wherever. And again I am really good at ideas but I am not good at making motions.
CHAIR RAJSKY: Are we okay with that, do we need to make another motion, or I think there is intent that we are going to use this regionwide. Does anybody feel uncomfortable?
DR. HUFFNER: I will make the motion that you know, we affirm the intent that we are going to use this program regionwide.
MARYANN SWEELY: Second.
CHAIR RAJSKY: Motion was made and seconded. Further discussion about it? Motion on the floor. Any discussion, seeing none, all those in favor signify by saying aye. Opposed? Abstentions? Carried. Awesome, great. Executive committee is done. State council. We did not meet. We meet later this month in the state capital. Tri-County critical incident stress management report, Maryann?
MARYANN SWEELY: This is the year end report for us, this team activity report November 1st through December 31st, in that time period we had a total of 13 debriefings, four defusings and six educational offerings. Our total team activity for the year is 116.
Now I do not have this up on overhead. And this report will go to Bob, does go to Bob, but just to give you an idea of where we started, we started in '92 and we had two activities, two debriefings, in '94 which is the third block here we had 26, and then let's jump up to the end of '97 which is this taller pyramid here, we had 92. The end of last year we had 94, next to the last, and this year 116. So we continue to rise.
Now I wouldn't want to say I am going to take, make an effort, I will, send out to the hospitals because I understand we have had a minor problem with one of the area hospitals not being able to get in touch with any debriefer. Again let me echo, Mike Smith knows where we are, Mike Sprague knows where we are, who we are, how to reach us. But I will send out communication again to hospitals. I will bring my brochures again. Call these gentlemen here, they know how to reach us, call Arnot Ogden, St. Joseph's and Corning Hospital. They know who to get there any time day or night. So I apologize if anyone has had any inconvenience. We certainly try to meet everyone's needs, and we will continue to do so. Thank you.
CHAIR RAJSKY: Thank you.
BERNADETTE J-OAKES: Can I add a comment towards recruitment retention. I think efforts of stress debriefing team I think they are probably one of the critical things we do for the paying members, the tremendous things they do and help us get through some of the stuff that we have to deal with.
MARYANN SWEELY: Thank you. STREMS has given us support as far as sending us to educational offerings so that we can keep abreast of the new things that are out there, new techniques and we really appreciate that and thanks STREMS.
BERNADETTE J-OAKES: One other comment I would like to thank Mike Smith on behalf of 911 and Chemung County for their timely notification of us last Saturday, we were able to get debriefers out to an on-site support type thing and did a defusing after a fire. And I think probably that wouldn't have come together as well had it not been for your dispatcher who pursued getting ahold of myself and we got together people to go out there. So thank you very much.
MIKE SMITH: You are welcome.
CHAIR RAJSKY: Other business to come before council this evening? I have maybe two items, actually the first I think Mr. Lewis talked about it earlier. The issue about restocking of EMS services through the hospital. We richly enjoy that one for one exchange currently and all the regional hospitals have been and are participating in that. Throughout the state and throughout the country it's haphazard, some hospitals have stopped, some are doing limited. All kinds of things. The thing I want to make sure that we realize that as long as all six of the Southern Tier hospitals stay strong and support that, I think that system will stay in place. If one hospital decides not to, then virtually by default all have to stop, because then it can be construed that one hospital is trying to coerce patients to go to that hospital because there is an exchange program in place.
So I encourage you as you interface with a hospital personnel, thank them, make sure they realize that importance of restocking. Because that virtually could wipe out our volunteer sector and will tremendously cripple even the professional services, the commercial services. So I just need to bring that up because that's, I think that's a huge huge issue.
The other issue is the notebooks. STREMS staff have put those together. Maybe Judy you want to go through what you assembled.
JUDY BLAIR: Nancy assembled it. Nancy did a tremendous job putting this all together. But Article 30, Part 800, Council Bylaws, policies, our deliverables from the state, membership lists with name, address, phone numbers, e-mails, we'll update that if anybody gives us any more information than is on there, committee description, a list of who's on what committee and a copy of the membership packet that we sent out if people are interested. We send them out a membership packet so they know what's going on, and the forms they, the application form they can fill out and send back in and a couple copies of our EMS brochure in the back.
There is plenty of room for you to add minutes and in the future when we send out the minutes to you they will be hole punched so you can stick them in there.
CHAIR RAJSKY: Thanks staff for assembling those.
ALAN LEWIS: Very nice job.
CHAIR RAJSKY: Anything else to come before council this evening? Seeing none, I will certainly entertain a motion for adjournment.
STEVE BENNETT: Motion.
CHAIR RAJSKY: Motion been made by Steve Bennet. Second.
MIKE SPRAGUE: Second.
CHAIR RAJSKY: All in favor? Opposed? Thank you everyone. Next meeting is February 8.
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