ADIRONDACK-APPALACHIAN
REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL
2920 State Route 30
PO Box 212
Speculator, New York 12164
Telephone (518) 548-3535 * 1-800-952-7367 - FAX Phone (518) 548-7605
e-mail:
www.aarems.org
AAREMS REMAC MEETING
Thursday, May 19, 2016
Holiday Inn, Johnstown, NY 12095
[Approved Motions are shown in bold face]
MINUTES
MEMBERS OF REMAC AND STAFF ATTENDING:
Sidney Chase, Patricia Green, RN David Markowitz, MD
William Fisher, MD Thomas Isenovski, MD Philip Mulleedy
Deborah Funk-Valois, MD Lewis Jones, RN Thomas Pasquarelli
MEMBERS OF REMAC AND STAFF ABSENT AND EXCUSED:
August Leinhart, MD Joyce Mulleedy, RN
MEMBERS OF COUNCIL AND GUESTS PRESENT:
Tony Agresta Howard Huth Mary Ramo
Chuck Barringer Richard Kersmanc Dean Romano
Bill Beevers Richard Knapp Michael Swartz
Edward Brandt Deborah Kufs, RN Roy Sweet
Jill Dunham Ben Louch Avis Warner, RN
Jack Farquhar Joseph Luz, MD Margaret Wilson
Joseph Farrell John MacMillan Margaret Zeek
Tim Foster Beth McGown Mark Zeek
Ryan Hejnal
*
The meeting was called to order at 10:40 AM by Dr. Fisher, acting in the excused absence of Chairman Dr. Leinhart. A voting quorum was present.
APPROVAL OF MINUTES OF THE MAY 19, 2016 MEETING
All members had received the May 19, 2016 Minutes in a timely fashion by email. They were published on the Regional web site and copies were also available today for all wishing to review them. Motion was made by Dr. Funk-Valois and seconded by Dr. Markowitz, as follows:
RESOLVED, that the Minutes of the May 19, 2016 meeting are approved as written.
This was adopted unanimously, with no abstentions.
NEW BUSINESS
Jefferson Rescue Squad Submits Approved Controlled Substances Operational Plan on July 05 - Informational
It was noted that the Jefferson Rescue Squad has submitted a copy of their approved controlled substances operational plan for informational purposes.
Updated List of AAREMS Controlled Substance Agencies Presented to DOH on July 28 - Informational
It was reported that a new listing of EMS controlled substance licensees in AAREMS was presented to Mary Ramo on July 28. Ms. Ramo also spoke to this briefly and advised that a number of agencies statewide were in process of obtaining these licenses in accordance with DOH regulations. Those that do not wish obtain this license have the option of returning to providing a BLS level of care.
Letter Received September 02 from ALSFR Agency about Exemption from CS Licensing – Discussion by Mr. Farrell and Ms. Ramo
Mr. Mulleedy reported that a letter received on September 02 from an ALSFR agency asked the question whether they could drop to providing service at the AEMT level and not come under DOH regulations regarding the necessity of obtaining a controlled substance license. The discussion that followed was led by Mr. Farrell and Ms. Ramo, and noted that currently there is no definitive classification from DOH as to whether an AEMT level of care can be considered ALS or ILS. A timely decision is expected from DOH on this, since there are many ramifications, including billing issues.
Springfield Seeks Approval for BLS Narcan Use
The Springfield Fire Department ALS First Responder Unit has requested approval for BLS Narcan use, and their paperwork is in order. Motion was made by Dr. Fisher and seconded by Dr. Isenovski, as follows:
RESOLVED, that the Springfield Fire Department ALS First Responder Unit is approved to begin the use of BLS Narcan.
This was adopted unanimously, with no abstentions.
Schoharie County Critical Care Team Seeks Confirmation of New Agency Medical Director – Dr. Joseph Luz
The Schoharie County Critical Care Team is seeking approval of Dr. Joseph Luz as their new agency medical director. Their paperwork is in order, and Dr. Luz is present. It was noted that Dr. Luz is currently the agency medical director for several other agencies in this Region (Jefferson, Scho-Wright and Middleburgh) Motion was made by Dr. Markowitz, and seconded by Dr. Isenovski, as follows:
RESOLVED, that Dr. Joseph Luz is approved as agency medical director for the Schoharie County Critical Care Team.
This was adopted unanimously, with no abstentions.
Use of On-Site Scoring Results Not Permitted for TEK Credentialing – Email Received from DOH on September 02 – Informational
Mr. Mulleedy reported that an email received from Mr. Johnson at DOH on September 02 clearly stated that on-site scoring results were not to be considered in the issuing of TEK credentialing. Mr. Pasquarelli advised that he had sidebar discussions on this subject during the SEMSCO meetings, and that Mr. Clayton had stated that this scoring could indeed be used for TEK credentialing. Lee Burns also concurred. Since there is an obvious discrepancy on opinions being given by DOH personnel, it is expected that a definitive written reply will be received in a timely manner. There was considerable discussion on this which developed into discussion on the advisability of having an agency medical director signature provided on every application for a regional TEK number. Mr. Romano of REMO spoke to this also, as regards REMO policy in their region. At the end of discussion Mr. Pasquarelli proposed a resolution of adopting on-site scoring results for credentialing purposes, pending a written opinion from Ms. Burns, and further proposed that an agency medical director signature be required on the regional application for a TEK number, and then subsequently for every other agency in the region in which the TEK applicant also seeks membership.
Motion was made by Dr. Funk-Valois, and seconded by Dr. Isenovski, as follows:
RESOLVED, that Department of Health EMS certification examination on-site scoring results shall be used in granting a TEK number for an applicant to AAREMS for such a number, and that this shall take effect following confirmation in writing of this use of on-site scoring from the Department of Health EMS Bureau.
This was adopted unanimously, with no abstentions.
Motion was then made by Dr. Funk-Valois, and seconded by Dr. Isenovski, as follows:
RESOLVED, that the AAREMS application form for a regional TEK number shall be amended to show the applicant’s agency medical director signature for the agency in AAREMS for which the applicant seeks primary membership, and there be an added requirement that the applicant submits this form for each additional agency in which membership is desired, although the credentialing requirements for TEK number issuance shall only be required for the primary agency.
This was adopted unanimously, with no abstentions.
Update on Status of AAREMS BLSFR Agency Recertifications – Mr. Farrell
Mr. Farrell advised that such paperwork is now virtually up to date in this region.
Update on Agency Compliance with DOH Recertification and/or Inspection Requests – Mr. Farrell
Mr. Farrell advised that there is now good compliance, with one agency in the process of submitting a plan of correction because of late recertification paperwork submission.
Some Regional Statistics taken from ePCR Uploads to the State EMS Bridge, as Requested by Dr. Markowitz on September 08 – Informational plus Discussion
Dr. Markowitz on September 08 requested that some statistics from the State EMS Bridge on the use of CPAP as well as the use of aspirin in response to the clinical presentation of chest pain be made available if possible, from uploaded ePCRs from this Region. Mr. Mulleedy provided those numbers to him by email at that time, and recounted them here as well. In 2015, there were 428 uses of CPAP recorded in AAREMS from ePCR uploads, all from ALS agencies. In 2016, as of September 08, 271 uses were recorded, again all from ALS agencies. As regards the use of aspirin for chest pain treatment, the total in 2015 was 360, with only 3 from a BLS agency. In 2016 as of September 08, the total is 961, a significant increase, and all recorded from ALS agencies. Only 4 BLS agencies are active in the AAREMS ePCR system at present out of a total of 28 agencies uploading to the State Bridge from AAREMS. There are 66 transporting agencies in AAREMS, of which 22 are BLS. Dr. Funk-Valois noted that it is possible that in some instances CPAP and/or aspirin might be administered by a BLS provider in a given ALS agency. It would be necessary to examine the individual ePCR to determine this. Mr. Mulleedy noted also that paper PCRs receive a general screening, but are not screened for any particular modalities due to the lack of staff time for this.
Mr. Hillenbrand requests Consideration of Two Protocol Items - Discussion
Mr. Hillenbrand was not present, so this item could not be considered.
Correspondence
No correspondence has been received that necessitates an executive session.
New Business/Old Business
There was no old business or new business brought before the meeting.
ADJOURNMENT
Adjournment was at 11:15 AM, on Motion of Dr. Fisher.
The next scheduled REMAC meeting will be held at the Holiday Inn in Johnstown on Thursday, November 17, 2016 at 10:30 AM, with an AAREMS meeting to follow at the same location on that date at 1:00 PM.
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AAREMS REMAC Minutes for September 15, 2016 Page 5