REVIEW AND APPROVAL OF MINUTES A. EMS Council - August 19, 2015 Meeting B. Ops Committee - Draft November 5, 2015 Meeting (Informational only)

THURSTON COUNTY MEDIC ONE EMERGENCY MEDICAL SERVICES COUNCIL EMERGENCY SERVICES CENTER/EOC AGENDA November 18, 2015, 3:30 PM I. CALL TO ORDER/ROLL CALL II. APPROVAL OF AGENDA III. PUBLIC PARTICIPATION - IV. REVIEW AND APPROVAL OF MINUTES A. EMS Council - August 19, 2015 Meeting B. Ops Committee - Draft November 5, 2015 Meeting (Informational only) V. COMMITTEE REPORTS A. Operations Committee Ops Chair or Representative B. West Region EMS Council WREMS Representative C. Staff Report Hambly VI. OLD BUSINESS ITEM PRESENTER EXPECTED OUTCOME A. TRPC Kirkbride Updae B. OLD BUSINESS - ISSUES & ACTIONS PENDING VII. NEW BUSINESS A. ITEM PRESENTER EXPECTED OUTCOME Brown/Fell Scholarship Application (Tristian Mundwiler) Hambly Discussion B. WREMS Appointment (Pace, Kathy) McPhee Discussion C. D. VIII. PUBLIC PARTICIPATION IX. GOOD OF THE ORDER X. ADJOURNMENT K:\Administration\Committees\EMS Council\EMSC Meetings\2015\Agendas\11 November 18, 2015 Agenda.doc

Thurston County Medic One Emergency Medical Services Council Regular Meeting Emergency Operations Center/ECC August 19, 2015 PRESENT: EXCUSED: ABSENT: GUESTS: STAFF: Greg Wright, Rena Merithew, Frank Kirkbride, Dr. Tom Fell, John Christiansen, Rich Gleckler, Roger McMaster, Margaret McPhee, Eileen Swarthout, John Ricks, Bud Blake Russ Hendrickson Lenny Greenstein, Dr. Larry Fontanilla Terry Ware, Meredith Hutchins, Anthony Kuzma, Steve Brooks, Darlyne Reiter Steve Romines, Cindy Hambly, Fay Flanery, Catherine Griffin, Alan Provencher I. CALL TO ORDER/ROLL CALL C hair McPhee called the regular meeting of the Emergency Medical Services Council (EMSC) to order at 3:30 PM. Roll was recorded by staff. II. III. IV. APPROVAL OF AGENDA MSC (Ricks/Kirkbride) moved to approve agenda as presented. PUBLIC PARTICIPATION None REVIEW AND APPROVAL OF MINUTES A. EMS COUNCIL June 17th, 2015 MSC (Kirkbride/Ricks) move to approve as published. B. OPERATIONS COMMITTEE August 6, 2015 MEETING CANCELED (Informational Only). V. COMMITTEE REPORTS A. OPERATIONS COMMITTEE Wright reported the Operations Committee did not meet in August. Next meeting is September 3, 2015. B. WEST REGION EMS COUNCIL Hambly stated the conference is a go but WREMS continues to seek additional grants. It will be held at Ocean Shores on February 26 th, 27 th and 28 th, 2016. C. STAFF REPORT Romines attended and provided a update on his current medical condition. Included with packet, Romines highlighted on: JEMS survey 750 cities annually and Thurston County was number 8 out of 100 as a top area for EMS providers. TRPCs scope of work has been approved and the contract will be signed so they can move forward. CPR program continues to be successful and the coordinator will be putting up a Facebook site. Protocol Update and agency training has taken place. Still working on updating and processing the electronic application. Medic Hiring Exam: Chief s and MPDs have worked out a process to include Public Safety Testing. After submitting applications and testing through the PST website, the top 24 candidates will move forward for a protocol exam and oral boards. WHEERS Radio (Washington Hospital EMS Emergency Radio System) Radio system that can reach SPH from any ALS unit in the region: DOH threatening to discontinue because of other funding priorities. Impact: we will need to recalibrate our local and regional MCI plan. Romines anticipates there will be a cost shift to hospitals and EMS agencies to maintain as DOH may be charging a fee for usage of this communications system. BLS data system Still in progress. All agencies (OFD expected online 10/01/2015) currently using program. McLane and Tumwater FDs are beta testing the QA/QI portion of the program. Medical supply inventory system is close to completion. It will be an on-line cloud based system. FD3 and Tumwater are piloting the program. All FD s should be online by October 2015. Fall EMT class: 24 applications received, 2 failed pre-tests and 1 self-dropped. 21 will be starting the class. VI. OLD BUSINESS A. 2016 Budget After review and discussion of the completed 2016 budget is was moved to accept and present to BOCC. MSC (Kirkbride/Ricks) Thurston County Commissioner Blake abstained. VII. NEW BUSINESS A. None k:\administration\committees\ems council\emsc meetings\2015\minutes\8-emsc minutes august 19 2015.docx Page 1 of 2

VIII. IX. PUBLIC PARTICIPATION None. GOOD OF THE ORDER Letter of Appreciation from Panorama City concerning Lacey FD3 EMS responders. McPhee represented Romines in the Tumwater City parade. McPhee has photos of an air-tanker dropping fire retardant on the Washington State Omak fire. Contact her if you are interested in receiving copies. Romines recognized everyone for their constant support and handed out Stand up to Cancer and Pancreatic Cancer bracelets for EMSC attendees. X. ADJOURNMENT Meeting adjourned at 4:32 PM. k:\administration\committees\ems council\emsc meetings\2015\minutes\8-emsc minutes august 19 2015.docx Page 2 of 2

THURSTON COUNTY MEDIC ONE OPERATIONS COMMITTEE ~ MEETING MINUTES EMERGENCY SERVICES CENTER November 05, 2015 PRESENT: Greg Wright, Brian VanCamp, Steve Brooks, Keith Flewelling, Terry Ware, Scott LaVielle, Dr. Larry Fontanilla, Dr. Bill Hurley, Stewart Mason, Dave Pearsall, Kathy Pace, Mark Gregory ABSENT: None EXCUSED: Jody Halsey, Alex Christiansen, Jim Fowler GUESTS: STAFF: Tony Kuzma, Wade Glenn, Byron Hamilton, Cindy Hambly, Catherine Griffin, Fay Flanery, Pete Suver, Alan Provencher I. CALL TO ORDER/ROLL CALL Chair Wright called the regular meeting of the Operations Committee to order at 2:03 PM. Roll was recorded by staff. II. III. IV. APPROVAL OF AGENDA MSC (Brooks/LaVielle) As amended. EMS training first in New Business; Remove TRPC and add GEMT. PUBLIC PARTICIPATION None. REVIEW AND APPROVAL OF MINUTES 1. Operations Committee October 1, 2015 MSC (LaVielle/Brooks) moved to approve. 2. EMS Council Draft August 19, 2015 Mtg. (Informational Only 10/16/2015 Meeting Canceled) V. COMMITTEE REPORTS A. WEST REGION Conference will be held 02/26 thru 02/28/2016 at Ocean Shores WA. B. SUBCOMMITTES 1. West Region EMS (WREM) Conference is February 26, 27 & 28 at Ocean Shores, WA. Meeting scheduled for November 10 th to finalize the conference. 2. Equipment Committee (EqC) No Report. 3. Mass Casualty Incident (MCI) Committee No Report. 4. Training Advisory Committee (TAC) Updated BLS protocols have been submitted to the vendor for the phone application. Anticipated it will be pushed out November 14 th. ALS protocol review/changes are still underway. Waiting to hear from King County EMS Online concerning requested administrative issues/changes. OTEP Cardiac arrest reviews and potential changes in requirements will be discussed with the MPD. Requested suggestions for future TAC projects. The majority of the Chief s concerns have been resolved. Medic One is working on getting the protocol & practice test online. Also timely notification of those that have passed/failed and areas of study. Epinephrine pens at $90K per year is becoming cost prohibitive. Other delivery systems will be researched. Instructor/Evaluator workshop is being held January 30/31, 2016. C. MEDIC ONE OFFICE UPDATE Director Romines may be returning around the end of November 2015. Current staff continues to fill in and cover other duties/positions. D. STAFF REPORT Staff report was included in the packet. Hambly highlighted the following: TRPC Brewster met with the Fire Chief s Association on 10/28/2015. BLS Protocol Update Hambly will email fire chief s when the phone application is rolled out. 2016 Budget Waiting for final approval after the public has commented. Paramedic Hiring Process Suver stated he is using Public Safety Testing. BLS Data System/SafetyPad Suver reported they have met with FD3 and WTRFA to discuss various issues and future requests. They continued to work on configuration, development and hardware issues. FDs will have QA/QI capability using the caseflow option. 4b draft ops november minutes 2015.doc

Inventory System Provencher reported the back end of the system is in place. One third of the departments downloaded and now have access to the program. They are testing orders that have been submitted through the web based program. A training session for end users should take place in the next couple of weeks. EMS Training Videos TFD, OFD and FD3 utilized a portion of their BLS budget to pay for a professional videographer. In addition, the departments donated the EMS provider s time/hours who participated in the making of these training videos. Here is the link to view those videos: https://vimeo.com/user32150889/videos EMT Class 2015-2 - We had 24 original applicants, (2 failed pretest, 2 self-dropped, 1 failed) 19 EMT candidates left. It is anticipated all will graduate. VI. OLD BUSINESS A. Special Projects Application Updated changes presented and reviewed. MSC (LaVielle/Brooks) move to approve. VII. NEW BUSINESS A. EMS Training Videos Glenn provided an overview of the process in the making of these 12 training videos. It was estimated that approximately 413 hours (OFD, FD3, TFD, individual participants hours) have been spent in their creation. These training videos demonstrate how a skill is performed and created to provide consistency. Glenn narrated and provided explanations thoughout a few videos. Per Hambly, these training videos can be freely accessed and used by anyone as they are not copyrighted. B. GEMT (Ground Emergency Medical Transport) Hosted by Fire Chief Central Pierce Fire & Rescue Keith Wright (lead for Washington State Chief s Assoication) and AP Triton LLC (consulting company). (Brooks, VanCamp, Gregory, Suver and Wright participated.) This is a program that may offset lost revenue from Medicaid patients that are currently being supplemented by the local taxpayers. Early public relations predicts $100 million statewide for fire service and $20 million for State of Washington. Inclusion of the pre-hospital provider(s) was signed by the governor this last April 2015. The State Plan (SP) allows for an amendment to be created and what pre-hospital dollars might be eligible to collect. There are guidelines such as you must: be a governmental (taxing) entity, enrolled as a Medicaid provider and bill consistently for services (those currently billing for ambulance transport services have an advantage but GEMT will only pay a percentage of the loss). Currently prehospital Medicaid care is not reimbursed and in order to determine reimbursement potential, a cost/loss analysis will need to be prepared. C. TRU Committee (Transport Resource Utilization) Chief Brooks provided an overview of the the October 19 th meeting. Initial CAD data was reviewed and they are requesting further data be supplied for a better picture of our BLS transport system (availability, utilization, cancellations, personnel training needs, etc.). Brooks continues to encourage all those interested and/or have a vested interest in the outcome. Next meeting scheduled for 11/16/2015, 2:30pm at 2703 Pacific Ave SE, Olympia for those who are interested in attending. D. Ambulance License Narrative Prior to the merger of South Bay Fire Department, FD7 had an ambulance license. Per VanCamp DOH indicated this license should be absorbed by FD8. Three months later FD8 was told if they wish to retain that amblunace license, they would need to re-apply. VanCamp submitted a narrative and application to the Ops Committee for review, comments and to make a determination if this license should remain with FD8. This is not a new license request, it is a only the transfer of a license per VanCamp. VIII. GOOD OF THE ORDER Wright askede where law enforcement stood with acquiring defibrillators for their units. Law Enforcement Vehicles & PADs will be placed on the next agenda for discussion. IX. ADJOURNMENT - 3:40 PM 4b draft ops november minutes 2015.doc Page 2 of 2

Thurston County EMS Council Medic One/EMS, Staff Report, November 2015 EMS System Operational Review, TRPC as Process Project Manager, proposed at July meeting, recommending contract to BOCC. Signed by BOCC September 25, TRPC initiating, last session 12/19, contacting Chiefs/Com, Report 6/19 EMS Council meeting 3:30, presented, to EMS community for comment. Presentations: EMSC 6/19, Fire Commissioner/Chiefs Assoc 7/16, BOCC 8/7 (Medic One website, System Reports), comments due, EMS Council accepts 9/18, to BOCC, Steering Committee (expanded) working, EMSC agenda/minutes recommendation 4.4 approved to staff on website; Governance recommendation 4.3.1 approved by BOCC. BOCC appoints new/vacant EMSC Citizen members (Dr Tom Fell, countywide MD rep, Rena Merithew BOCC 1 rep). Steering Committee report to EMS Council, projects prioritized at July meeting, reviewed at September meeting, approved work plan at Jan 21, to Business Plan. TRPC reviewing priority project list for proposal. Medic One staff and TRPC met with Fire Chiefs Assoc May 29. TRPC Scope of Work approved by EMS Council. Medic One has established a separate contract with TRPC. Paul Brewster will hopefully met with Fire Chief Association in November 2015. Citizen CPR Program 6 month review: Total Number of Classes: 114 (approx. 5 per week), Citizens Trained: 1,254 (average 11 students per class), Compression Only Classes: 75 (907 citizens trained), AHA CPR Classes: 39 (347 citizens trained). CPR Outreach: CPR Outreach Coordinator is working on a Facebook Site for Thurston County CPR Training (completion date September). Ebola planning, 9-1-1 screening protocol, supplemental PPE received (completed), PPE protocol developed, training being prepared, response plan being developed Protocol update processing to agencies, app update to follow. Update classes scheduled, required EMS attendance. All BLS protocol update classes are complete (43 classes from March through June). EMS protocol update (BLS) complete. Phone Applications updated. 2015 Budget drafted by staff and budget committee, presenting to EMSC, 7/16 meeting, Status quo budget being recommended, targeting zero increase, EMS Council recommends $1,000 per agency enhancement, to BOCC, rejected, Fire Commissioners Assoc to request reconsideration at budget hearing, approved to add $1,000 base/agency financial. 2014 Business plan Q2 report on website. Website updated for plan, agendas, minutes, bylaws, members, completed. 2015 Levy Rate = $0.3709/$1,000; $9,958,158.20 (2014 = $0.3855/$1,000; $9,738,937.35) EMS Council approved budget August 19, 2015, presented to BOCC September 24 th. Waiting final approval BOCC approval of budget. Medic Hiring and Oral Exams: Completed May 4-5 2015 exam, 15 aps, 1 protocol review attendee, 3 pass written, 2 passed oral, 4 on list from May exam. One additional PM candidate added (quit Lacey FD) to bring a total of 5 candidates on the eligibility list. Medic hiring in October will utilize Public Safety Testing (PST). Prior to October 15 th the PM candidates will take a general knowledge exam through the PST website. PST will collect all the candidate information. Medic One selected 28 candidates to go forward. TC Applications due November 9, ( received 10 completed applications). Written exam November 16 th, and Oral Board November 17 and 18. NurseLine Criteria Based Dispatch Program, started December 11, 8AM, calls routed to Evergreen Hospital Healthline, contract completed, implemented: 15 in August 2003, 14 September, 15 October, 15 November, 16 December, 11 January 2004, 13 February, 11 March, 8 April, 11 May, 7 June, 11 July, 8 Aug, 12 Sept, 8 Oct, 8 Nov, 13 Dec, 11 Jan 2005, 13 Feb, 12 Mar, 10 Apr, 11 May, 10 June; 11 July; 6 Aug; 4 Sept; 9 Oct; 5 Nov; 12 Dec; 14 Jan 2006; 11 Feb; 4 Mar; 14 Apr; 4 May; 9 June; 9 July; 11 Aug; 8 Sep; 7 Oct; 15 Nov; 6 Dec; 10 Jan; 12 Feb; 13 Mar; 7 Apr; 20 May; 15 June; 18 July; 10 Aug; 13 Sept; 8 Oct; 15 Nov; 11 Dec; Jan 08 11, 15 Feb, 10 Mar, 12 Apr, 14 May, 11 June, 14 July, 15 Aug; 22 Sept; 11 Oct; 14 Nov; 7 Dec. 5 Jan 09, 7 Feb, 6 Mar, 17 Apr, 7 May; 10 Jun; 17 Jul; 7 Aug; 10 Sep; 11 Oct; 15 Nov; 14 Dec; 11 Jan 2010; 7 Feb; 14 Mar; 10 Apr; 10 May, 16 Jun, 21 Jul, 18 Aug, 23 Sep, 14 Oct, 10 Nov, 16 Dec; 11 Jan 2011, Feb 15, Mar 24, Apr 19, May 20, Jun 10, July 21, Aug 14, Sep 17, Oct 15, Nov 10, Dec 21; 12 Jan 23, Feb 16, Mar 17, Apr 18, May 19, Jun 14, Jul 9 Aug 25, Sep 16, Oct 13, Nov 14, Dec 16; Jan 13, Feb 9, Mar 9, Apr 14, May 5, June 14, July 10, Aug 12, Sep 11, Oct 27, Nov 17, Dec 12; 14 Jan 16, Feb 11, Mar 13, Apr 9, May 14, Jun 17, Jul 16, Aug 10, Sep 10, Oct 19, Nov 4, Dec 13; 15 Jan 19, Feb 15, Mar 7, Apr 2, Total to date= 1,784/140 (avg 12.8/month) Rate increase to $17.40 from $17.05/call allowed by contract medical CPI (line fee is same $100/month) WHEERS (Washington Hospital and EMS Emergency Radio System): DOH has discontinued the lease contract with WSP for the WHEERS repeaters as of June 30, 2015. WSP has given the stake holders until December 31, 2015 to organize an alternative to fund and manage the WHEERS system. WREMS is reaching to all the hospitals that are DMCC (disaster medical control centers) in the State to solicit their partnership in maintaining the WHEERS system. EMS Data 2013 (TCOMM source), 28,630 system call volume +2,060 calls, +7.7% (2013 data volume 26,570). ALS response time 7.0 minutes average countywide, 94% goals achieved, call volume 8,622, +295 calls, responses +3.5% (2013 response time 7.6 minutes, 94% of goals, 8,327responses). BLS call volume 20,008, +1,765, +9.7% (2013 18,243) Countywide BLS average response time 6.6 minutes, all BLS. BLS TCOMM Data Warehouse report, draft data to Operations Committee for review. EMS Data 2014 report will be presented to EMS Council on June 17th

BLS data system: All Fire Departments and Olympic Ambulance have completed SafetyPad training. Starting October 1 st all departments online. Staff is working with SafetyPad to implement Case Flow. This is a module for QA/QI. This can be used at agency level or county level, option for all departments to trial. WATRAC Advisory Group member added, meeting 9/9, planning sessions next 5/16, next regular meeting 6/1 Inventory System: Online product will enable fire departments to order medical supplies online. Pilot under way with Tumwater Fire Department. Majority of the fire departments online by December 31st. TRAINING: average pass rate NR EMT exam = national 79%, WA state 85%, WR 90%, CR 93%, TC 95% First Responder Course, none held. NREMT will increase fees in 2017 ($80 EMT, $125 PM). Effective immediately NREMT Authorization to Test (ATT) will be valid for 90 days from the date of issuance. Candidates who do not complete their cognitive examination prior to expiration date will be required to complete a new application, including payment of the application fee. EMS Training videos are complete. Production was combined effort from Tumwater, Olympia FD, Lacey FD and Medic One. They utilized their BLS funds to pay for the videographer. Wade Glenn, PM SEI Olympia FD was the lead coordinator for the project. The agencies utilized their personnel to demonstrate the skills. Everyone can access the training videos through the Medic One website under EMS Resources. EMT Course 15-2: 24 applications received. 2 failed pre-test, 1 self-dropped. Course began with 21 EMT candidates. One candidate has dropped since beginning of class, 1 fail, 19 EMT candidates currently. NIMS online training available at http://training.fema.gov/emiweb/is/is700.asp J:\My Documents J\stfrp0615.ops.j.docx