MINUTES NORTH CAROLINA OFFICE OF EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL

MINUTES NORTH CAROLINA OFFICE OF EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL Injury Committee Department of Health and Human Services Division of Health Service Regulation Office of Emergency Medical Services Members Present Mr. F. Wayne Ashworth, Chairman Dr. William K. Atkinson Mr. Bob Bailey Ms. Kathy Dutton Dr. Steven Landau Mr. Tony Seamon, Jr. Dr. Tripp Winslow McKimmon Center 1101 Gorman Street November 9, 2010 9:30 a.m. Others Present Mr. Dale Hill Mr. Keith Hill Mr. Gordon Joyner Dr. Henry Kornegay, Jr. Ms. Gail Kluttz Ms. Tracy McPherson Mr. Chuck Owens Ms. Sabrina Walter Members Absent Dr. Michael Chang Dr. Russell Howerton Mr. Carl McKnight Dr. Donna Moro-Sutherland Dr. Brent Myers Staff Members Present Ms. Shelley Carraway Ms. Barbara Chorney Mr. Joe Comello Ms. McKenzie Cook Ms. Gloria Hale Ms. Brenda Harrington Ms. Nadine Pfeiffer Ms. Mary Beth Skarote Dr. Mike Thomason

(1) Purpose of the Meeting: The Committee met to receive an update on the EMS for Children (EMSC) program as well as to receive information on the updated Trauma Rules and Gaston Memorial Hospital s initial Level III designation process. (2) Actions of the Committee: Mr. Ashworth called the meeting to order at 9:32 a.m. (a) Motion was made by Mr. Bailey, seconded by Dr. Landau and approved that: RESOLVED: The Injury Committee minutes of the May 11, 2010, meeting be approved. (b) Motion was made by Mr. Bailey, seconded by Mr. Seamon and approved that: RESOLVED: The Office of Emergency Medical Services prepare a template to specify the process for hospitals seeking trauma designation and those who seek to participate in the trauma system while retaining no designation. Explanation: Dr. Atkinson commented that while we are encouraging other hospitals to seek a trauma center designation it is up to the State to safeguard the citizens and visitors to the State that they are receiving optimal traumatic care. The committee noted that a time frame for a practicing level designation should be put in place to ensure that the State will hold the hospital accountable for completing the initial trauma designation. Other Actions of the Committee: (a) (b) (c) Ms. Gloria Hale provided an update on the EMS for Children (EMSC) program. Work has begun with Department of Administration, Agency for Public Telecommunications, to develop online training for EMS on proper restraint of children in ambulances. KIDBase: Two additional county EMS Systems and one additional hospital are now on board with the KIDBase program: Forsyth and Stokes County EMS and Forsyth Memorial Hospital; one more county EMS System, Catawba, is expected to be on board by the end of October 2011. Ms. Hale completed her term as Chair of the Pediatric Emergency Care Council with NASEMSO, but will remain active as a Steering Committee Member as Immediate Past Chair for the next two years. Katrina Altenhofen, EMSC Program Manager of Iowa, will be the new chair. Ms Nadine Pfeiffer updated the committee on the Medical Care Commission Rules. The chemical dependency rule was adopted by the Rules Commission and was effective October 1, 2010. OEMS has been working with the Board of Nursing to get the program started by January 1, 2011. The trauma rule and trauma systems rules are still waiting on department approval and a public hearing. Ms. Nadine Pfeiffer updated the committee on Gaston Memorial Hospital seeking a Level III Trauma Designation, which started November 1, 2010. The Office asked Gaston Memorial Hospital to submit part of their RFP to see what kind of policy and procedure they had in place to make sure they would be trauma center eligible. Since Gaston Memorial Hospital was not submitting data the Office required a month of submission and Gaston would be 2

elevated to a Practicing Trauma Center. Discussion among the members recommended that the Office come up with a set of guidelines for all future hospitals seeking a trauma center designation that may fall into the same category as Gaston Memorial Hospital. With no further business, the meeting was adjourned at 10:17 a.m. Minutes submitted by McKenzie Cook. 3

MINUTES NORTH CAROLINA EMERGENCY MEDICAL SERVICES FOR CHILDREN ADVISORY COMMITTEE Members present via conference call Mr. David Cuddeback Dr. Cheryl Jackson Dr. Jessica Katznelson Dr. Gerri Mattson Dr. Donna Moro-Sutherland Ms. Muriel Overman Mr. Myron Waddell Staff present: Ms. Gloria Hale Ms. Nadine Pfeiffer Department of Health and Human Services Division of Health Service Regulation Office of Emergency Medical Services Dorothea Dix Campus Wright Bldg., Room 134 Raleigh, North Carolina November 15, 2010 1:30pm (1) Purpose of the Meeting To provide an update on initiatives of the EMSC Program and discuss ideas for addressing needs in EMSC. (2) Actions of the Committee (a) Ms. Gloria Hale opened the meeting with introductions and Dr. Donna Sutherland chaired the meeting in the absence of Dr. Kim Askew. The meeting minutes from May 11, 2010 were approved with Dr. Cheryl Jackson making a motion and Mr. Myron Waddell seconding it. Next, Mr. David Cuddeback made a motion to approve the August 10, 2010 minutes and Dr. Cheryl Jackson seconded it. These were approved as well. (3) Announcements (a) Ms. Gloria Hale announced that the federal Commission on Children and Disasters issued its final report which contains several recommendations for preparedness, recovery, and response at various levels. Interest in the report was expressed by Dr. Roy Alson, OEMS Medical Director for Disaster Preparedness, in communications with Ms. Gloria Hale. A workgroup may be convened in the coming months to assess the state s disaster preparedness efforts for children. Advisory committee members expressed an interest in having a representative on this workgroup. In addition, it was suggested that a

2 RAC Coordinator participate to bring a regional focus to the discussion. Ms. Gloria Hale will e-mail a copy of the report to the EMSC listserv and solicit any suggestions on how the state should proceed in addressing any of the recommendations. (b) OEMS and the state Agency for Public Telecommunications recently signed a Memorandum of Agreement to develop an online video-based training on properly restraining children in ambulances. Members discussed the importance of making all county EMS systems aware of the training and suggesting that it be required for continuing education. Committee members requested review/input on the content of the training. Mr. Myron Waddell offered to review Indiana University s DVD training on transporting children safely in an ambulance to inform the OEMS project. He will forward any comments to Ms. Gloria Hale. (c) The national Rural Trauma Team Development Course is being revised and will include pediatric considerations. Ms. Gloria Hale will find out more details, including whether there will be a comment period. (4) Old Business (a) Emergency Guidelines for Schools the State Department of Public Instruction has requested that we look for ways to decrease the cost of reproducing this document. A black and white version was discussed as well as simply increasing awareness of the availability of the electronic copy that is posted online. Ms. Muriel Overman and Ms. Gloria Hale commented that demand for additional hard copies was high. Dr. Gerri Mattson will ask the State School Nurse Consultant, Ms. Jessica Gerdes, if she can determine what schools need. Ms. Hale she will obtain cost estimates from DPI on a couple different versions of the document. (b) Emergency Department Preparedness for Pediatric Care Dr. Cheryl Jackson reported that the workgroup met recently via GoTo Mtg. to make final revisions to the survey tool. A test of the Department s survey software will be done in the next few days. After a pilot test is done at a few hospitals, the survey should be ready to be launched statewide within two months. (c) Children with Special Health Care Needs Dr. Donna Sutherland has spoken with Dr. Tripp Winslow, Chair of the Pre-hospital Care Committee of the North Carolina College of Emergency Physicians, to request the inclusion of special needs protocols in the organization s current review and revision of all state EMS protocols, procedures, and standards. Duplin County s special needs protocols for children have been submitted to Dr. Winslow. However additional protocols to address all of the special needs identified in the guidelines currently included in the Other References section of the NCCEP EMS Standards will be sought to be included, even if they address both adult and pediatric special needs. Dr. Donna Sutherland will spearhead this project and serve as the liaison with NCCEP. (d) EMSC Grant Activities Update KIDBase is now active in 3 additional counties: Forsyth, Stokes, and Catawba. Three ENPC Provider courses and one ENPC Instructor

3 Course will take place across the state during the remainder of this grant year. The EMSC Performance Measure survey on pediatric inter-facility transfer policies and agreements was launched. Hospital emergency department responses are still being received. The EMSC Performance Measure survey on pediatric equipment and supplies will be launched soon to EMS systems through the EMS Performance Improvement Center. Ms. Gloria Hale continues to meet with RAC Coordinators and present at RAC meetings to encourage the adoption of transfer policies and agreements by all hospitals. (5) New Business: (a) NC EMS Standards/Policies Revisions: Dr. Donna Sutherland will take the lead on reviewing all of the standards that are pertinent to pediatric pre-hospital care. She will serve as the liaison with NCCEP and share any proposed revisions with EMSC Advisory Committee members for comment. (b) Pediatric Project with Critical Access Hospitals Dr. Jessica Katznelson requested to table this discussion at this time. (c) KIDBase and the NC Hemophilia Association - Discussion was tabled since the new EMSC family representative, Tiffany Holland, was not able to attend. (6) Other Business (a) Discussion was held on whether to have face-to-face meetings or conduct them via conference call and GoTo Mtg. when necessary. Ms. Gloria Hale indicated that there had been a federal EMSC program expectation that at least half of an EMSC Advisory Committee s meetings be held face-to-face. The majority expressed a desire to hold the quarterly meetings by conference call to potentially allow for more participation and encourage participation from more distant areas of the state. It was decided that the next meeting will be held via conference call. Potential dates for the next meeting were discussed. Ms. Gloria Hale will check with the Chair, Dr. Kim Askew, to determine his availability in February 2011. A confirmed date for the next meeting will be sent out via the EMSC listserv. The meeting adjourned at 3:05pm.

MINUTES NORTH CAROLINA OFFICE OF EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL Compliance and Education Committee Department of Health and Human Services Division of Health Service Regulation Office of Emergency Medical Services Jane S. McKimmon Center Raleigh, North Carolina November 9, 2010 9:30 a.m. Members Present Mr. Terry Barber Dr. Thomas Blackwell Ms. Carolyn Hughes Mr. R. Keith Lovin Mr. Robert Poe Ms. Susan Safran, Chair Mr. Dennis Taylor Mr. Stephen Taylor Others Present Mr. Jim Albright Ms. Renee Godwin-Batts Mr. Robert Bednar Mr. Joel Faircloth Mr. William McCormick Mr. Tommy McNeill Mr. Danny West Mr. Jeff White Mr. Joseph Zalkin Members Absent Dr. Nicholas Benson Dr. Elizabeth Kanof Ms. Stacey Ryan The Honorable William Wainwright Staff Members Present Dr. Roy Alson Ms. Ann Marie Brown Ms. Regina Godette-Crawford Ms. Alesia Hester Ms. Heather Majernik Mr. Todd Messer Mr. Tom Mitchell Mr. Donnie Sides Ms. Kimberly Sides Ms. Julie Williams

(1) Purpose of the Meeting: The Committee met to receive updates on OEMS activities of the Compliance and Education Sections. (2) Actions of the Committee: Ms. Safran called the meeting to order at 9:30 a.m. (a) Motion was made by Ms. Hughes, seconded by Mr. S. Taylor and approved that: RESOLVED: The Compliance and Education Committee minutes of the August 10, 2010 meeting be approved. (b) Motion was made by Ms. Hughes, seconded by Mr. S. Taylor and approved that: RESOLVED: The Compliance and Education Committee recommend to the EMS Advisory Council that the NC Office of Emergency Medical Services proceed with the corrections and revisions of the EMS rules to initiate the rule-making process. Explanation: Mr. Sides reported on the current OEMS Rule Revisions. The current Rules discussed were.0221,.1500, and.1502-.1510. In the Rules, where the word May was used, it will now read Shall. There was discussion on convicted felons receiving NC EMS credentials (Rule.1500). Mr. Sides explained that not all felonies will hinder individuals from receiving a NC EMS credential. In Rule.0221 (b), the word ground will be added after Every Other changes to be made to the OEMS Rules are that OEMS be changed to Department. Rules.0217 and.0220 have been published. These new and revised Rules will be discussed at the next Medical Care Commission Board meeting on December 7, 2010 at 10:00am in the Council Building, Room 201. (c) Motion was made by Mr. D. Taylor, seconded by Ms. Hughes and approved that: RESOLVED: The Compliance and Education Committee recommend to the EMS Advisory Council that a letter be sent to Surry County EMS for winning the 2010 Paramedic Competition and then advancing on to the International Trauma Life Support Competition and winning first place. Explanation: Roger Horton and Barry McMillian of Surry County Emergency Medical Services were announced the winners of the 20 th annual Paramedic Competition at an awards banquet during the 37 th annual EM Today conference. They along with Robert Coleson advanced on to win first place in the International Trauma Life Support Competition held in Reno, Nevado. Other Actions of the Committee: 2

(a) (b) (c) Mr. D. Taylor reported on the Education Task Force meeting held in October. There were approximately 150 participants. An open meeting will be held immediately following the full Advisory Council meeting today to have further discussion on the current education issues that the Task Force is currently facing. The Task Force plans to hold public meetings by 2011. Ms. Majernik reported that the 2010 EM Today conference was a huge success with 873 attendees which is higher attendance than the past two years. The 20 th Anniversary of the Paramedic Competition was honored as well as this year s winner, who was Surry County EMS. Ms. Sides reported on the Chemical Dependency Program which will go into effect on January 1, 2011. This program will begin with only ten eligible candidates per year. Procedures are being developed and will be available by March-April, 2011. Rules are already in place and the OEMS is working on the M.O.U. for approval. With no further business, the meeting was adjourned at 10:15 a.m. Minutes submitted by Alesia Hester. 3

MINUTES NORTH CAROLINA EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL Department of Health and Human Services Division of Health Service Regulation Office of Emergency Medical Services The Jane S. McKimmon Conference Center North Carolina State University Raleigh, North Carolina November 9, 2010 11:00 A.M. Members Present Mr. Graham Pervier, Presiding Mr. F. Wayne Ashworth Dr. William K. Atkinson Mr. Bob Bailey Mr. Terry Barber Dr. Thomas Blackwell Ms. Kathy Dutton Ms. Carolyn Hughes Dr. Steven E. Landau Mr. R. Keith Lovin Dr. Donna Moro-Sutherland Mr. Robert Poe Ms. Susan M. Safran Mr. Tony Seamon, Jr. Mr. Dennis A. Taylor Mr. Stephen E. Taylor Dr. James Winslow, III Members Absent Dr. Nicholas Benson Dr. Michael Chang Dr. Elizabeth Kanof Mr. Carl McKnight Dr. Brent Myers Ms. Stacey Ryan The Honorable William Wainwright

Staff Members Present Dr. Roy Alson Ms. Elva Barnhardt Ms. Ann Marie Brown Mr. Ed Browning Ms. Shelley Carraway Ms. Barbara Chorney Mr. Joe Comello Ms. McKenzie Cook Ms. Regina Godette-Crawford Ms. Gloria Hale Mr. Danny Harbinson Ms. Brenda Harrington Ms. Alesia Hester Mr. Allen Johnson Ms. Heather Majernik Mr. Todd Messer Mr. Tom Mitchell Mr. Jim Morris Ms. Nadine Pfeiffer Mr. Donnie Sides Ms. Kimberly Sides Ms. Mary Beth Skarote Mr. Brad Thompson Mr. Carl Van Cott Ms. Julie Williams Others Present Mr. Jim Albright, Guilford County EMS Ms. Renee Godwin Batts, NC Community College System Mr. Robert Bednar, UNC Air Care, NC Academy of Physicians Assistants Ms. Betsy Casanave, WakeMed MCCS Mr. Joel Faircloth, NC Association of Rescue and EMS Mr. Sean Gibson, WakeMed Mr. Dale Hill, Capital RAC/WakeMed Mr. Keith Hill, Wake Forest Emergency Medicine Mr. Josh Holloman, Johnston County EMS System Mr. Gordon Joyner, NC Association of Rescue and EMS Mr. Randy Kearns, UNC Ms. Gail E. Kluttz, Triad RAC/Wake Forest University Baptist Medical Center Dr. Henry Kornegay, Jr., NC Association of Rescue and EMS Mr. Reid McCormick, Guilford County EMS Mr. Tommy McNeill, NC Association of Rescue and EMS Ms. Tracy McPherson, NC Community College System Mr. Chuck Owens, Greenville Fire-Rescue Mr. Joe Penner, Mecklenburg EMS Agency Mr. Kent Spitler, Gaston College/NC Association of EMS Educators 2

Dr. Mike Thomason, NCOEMS Trauma Advisor Ms. Sabrina Walter, Carolinas Medical Center-NorthEast Mr. Danny C. West, NC Association of Paramedics, Charlotte Fire Department Mr. Jeff White, Johnston Ambulance Service Mr. Ed Wilson, WakeMed Mr. Ed Woodard, WakeMed Mr. Joseph Zalkin, Wake County EMS (1) Purpose of the Meeting: The NC EMS Advisory Council met to hear reports from the Compliance and Education Committee, the Injury Committee and to hear a Hospital Preparedness update. (2) Actions of the Council: Mr. Pervier, chairman of the Council, called the meeting to order at 11:00 a.m. (a) Motion was made by Mr. Lovin, seconded by Dr. Atkinson, and unanimously approved that: RESOLVED: The EMS Advisory Council minutes of the August 10, 2010 meeting be approved as submitted. (d) Motion was made by Ms. Safran on behalf of the Compliance and Education Committee and unanimously approved that: RESOLVED: The Council accept the recommendation of the Compliance and Education Committee to accept changes to Rules.1500 and.0221 and to move forward with presenting these rules to the Medical Care Commission to initiate rule making. Explanation: At the August 10, 2010 EMS Advisory Council meeting, Section.1500 rules were pulled for further discussion and feedback. Where the word may was used, it will now be replaced with shall. Also, OEMS will be changed to Department for consistency. For clarification on Rule.0221 (b), the word ground will be added after the word every to read every ground ambulance. (e) Motion was made by Mr. Ashworth on behalf of the Injury Committee and unanimously approved that: RESOLVED: The Council accept the recommendation of the Injury Committee that the OEMS develop a template or guideline for a practicing Level I, II or III Trauma Center for hospitals seeking designation. Explanation: Gaston Memorial Hospital has submitted initial documentation to begin the process of becoming a designated Level III Trauma Center. Rule requires tremendous amounts of data be submitted for Level III designation. Due 3

to their location near Carolinas Medical Center, Gaston Memorial is often bypassed; therefore, they are not able to collect the needed data. (3) Other Actions of the Council: (a) (b) Mr. Pervier welcomed guests to the Council meeting. Ms. Safran, chair of the Compliance and Education Committee reported on the following: An update on the Educational Task Force was given by Mr. D. Taylor, chair. Meetings were held in September and October. The October meeting was held at EM Today with over 150 participants. A history of the Educational Task Force was given and there was discussion on issues the Task Force has encountered. Very good feedback was received from participants. Another meeting of the Task Force will be held at 1:00 pm today to define their timeline and generating information to the public. Public meetings are planned for January 2011. An education update was given by Ms. Heather Majernik, EMS Education and Credentialing Manager. Ms. Majernik reported that EM Today was a huge success with 873 registrants. In recognition of the 20 th anniversary of the Paramedic Competition, a special program was given that highlighted the history and traditions of the competition, honored past competitors and judges, and included several other special recognitions. Surry County EMS was this year s Paramedic Competition winner and then proceeded on to win the International Trauma Life Support Competition in Reno, Nevada. A letter from the EMS Advisory Council will be sent to congratulate the EMS team. Ms. Kimberly Sides, Compliance Specialist, updated the Committee on the Chemical Dependency Program which Dr. Kanof passionately worked so hard to have put into place. This program will go into effect on January 1, 2011, with hopes to have the first individual enrolled by March. This program will begin with only ten eligible candidates per year with a 3-year commitment depending on their recovery. A website is being designed and should be available by early 2011 for further information. (c) Mr. Ashworth, chair of the Injury Committee, reported on the following: Ms. Gloria Hale, EMSC Specialist, reported that OEMS and the state Agency for Public Telecommunications recently signed a Memorandum of Agreement to develop an online video-based training on properly restraining children in ambulances. Ms. Hale also reported that KIDBase is now active in three additional counties which include Forsyth, Stokes and Catawba. 4

Ms Hale has completed her term as chair of the Pediatric Emergency Care Council with NASEMSO and did a great job in representing the OEMS. Dr. Landau was congratulated on his book entitled Fine as Frog's Hair subtitle A Rural Lexicon. (d) Mr. Bailey provided the Council with the following Hospital Preparedness report: Year two of the three year grant cycle with ASPR is underway. Each Regional Advisory Council (RAC) has submitted grant project applications. Final approval of these applications is anticipated to be completed by the end of November; OEMS was not awarded grant funding for ESAR-VHP which is the Emergency System for the Advance Registration of Volunteer Health Professionals known as ServNC; ASPR hosted a meeting with Region IV Hospital Preparedness Program Coordinators in Raleigh on September 14 th and 15 th. Region IV membership includes Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee; Directly following the Region IV Hospital Preparedness Program meeting, the Region IV Unified Planning Coalition (UPC) met to discuss concerns and progress of the state Hospital Preparedness Program; Plans are being finalized for the NC ASPR site visit in late November. The ASPR Project Officer, the Field Officer and the Public Health Analyst for the NC Hospital Preparedness Program Continuation Agreement will be meeting with staff to review our program as well as take a tour of our Mobile Disaster Hospital; The State Medical Response System Mobile Disaster Hospital has continued to provide demonstrations across the state with the readiness of both a mobile operating room and now a mobile surgical unit; and OEMS has been collaborating with NC Emergency Management on developing a Licensed Care Facility Disaster Plan Template to provide an established format for developing a basic emergency preparedness response plan to encourage facilities to take advantage of this guide in order to develop standard operating procedures for use during an emergency and address specific hazards pertinent to their area. (e) Dr. Winslow, chair, NCCEP EMS Committee, announced that meetings will be held across the state on January 19 in Greenville; March 30 at MEDIC in Charlotte; May 25 at Wake EMS; and July 27 in Asheville for as much input as possible on revisions of the NCCEP documents, procedures and protocols. Dr. Winslow thanked Mr. Joseph Zalkin for being instrumental in pushing out a survey to EMS Administrators, Medical Directors and other stakeholders across the state for their input on these documents. 5

Agency Update: Ms. Crawford reported on the following: Joe Comello has accepted the Planning & Logistics Manager position with the Disaster Medical Program; Mary Beth Skarote has accepted the Assistant Hospital Preparedness Coordinator with the Disaster Medical Program; Executive Order 70 Rules Modification and Improvement Program was issued on October 21, 2010 for transparency and public input; Lead the Wave Project funded by the Duke Endowment launched at EM Today. A total of $1,750,000 will be made available to NC EMS Systems through this program to purchase 12-lead ECG and waveform capnography equipment for permitted in-service EMS vehicles responding to 911 events; EMS Field Triage Project is an 18-month project to describe and evaluate the CDC EMS Field Triage Decision Protocol within NC s EMS Trauma System. This project will create an opportunity for North Carolina to apply its newly linked EMS outcomes data with existing state EMS trauma system infrastructure and expertise. This project was funded by the Department of Transportation (DOT), National Highway Traffic Safety Administration (NHTSA); EMS and Pediatric Trauma Care Project is a 3-year project objective to improve the EMS early recognition and care of severely injured pediatric trauma patients within North Carolina s Regionalized Trauma System. This project was funded by the DHHS and HRSA; and All state agencies were required to submit a projected budget reflecting a 5, 10 and 15% reduction for the upcoming year to the Office of State Budget and Management. OEMS lost one vacant position. No additional reductions have been requested at this time. With November 11 th honoring Veteran s day, Mr. Pervier gave special recognition to our Veterans and quoted the poem entitled In Flanders Field. The next Advisory Council meeting will be held at the McKimmon Center on Tuesday, February 8, 2011. There being no further business, the meeting adjourned at 11:50 am. Minutes submitted by Julie Williams. 6