KSBEMS Meetings February 2016 Disclaimer: This summary is provided courtesy of Region III EMS Council. All efforts have been made to accurately report on the committee and Board meetings. However, these are NOT the official minutes of the meetings. Please reference the Kansas Board of EMS for the official minutes of committee and Board meetings if you have questions. Planning and Operations Standing Items 1. KEMSIS Report from Chad Pore on 4 services that have gone live on new Image Trend software 2. Booth at State Fair Received the contract for the 2016 fair. Signed and returned. Looking for suggestions, groups and organizations that would like to participate 3. Service Inspections All services have been inspected 32 services/18.6% received outstanding inspection award for 2015 Old Business 1. Regulations update JCARR hearing on the following regulations was held January 7, 2016. Public hearing scheduled for Feb 8, 2016 1000 in Rom 560. 109 1 1 Definitions 109 2 1 Ambulance service operator 109 2 2 Application for service permit/vehicle license 109 2 6 Classes of ambulance services 109 2 7 Ground and Air ambulance staffing (revoked) 109 2 8 Standards for ambulance types and equipment 109 2 11 Standards for type V ambulance and equipment 109 7 1 Fees 2. Service Recognition Program KBEMS staff met with representatives from EMSC and KDHE Trauma program January 12, 2016. Developing an all inclusive recognition program. Next meeting scheduled for March 2, 2016 Working to develop different levels of recognition for things that are going well in a service not just inspections. Peds Trauma Safety Community involvement Cardiac Stroke 3. Inspection Policy
The revised inspection policy will be brought back to committee for discussion and possible approval during the April meeting Request the proposed changes be mailed to the regions prior to the April meeting so they can be reviewed and provide feedback before the meeting. James will email to work group and regions, and would like feedback by end of Feb so changes can be made and sent back to review again before April meeting New Business None Managers Report see board packet for breakdown of attendant information Compliance manager Ed Steinlage, started in December New service license AirEvac Lifeteam in Oklahoma Concerns about attendants no knowing scope of practice taking med lists to service directors at time of inspection. Region and Association Comments Region 1 meeting in 2 weeks at Hoxie, talking about educators workshop. Met with Dr Mosier and NW Kansas Stroke/STEMI group. Initial meeting concerned hospitals, want to expand to include EMS Region 2 Region 3 Feb 26, MERGe team meeting for business and tabletop April 5/6 KDEM doing full scale drill at Crisis City 3 operational periods of 12 hours, 36 hours straight thru. $100,000 grant for two prime pullers for LARC trailers. All services that have mini larcs will be another training session for these in Newton looking at March. Region sponsoring Bob Page in Great Bend check dates Region 4 meeting Tuesday, also working with Salina Regional on Stroke care. Region 5 meeting next week, EPC class in March. Region 6 meeting last week, 3 projects completed affiliation with University of Miami for advanced stroke class, have 22 instructors, will have one class a month thru the year. Guardians of the Heart Feb 22,23. Bob Page day one, day 2 Stroke in AM, PM lecture and breakout sessions. Hosting regional medical directors meeting again. KEMSA new website, annual golf tourney April 15, registrations are open, annual conference in August at Ks Star Event Center, registrations are open for hotel. KEMSA apparel available to be ordered thru Navrats in Emporia. Working across the street with in person and written testimony KEMTA conference next week, taking registrations, bringing in Randolph Mantooth. Secured CO detectors to be placed on all cots in the region KANAAMS re evaluating purpose, mission, and affiliation, Air medical world has taken a bit of different direction from original purpose. Kansas Air Medical Transport Society is new name of group seeking interest and forming board. KDHE hosting PPE training across the state, KSTrain for registration. Public Comments Education Committee
Standing Items 1. Regulations update a. The education regulations became law January 4, 2016 (109 5 1, 109 5 1a, 109 5 1b, 109 5 1c, 109 5 1d see board packet for documents) At AG s office waiting approval once these are approved, they will move to open comment period. 2. Variances None received 3. BLS Examination Vendor Report SKEMS no one present for report. 4. EDTF Met by teleconference Jan 8, continuing to work on documents for policies/procedures, educator proposal and scenarios and revising skills exam check sheets to match scenarios. Old Business None New Business 1. Audits Random audits of continuing education hours will begin Spring 2016 Audits were suspended during transition years, these will start again. Managers Report 1. Retroactive approval regulation Recommendation for revision of 109 5 5 (see board packet for document) Would like to extend 90 day submission period to 180 days. Needed to add amount of college credit 1 credit hour worth 15 clock hours, Description of determination hours based on certificate or cred hour. Still have to provide objectives. This will determine application to core components/subcategories. Comments Much discussion followed about retroactive approval, and 90 vs 180 days. Will move forward as 180 days. 2. 2015 Statistics (See board packet for document) 3. Staff Update a. Education Specialist Emilee Turkin b. Exam Specialist Kim Cott Public Comment None
Executive Committee Standing Items 1. Legislative Update see board packet for documents a. Federal Legislation HR 4365 Controlled Substance Act Potential action Recommend that the board support this bill Old Business New Business Investigations b. Kansas Legislation HB 2376 / SB 224 Ability to levy a civil fine/issuance of subpoenas HB 2387 / SB 226 Amendments to EMS statutes HB 2386 / SB 225 Interstate Compact SB 274 Seat Belt Bill would reduce percentage disbursed to EMS Revolving Fund (KRAF) and Kansas Trauma Program SB 131 Peer Support Counseling the language within this bill passed during 2015 session in HB 2025 KSA60 473 SB 133 Immunity from criminal prosecution for minor seeking medical assistance HB 2456 Interstate Medical Licensure Compact (Physicians) HB 2437 Concerning Maintenance of Effort Requirements Consent Agenda 1. 2013 032 Report that an attendant from another state practiced in Kansas prior to issuance of Kansas certification Investigation determined the event did not occur. The attendant no longer lives in Kansas and their KS certification is now expired. Staff Recommendation close the case and flag in database. 2. 2013 057 Submitted a felony application Investigation determined the respondent failed to submit the required documents to complete the application process Staff recommendation deny the application 3. 2015 076 Report of attendant worked several months on an expired certificate Investigation determined the respondent was employed, this is no evidence they provided patient care during the expired period. Staff recommendation close the case
4. 2015 081 Complaint against Instructor/Coordinator Investigation determined there is insufficient evidence to support the allegation Staff recommendation close the case 5. 2015 091 Complaint a Facebook posting violated patient privacy Investigation determined the incident occurred, but with the patient s permission Staff recommendation close the case 6. 2015 092 Submit a felony application Investigation determined the respondent failed to submit the required documents to complete the application process Staff recommendation deny application 7. 2015 093 Submit a felony application Investigation determined the respondent failed to submit the required documents to complete the application process Staff recommendation deny application 8. 2015 104 Submit a felony application Investigation determined respondent met all terms of sentence, probation and restitution. 9. 2015 106 and 107 Complaint a Facebook posting violated patient privacy Investigation determined the posting did not disclose any personal information and did not violate the patient s privacy Other Cases 2015 063 removed from consent agenda Complaint involving patient care Investigation determined the Medical Director felt care was adequate and there were no protocol violations Staff recommendation close the case Accept local action and send a cautionary letter that this violated standard of care but local action has covered this 1. 2014 048
Previously, respondent was arrested on multiple felony child sex crimes and Board Staff issued an emergency order to suspend attendant certificate. Recently, respondent pled guilty to two level six person felonies and will face several years in prison. Investigation confirmed conviction Staff recommendation is to revoke attendant certificate. Motion to revoke by summary proceeding order motion passed 2. 2015 002 Previously, respondent was arrested on multiple person felony charges and Board Staff issued an emergency order to suspend the attendant certificate. Recently the attendant pled to all misdemeanor crimes and has paid restitution. Investigation determined the criminal case is complete, all convictions are misdemeanors and all fines are paid Staff recommendation is to lift the Emergency Order of Suspension and close the case. Motion to lift suspension as it has been suspended a year, reinstate to normal renewal process motion passed 3. 2015 005 A service complained that another service transported their patient without authority. Investigation determines the events did occur but there is a probability this occurred due to poor communication skills by both the hospital and the service. Staff recommendation is to send a letter to the offending service that explains the investigation findings and recommend they identify a process to improve their communication process. Motion to close case, nothing to take action on. Motion passed 4. 2015 048 and 103 Complaint that members of a service are representing themselves at certification levels they are not, and allowing and RN with no EMS credential to work as an attendant. Investigation substantiates the complaints, but also found staffing violations by the service, that an attendant falsified a portion of a certification course and had practiced beyond their authorized activities Staff Recommendation 048 consider multiple applications of the graduated sanctions KSA 65 6133 including (a)(2) and (a)(7) unprofessional conduct. Performed activities not authorized at level of certification, performed acts beyond authorized activities. Fraudulent act related to the qualifications, functions or duties of an attendant. Falsifying an ambulance service record. Invoked Kapa 103 consider graduated sanctions KSA 65 6132(a)(3) unable to provide adequate ambulance service. 5. 2015 067 Previously, Board Staff denied a transition application after it was discovered a student failed to sign in and out of a course. Board Staff opened an investigation involving the Instructor
Coordinator and after three written and verbal requests, the respondent failed to provide the documents requested by the Board s Investigator. Investigation determined the respondent refused to cooperate with the investigation. Staff recommendation is to consider the Graduated Sanctions KSA 65 6133(a)(7) unprofessional conduct as related to an Instructor Coordinator and Training Officer, failing to cooperate with the Board s investigation. This does not address the transition course, only the instructor. Letter was sent out May 8 requesting paperwork. After not receiving paperwork, investigator opened a case. Transition paperwork must be kept for 5 years. Respondent present, failed to keep copy of paperwork for himself, no longer works for hospital, no paperwork available at hospital. Failed to respond to the board. Sponsoring organization (hospital) does not provide ambulance service any longer. Request to send what paperwork you have, would like to know more about process during switchover that paperwork was lost, transition of ownership and leadership Table this with direction to work with Mark. Instructor responsibility to maintain copies of paperwork. 6. 2015 085 and 086 Report of a Medication Error Investigation determined the incident occurred as described and respondent sought additional education. Staff recommendation 085 consider graduated sanctions (a)(7) unprofessional conduct, failing to take appropriate action to safeguard patient. 086 with respect to service, close the case Paramedic instructed AEMT student to administer 1:1000 epi rather than 1:10,000 epi, agency required paramedic to go through a PALS class for refresher. Dose was correct, concentration was incorrect. Motion to close case and accept local action. Motion passed 7. 2015 098 Previously, investigation committee heard 2015 061 involving a transport with medications beyond those authorized on the approved medication list. The committee voted to open this case against the second attendant. Investigation determined the events occurred as described. Staff recommendation is to consider the graduated sanctions (a)(2) and (a)(7), unprofessional conduct, performed activities not authorized at the level of certification and performed acts beyond authorized activities. Move to close without action. Service director was EMT, medications were handled by AEMT who has the responsibility motion passed 8. 2015 101 and 102 Report on attendant completed an inter facility transport with a medication beyond those on the authorized medication list.
Staff recommendation with respect to the respondent in 101 consider graduated sanctions (a)(2) and (a)(7), unprofessional conduct, performed activities not authorized at the level of certification and performed acts beyond authorized activities. 102 close the case Motion to 90 day suspension by SPO, 90 day probation and write a paper on this. Motion passed Motion to close 102, motion passed 9. 2015 108 and 109 Report of staffing violation Investigation determined the event occurred as described Staff Recommendation 108 consider the graduation sanctions (a)(7) unprofessional conduct, failure to safeguard the patient. 109 consider graduated sanctions 65 6132 (a)(3) unable to provide adequate ambulance staffing Service director took transfer, had husband (non credentialed) drive violating staffing requirement. This is a long time service director, and did not self report. Had another technician there, but was sent home as director and husband were going to run call. Motion for consent agreement for $150 fine for individual. Motion passed Motion for letter to county commission from board of ems of this violation. Any future violations could result in action against their permit or fines. 10. 2015 110 and 111 Report of medication error Investigation determined the event occurred as described Staff recommendation 110 consider graduation sanctions (a)(7) unprofessional conduct, Failure to safeguard the patient. 111 close the case Inter facility transport for very critical patient, had very high dose of medication running, could not find anything in protocol regarding this dose, decreased dose to within protocol without discussing it with a physician. Agency has evaluated and rewritten protocols to address this medication at high doses. Motion to accept local action and close both cases. 11. 2016 001 On internal audit, a service discovered the respondent falsified their certification renewal by indicating an incorrect number of continuing education hours Investigation determined the event occurred as described Staff recommendation consider graduated sanctions (a)(7) unprofessional conduct, violated regulation. Motion to dismiss the case motion passed
Board Meeting Feb 5, 2016 1. Call to Order 2. Approval of Minutes 3. Committee Reports a. Planning and Operations (see committee notes) b. Education (see committee notes) c. Executive i. Federal HR 4365 Controlled Substances Act ii. KDHE Trauma Bill (no number as of Jan 21, 2016) d. Investigations 4. Office Update 5. New Business a. Transportable Physician Orders for Patient Preference (TPOPP) i. AG opinion 2015 001 states that a healthcare provider withholding CPR relying on a TPOPP form as a directive may not be immune to liability due to the TPOPP form not being a valid DNR directive pursuant to 65 4941. b. Election of Chair and vice Chair 6. Public Comment