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FLORIDA MEDICAL SERVICES ADVISORY COUNCIL QUARTERLY MEETING OMNI ROSE HOTEL JULY, 2001 TRANSCRIPT OF PROCEEDINGS HELD JULY 2001, COMMENCING AT 8:00 A.M. AT THE OMNI ROSEN HOTEL, ORLANDO, FLORIDA. BOARD MEMBERS PRESENT: DAN HARDESTER, CHAIRMAN JANET LIVINGSTON, VIC CHAIR CHUCK BEMENT, CHIEF DR. SLEVINSKI, MEDICAL DIRECTOR ROBBY BROWN, SECRETARY FRANCES COX-MYERS SAM GILLESPIE PAT PIERATTE CRAIG FUGATE KEITH GASTON JUDY CONLIN CHUCK KEARNS RUBEN ALMAGUER LINDA SWISHER SALVATORE SILVESTRI LAWRENCE LOTTENBERG SHIRLEY WATKINS-BLYTHE PHYLLIS STENKLYFT MATTHEW DOUGLASS FERNE G. MOORE NESTOR BERRIOS-TORRES WALTER KOPKA JAIME CALDWELL DAVID TRANCHAND ALSO PRESENT: JESSICA SWANSON, MSW FLORIDA DEPARTMENT OF HEALTH SENIOR MANAGEMENT ANALYST I BUREAU OF EMERGENCY MEDICAL SERVICES CHAIRMAN HARDESTER: Good morning everyone. I'm Dan Hardester. I'm the Chairman of the Advisory Council. Welcome everyone to our July meeting of the State EMS Advisory Council. Good morning. I'm glad to see so many of you here bright and early at 8:00 a.m. in the morning. Welcome to all of you. Just a reminder, the usual procedure. The speaker cards are available in the back of the room. And we will -- if there are any constituency groups here that want to inform the Council about any awards that they've given over these series of meetings, please do that by utilizing the speaker cards. And we'll do that in the public comment period. Also, at this point we have a change in the agenda. Many people who are receiving the annual awards were notified that that would occur around 10:00 a.m. So, in order to try to keep with what they were told, we will move the awards section -- we will hold the awards section until after the whole business section of the agenda. With that, what I'd like to do is just go around the table here briefly and have the Council members simply introduce themselves and their affiliation on the Council. Starting with My far left? MR. TRANCHAND: Dave Tranchand, lay member of the Council. MR. CALDWELL: Jamie Caldwell, Commercial Ambulance. MR. KOPKA: Walter Kopka, Air Ambulance Operator. MR. BERRIO-TORRES: Nestor Berrio, EMT, Non-Fire. MS. MOORE: Fern Moore, Lay Elderly. MR. DOUGLASS: Matt Douglass, EMS Administrator, Non-Fire. MS. STENKLYFT: Phyllis Stenklyft, Emergency Medical Services for Children. MS. WATKINS-BLYTHE: Shirley Watkins-Blythe, Emergency Nurse. MR. LOTTENBERG: Larry Lottenberg, Physician Trauma Surgeon. MR. SLEVINSKI: Richard Slevinski, State EMS Medical Director. MR. BEMENT: Chuck Bement, State of Florida EMS Bureau Chief. MS. LIVINGSTON: Janet Livingston, Hospital Administration. MR. BROWN: Robby Brown, EMT Fire. MR. SILVESTRI: Sal Silvestri, Physician Medical Director. MR. ALMAGUER: Ruben Almaguer, Paramedic, Fire Service. MS. SWISHER: Linda Swisher, EMS Educator. MS. CONLIN: Judy Conlin, Department of Education. MR. GASTON: Keith Gaston, Department of Highway Safety and Motor Vehicles. MR. GILLESPIE: Sam Gillespie, Department of Insurance. CHAIRMAN HARDESTER: Good morning, Council members and we especially welcome two of our new members. We'll move on now to the area of our agenda with the Bureau of the EMS Bureau Chief, Chuck Bement. MR. BEMENT: Good morning. For those of you that have realized that Betsy Lasiter (ph) isn't here for this meeting, she delivered a six pound baby girl on July 6th. Both mother and daughter are doing fine. We expect to see Betsy again at the end of October. So, that's why Betsy's not here. However, she is very capably filled in for Jessica Swanson and Pam Lasiter. The Bureau just finish going through a reorganization. It's been several months in the workings. And I just want to make you aware of the sections that currently exist. We've gone from four to five sections within the Bureau and briefly describe what they are, whose in charge and their primary responsibilities. The first section is education and training, which will be under the direction of Sue Travis. And the primary focus of that section will be to hopefully establish on- line certification by the next recertification cycle. I'm not making any promises. Hopefully we'll be able to have that established by the next recertification cycle. But we're really going to undertake some efforts to accomplish that between now and when recertification starts again. Data section headed up for another few days Deb Trophy is not here today. Andrea Slate is filling her shoes in the interim, until we get another supervisor for that section. Deb has accepted a position in Pensacola with the Department of Health and we wish her well. The primary responsibilities for the data section at this time are going to get the pre- hospital entry data collection system up and running, of which, it's pretty much ready to go right now. I know Deb and Andrea have been demonstrating it at several consistency group meetings and we're very pleased to have those systems essentially up and running right now. We're willing to take folks that are willing to help us Beta test the data collection systems. Folks that wish to help us with that, please talk to myself or Andrea before you leave and please call us. Andrea is currently available on-line, so it will be an on- line data report. I just want to reiterate that there's a mandatory requirement as of February of 2002, we will accept data. And this time we'll be able to do a lot of good things with it as far as analyzing and being able to bring feedback of what's going on in the state of Florida. Planning and Investigations section supervisor, we have a new person on board. His name is Doug Caffey (ph). He's accepted the position of section supervisor for Planning and Investigations. Doug starts August 6th, however he's in the building for a conference. He comes to us from Deltona Fire. And we're really looking forward to having Doug come and help us with the Planning and Investigations section. The primary responsibilities for that section include a State plan, and obviously our investigations section. Injury, Prevention and Grants, I just want to reiterate that the grants program is now in injury and prevention, which is headed by Lisa Vanderworth-Corrigan. The primary focus of that section is obviously to continue to work on the prevention programs, such as EMS for children. There's a lot of good things coming out of that and there's a lot of good projects in place right now, Risk Watch, Safe Kids. Just to continue to develop those programs. And, obviously, to continue to work with the fine grants program that we have right now. I just want to let everybody know that the Inspector General's Office has just completed an audit of our grants program and found that really just with some tweaking of some documentation, we have a pretty good grants program in place. And we're quite pleased with the results of that. Last but not least, our Trauma section headed up by Susan McDivitt (ph). She's doing a fine job. I just want everybody to know that the DOT recognized her with their first award. I'm sorry, Doctor Lottenberg we're quite proud of that and quite pleased that she received that with regard to her work with regard to trauma in the state of Florida. Her big project, her focus, has been the trauma registry in conjunction with our data folks. And I'm pleased to announce that after ten years in the workings we've now have electronic data in our trauma registry to be able to give some life saving information, record some feedback on that. So, we're quite pleased that our trauma registry can accept electronic data now. Obviously, Susan is in charge of our ambulance inspection program, as well, and has been for quite some time. And one of the big projects we're working on there is unannounced inspections. But I'll talk about that when we're in new business. That's really it for our section. We've got new people on board over the last quarter. Jeff Caffey (ph) Investigations Section supervisor, who I've just mentioned. Bob Maden(ph), our planning coordinator who will be working extensively with our state plan, as well. Debbie Newton, our new Investigation Section supervisor. She's done a tremendous job since she came on board a few short months ago. And Marion Hursog(ph) is a senior clerk with our Planning and Investigations Section. The next topic I wish to discuss was our 2002 legislative package. And I guess there's a little confusion on that during the meetings over the past few days. I'm going to preface this by saying that the Bureau explored recommendations -- considered recommendations that came out of the Council with regard to paramedic -- second level paramedic certification, accreditation and I believe some medical dispatch. And I guess there is some feeling that the Bureau kind of took an initiative and really didn't advise the group. I want to let you know what happened this year. We were tasked a few short weeks ago with developing our 2002 legislative package within the Bureau. So, it really left us little time to work with the constituency as far as language goes. Actually, we had to get our assignments in before the meeting even started. To accept and up the Chair for approval as to what would be a move forward for the Department for the 2002 session. Had we not started this process, we wouldn't have handled the legislative package for 2002 for another year. So, we kind of brought this back to the meeting with the understanding that we do have new language drafted. We have made that available to the constituency group. And, essentially, that's where we're at right now. Due to the fact that this year's legislative session got moved up until January, we were kind of put under the gun to get the 2002 legislative package to the Bureau. And as a result, it's just one of those fluke things. But I know some of the contingency groups are looking at the language. We welcome any suggestions or changes they may have. We probably wish for the groups to get info back to us before the October meeting, only because whatever we decide to move ahead with, we're going to start doing the formal analysis on it and addressing language probably in September. That's when the workshops will start. So, that's really the only issue that came up. I guess there was some confusion as to why the groups weren't involved. Again, that's the reason. We were kind of put under the gun. We had some deadlines that didn't exist last year. And normally, we would probably have started the process of developing language at this meeting and had some time to work on it between now and October. Weapons of mass destruction, I'll talk about a little bit more during new business. And the Bureau's undertaken a trauma cost study with primarily twenty trauma centers within the state of Florida and all the associated groups that are key players in trauma in the state of Florida, mainly CEOs and CFOs, trauma surgeons, EE medical directors and many other groups. Of the discussions came to the fact that pre- hospital costs are a major part of developing a cost methodology within the state. So, EMS representation is going to be needed on the work group. There's going to be three meetings between now and March when our final meeting will occur between everybody involved. And, hopefully, we'll be able to tell you about the same methodology. We've asked several folks in the EMS community to please work with us in the working group. Anybody else that's interested in working in the EMS pre-hospital working group, which would include air medic, I would encourage you to get with myself or Susan McDevitt and let us know if you wish to participate in a working group that's going to allow us to develop a state cost methodology for hospital trauma in the state. Legislative updates, 2001 legislative update provided several things. We have a CPR and ACLS course section that was passed into statute. This amendment authorizes the Department to define by rule CPR and ACLS courses equivalent to American Heart Association and American Red Cross courses. The Bureau is apparently initiating the process to develop the necessary rules for this statute. There is a procedure for exam review and authorizes the Department to establish by rule, procedures for EMT and paramedic examination review. The Cardiac Arrest Survival Act, which will become effective October 1st. Essentially this act deals with the use of automated external defibulators and directs the Secretary of the Department of Health, with the assistance from the Department of Management Services, to establish through rule guidelines on placing and deploying automatic defibulators in buildings owned or leased by the State. It also provides immunity from liability if a person attempts to use a defibulator in a medical emergency, provided they follow criteria. Abandoned newborn legislation was passed which assigns emergency medical stations and facility in which newborns can be left. The Division also adds paramedics as a designated person that can receive the newborn. A hundred thousand dollars was appropriated for the development of a media campaign, which Lisa Vanderworth-Corrigan has been working on a media campaign. Did you want to say anything, Lisa? MS. VANDERWORTH-CORRIGAN: If they have any, they can call. MR. BEMENT: I know they've been working on an extensive media campaign with our Department media folks. And we're going to see some -- you're going to notice the result of the media campaign between now and -- when is the media campaign supposed to begin? MS. VANDERWORTH-CORRIGAN: We hope to have it anywhere from October to December. The reason I give that time frame is because we have to do PR & A media buy. It should be sometime this fall. We will notify everyone by sending out letters to all EMS providers, fire departments and hospitals and similar facilities. What we plan to do is work the media angle. MR. BEMENT: Thank you, Lisa. And just to repeat that, we're going to begin a campaign in the fall and we will notify everybody involved before the campaign starts. Legislation did not pass 2001. The Governor vetoed the local bill affecting Volusia County, stating it could have ramifications state wide, even though it was a local bill. The bill would have allowed municipalities in Volusia County to issue COP CN without the County approval. A study is being conducted by the County, which will be completed next year and will address the possibility associated with delivery of EMT services. The Governor also vetoed a county-wide request for five hundred thousand dollars from the EMS National Grant Fund to purchase EMS equipment for the Plant City Fire Department in Hillsborough County. State guidelines establish and we will stipulate that matching grants be awarded through a competitive process. And the Governor also vetoed Senate Bill 1412, which related to the Child Safety Booster Seat Act. The Bill required the operator or owner of the vehicle transport any child eight years or younger and four feet nine inches in height or less to restrain the child in a child restraint device. Current law requires a child five years or younger to be restrained in a child restraint. The other section of business you can find in our quarterly report, which is available at the back desk. And that's it for my report. CHAIRMAN HARDESTER: Thank you very much Chuck. And now you've been here a full quarter between meetings. So, you're a full fledged member now. Your honeymoon period is officially over. And we do thank you for being proactive with the legislative initiatives. We appreciate your comments on that. We'll take any questions for the Bureau Chief from the Council members. Any on my right, any questions for Chuck? On my left? We'll move to the portion of the agenda now where we recognize our outgoing Council members. Chuck and I will step up to the podium. MR. BEMENT: We'd like to recognize the contribution of our outgoing members to the Council, essentially, four members that are outgoing. Doctor Swisher, we'll start with you. As an outgoing member, in recognition of your service to the Council for the past two years. We look forward to your continued work with the Council over the next four years. The next person I'd like to recognize is George Fox. Is George in the room? He's not here. I just want to reiterate that George Fox has done a tremendous job over the past few years. And if we can get him back in here for his award, we'll say more nice things about him. The next award for past service is Sandra Barber. And I'd like to recognize the efforts of Andrea. Thank you. And our fourth person we'd like to recognize is Dr. Laurie Romig. I'd like to say a few special comments first. I wish to commend Dr. Laurie Romig for exemplary service to the state of Florida, Emergency Medical Services Council. Her commitment and dedication to the enhancement of State and local EMS systems has positively impacted the EMS community as well as benefitted the citizens of the state. Dr. Romig has served the Council well, both as a member and Chairperson. She has contributed a great deal of time and effort in leading Council initiatives, and concepts, and practices. I've also personally witnessed Dr. Romig's leadership in action as I've occasionally walked into meetings that she's been working with. I found her leading the discussion and tasking the group with action. I was quite encouraged to watch her motivate others to action, the true sign of a leader. Dr. Romig, I ask of you on behalf of the state of Florida, Department of Health and Emergency Medical Services, to please remain engaged as a leader within our State. Through the guidance and direction of people such as yourself, the EMS community of the state of Florida will continue to be recognized nationally as leaders of EMS innovation. Dr. Laurie Romig, thank you. CHAIRMAN HARDESTER: Thank you very much, Chuck. And thank you very much to our out-going Council members. And at this time I just want to welcome in particular Mr. Chuck Kerns, who is the Executive Director of Pinellas County EMS and Fire Administration. And I'll put my glasses on and see where you are. There you are. Good morning, Chuck. Welcome. Beginning before your appointment. Thank you very much for taking that on. We have a Division Chief of Special Operations from Miami/Dade, Chief Ruben Almaguer. Good morning, Ruben, and welcome to begin a four year commitment. As Chuck had mentioned, Dr. Swisher who had completed an expired term for two years, is returning for an additional four. Thank you, Dr. Swisher. And we have another new member, Dr. Salvatore Silvestri who is the Orange County EMS Medical Director. Good morning, Dr. Silvestri. Thank you very much for taking the appointment. Just another word about Dr. Silvestri. He's an emergency medical physician. He was also a paramedic with NYES. Good morning to all of you. We'll move now to Dr. Slevinski's State medical director report. Dr. Slevinski? DR. SLEVINSKI: It's going to cover many other areas. We got into a very heated discussion about this. I'll do my best to get letters out and contact the State Board of Pharmacy, the FDA and various drug people about their recommendations on drug storage and drug temperature. Thank you. CHAIRMAN HARDESTER: That was extremely short. I guess we'll be hearing from you many times on many other agenda items. Turn now to Council member reports and starting on my far left, which is Mr. Tranchand. And for the report if you would start by stating your name before your report. Thank you. MR. TRANCHAND: Nothing at this time. CHAIRMAN HARDESTER: Mr. Caldwell? MR CALDWELL: Jamie Caldwell, Commercial Ambulance. I'll be having many discussions throughout the agenda. Mr. Kopka? MR. KOPKA: Good morning. Walter Kopka. Two items of note. First, the National Air Ambulance Conference will be held in September at the Peabody Orlando. If you're interested in that information, you can contact Joe Levine. And the second bit of information is the air ambulance provider will be working with the State office regarding 401- Ks to the equipment. Mr. HARDESTER: Thank you, Mr. Kopka. MR. BERRIOS-TORRES: Nestor Berrios. Nothing at the moment. MR. HARDESTER: Thank you. Doctor Moore? DOCTOR MOORE: Doctor Ferne Moore, Chairperson of FLIPPS. I'd like to report that as you saw in the emergency medical services quarterly report, FLIPPS which is the Florida Injury Prevention Program for Seniors, has moved from the Department of Health to the Department of Elder Affairs. We are extremely pleased that Doctor Emma Hernandez really wanted the FLIPPS program as part of her administrative force. However, we are comforted by the thought that we have the continued support and interest of the Health Department, as demonstrated by Lisa Vanderworth-Corrigan and Karen Miller even this week. We look forward to continuing our mission as described before. And we are in hopes of completing our five years strategic plan, which was just written a few months ago. And we hope to carry it out under the hospices of the Department of Elderly Affairs. CHAIRMAN HARDESTER: Thank you, Doctor Moore. Mr. Douglass? MR. DOUGLASS: Matt Douglass. As Charles had mentioned earlier, I think it's imperative that those of us in the EMS community become involved in the trauma center cost methodology that's coming up. We're an integral part of trauma centers and emergency medical services and I strongly urge you to become involved in this process. CHAIRMAN HARDESTER: Thank you, Mr. Douglass. Doctor Stenklyft? DOCTOR STENKLYFT: Thank you. The EMS State Needs Assessment has been completed. It's going through final review in the Department of Health right now. And we're hoping that will be published and distributed to you in the October meeting. I think you'll find a lot of very interesting information in it. We have information broken down by county so that you can use it for your information planning efforts for children. We're starting the process for developing our EMSC State Strategic Plan. We're trying to determine who our facilitator will be at this time and determine a date, and some of you may be asked to participate in that. We're beginning to look at recommendations for new appointments to our committee and make recommendations to the Secretary of Health. Those appointments will be made in October. Our Risk Watch program is proceeding very well. We had one little glitch in that the teachers were very concerned about the curriculum needs, their FCAT requirements. So, we did consult with someone and developed that so that we'll meet FCAT requirements in that to please the teachers in the areas they were working with. We've also applied for a Paternal Child Health Bureau grant that involves trauma systems, rural health and EMS. And I anticipate we'll receive that thirty-five thousand dollar grant. It's a supplement that was added to the states to get the Paternal Child Health Bureau more information about challenges in the trauma system in their state, with particular emphasis on rural areas. One thing I'd like to bring to your attention, that the American Heart Association has released recommendations for the use of AEDs in children. AEDs are not recommended for use in children under eight years of age at this time. If you have any concerns about that, feel free to contact me or someone in the Bureau office for that release so that we can send you a copy of it. Lastly, we had a very successful first EMSE day in Florida. I'd like to thank everyone that participated in that. We did mail out some educational materials to all the pre-hospital services. We were recognized at the National EMSE conference for our efforts for the first EMSE day in Florida. Thank you. CHAIRMAN HARDESTER: Thank you, Doctor Stenklyft. And congratulations on the success of the EMC day. We look forward to that being an annual thing. MS. WatkinS-Blythe? MS. WATKINS-BLYTHE: Shirley Watkins- Blythe. The Florida ENA is making donations to ENA Foundation Challenge and also to the Florida Emergency Medicine Foundation. And the ENA is also holding their national conference here in Orlando in September. There will be an instructive course given on August 3rd at St. Joseph's in Tampa. The ENA has received copies of the emergency service task force report and would like to request if there are any more emergency services task force developed, that an emergency nurse be included in the group. Also, being aware of the mandates to rotate around the meeting sites, we would like to suggest that the October fall meeting be moved out of South Florida. October is like at the height of hurricane season and South Florida is often more active than the rest of the state. Last October, if you remember, we were kind of flooded out in Miami. And now we're going down to Duck Key, so we were thinking if it could be rotated it another way so that isn't during the height hurricane season. And also to make mention of going to the Duck Key, the area is kind of requires two -- an airplane flight for many of our members, plus a drive up, which increases the cost for that particular meeting. Thank you. CHAIRMAN HARDESTER: Thank you. Doctor Lottenberg? DOCTOR LOTTENBERG: Good morning. We had our Florida Committee Trauma Meeting yesterday. I'm just going to give you some brief highlights. ATLS continues to flourish throughout our state. We have now eight sites. We have a new research site in Lakeland, PHDLS. We were given a report by Brian Esbera(ph). In three and a half years of PHDLS, it's been repromulgated throughout the state. We have over four thousand PHDLS providers now in the state of Florida. We looked at our education. We still have a slide show called Team that we use for medical students, which can be used for hospitals and for nursing. We also have had several ATLS courses in which we use the Med-T human patient simulator with great success. It's in the exhibit room here. We submitted an abstract to Southeastern Surgical Congress on the use of that simulator. We're also looking at several other simulators. The COT continues to have an excellent web- site. For those of you that would like to query it, you can go to www.facs.org and drop down to trauma to find it. In our injury prevention report we had three different presentations updating the situation with motorcycle helmets. One of the presentations is a paper that was written by the University of Miami Rider Trauma Center called, Examining the Impact of Florida's Repealed Motorcycle Helmet Law. The paper's going to be presented at the American Association for the Surgery of Trauma in Seattle in September. They looked at their experience now with the repeal of the motorcycle law. And, basically, in summary they found that helmet use among injured motorcyclists decreased from eighty-five percent to sixty-two percent after the helmet law was appealed. However, there was really no statistical difference in injury severity, and hospital length of stay, and hospital charges. The main difference that was found was that brain injuries increased by some fifty percent. And the overall cost savings of these brain injuries, counting rehab and what not, was estimated at several million dollars. So that -- and the other issue that they found was that scene deaths nearly doubled related to these head injuries. The second presentation that we had on motorcycle helmets was a report that was generated by the state of Florida looking at motorcycle death statistics and the severity of injuries. And it was obvious to everybody that the numbers of deaths and debilitating injuries after the motorcycle helmets came off was significantly increased. Then we looked at a report from the University of Florida Trauma Net, which is now Jacksonville Shands, Halifax, Daytona and Melbourne and their report was similar. After a lot of discussion we felt that it is somewhat premature to try and go back to the legislature to look at this issue. And we're going to collate at least another twelve to eighteen months of data and revisit this in the 2002 session from the point of view of the Florida Committee on Trauma. The trauma nurses had their meeting and gave us a report. They are intimately involved in the trauma cost study, which I will get to shortly. Currently our membership now of the Florida Committee on Trauma is up to a hundred and forty members. We also have organizational memberships from almost all the trauma centers in the state. We approved and appreciated the grant that Doctor Stenklyft referred to from EMSC. Mr. Bement and Susan gave a report from the state looking at the various issues. Over fifteen hundred state trauma plans have been distributed. Up-coming site surveys are going to be in Lakeland, which is a level 2 center, and that's for August the 6th. My institution, Memorial Regional Hospital, is going to be surveyed on September 10th. Broward General in Fort Lauderale is on September 12th. And Sacred Heart is going for their provisional level 2 adult on October 1st. Trauma center letters of intent will be mailed out. We think that there is significant interest in promulgating trauma centers in both Tallahassee and Gainesville. I won't say anything more about that at this time. We had a long discussion about the trauma cost study, of which the first meeting was held this last Monday here. And it was fairly well attended by numerous trauma medical directors, numerous trauma program managers. Only one emergency room doctor from the trauma centers attended. That's disappointing. And several CEOs and CFOs were invited, as well. The meeting was more of an organizational meeting to present the fact that this state has entered into an agreement with a group called MD Content (ph). They are a consulting group from Michigan, lead by a trauma surgeon by the name of Paul Taharry (ph) and an economist named Dave Busk. They are going to be responsible for working out the methodology of identifying costs for trauma. They are going to be using the AHCA data. We emphasized, as we stated here, the need for looking at pre-hospital air transport, rehab and other things that are not available through the ACHA database. One of the glitches in the situation is the buy-in from the CFOs and CEOs. We're working on that and perhaps Mr. Bement will comment on that at another time. As mentioned, we awarded our first ever special recognition award for excellence in trauma system development to Susan McDevitt. Well deserved. And she was shocked to get the award. I don't know why. But we were very honored and pleased with that. Upcoming meetings, our visiting trauma professor is Doctor David Hoight (ph), who is the Chairman of the national committee on trauma. He will be touring in the second week of November and end up in Orlando at Orlando Regional Medical Center on November 9th when we have our annual meeting and our resident paper competition. I have no further report. Thank you. CHAIRMAN HARDESTER: Thank you, Dr. Lottenberg. And thank you for your championship of following up on the motorcycle helmets. I know it was a very difficult thing to get the information. We appreciate it. We congratulate Susan McDevitt for the award that is certainly well deserved. I'll turn back to our Vice-Chair, Janet Livingston. MS. LIVINGSTON: Janet Livingston. I have no report at this time. CHAIRMAN HARDESTER: Thank you. Chief Brown? MR. BROWN: Robby Brown, EMT Fire. I would like to report that since the last meeting, I attended the National Medicare Flex Conference as part of the team representing Florida, dealing with EMS integration in the rural hospital program. In Florida the Medicare Flex Program is basically called the critical access hospital program for rural EMS. If you're not participating in the rural health networks in your area and working closely with the small hospitals, there is the ability to receive additional funding for recruitment, retention, training and education through the Department of Health, through the Office of Rural Health. I'd encourage you to become active in that. If you have any questions, please contact me. It's an excellent opportunity to travel and represent the state. Roger Twitchel (ph) went from the state office and made a presentation. There was a lot of good information. On the national level, integration of EMS, which is a critical access hospital, medical flex is a national program target point for them. So, obviously it means that there's Federal dollars available to help rural EMS providers. Other than that, Mr. Hardester, we'll defer to the other reports. CHAIRMAN HARDESTER: Thank you. Mr. Kearns? MR. KEARNS: I do have a few things to share with everyone today. First, as of last Tuesday night, many of you may have known this, but thirty some odd years of his practice of medicine in EMS, Dr. Bruce Pennicott (ph), who was the EMS Medical Director of the year, had to retire as of last Tuesday night. And we have replaced him with Dr. John McPhearson. He is already in place and our new medical director is now John. I have some wonderful news to report. Since education has been such a big issue here in the last several months on the Council, I have been informed that St. Petersburg Junior College, which recently changed it's name to St. Petersburg College because they are now a four year degree school, is working out the final arrangements with George Washington University to have the first state of Florida four year degree in EMS. It will be a Bachelor's of Science degree program in EMS being offered this fall at St. Pete College. We're very pleased about that. We discovered a couple of years ago that there is a little glitch in the motor vehicle law. And I apologize, Captain Gaston, I don't mean to surprise you here. If you are not a fire department and your vehicle is not permitted by the state, as all of our ambulances are, then you're not allowed to run lights and sirens in the state legally. You're not recognized. Your vehicle is not recognized as an authorized emergency vehicle. Now, volunteer the fire fighters can run with the red light but no siren. And the physicians have that ability, as well. However, the Sheriff in each county has to grant authority for any other marked or unmarked non-fire emergency vehicles. So, it's in Chapter 316 of the Florida law. We had a couple of discussions in some of the constituency groups the other day and it appeared to me that several folks weren't aware of that. You might want to go back and check to see if your vehicles have been permitted. You need approval there from your local Sheriff. Some of you have e-mailed me after a story hit the newspaper about the dilemma we've had in my county with some hospitals not wanting to pay the bill for ambulance transport, since the law changed for the patients under the Baker Act. I'm happy to report I got a check yesterday from one hospital for over a million dollars. They did not contest that they were supposed to pay. They just didn't want to pay. So, for those several counties who have contacted me, continue to fight on. You can get that money. I'm going to Disney World. And then the last thing. We got a call from ABC News in New York. And I'm not sure of the date. Mike, do you know the date it's going to show on T.V.? AUDIENCE SPEAKER: I believe it's August 17th. MR. KEARNS: On August 17th there will be an ABC News special on government services and there will be about a three minute segment in that one hour show on Pinellas County. We're very pleased about that. Thank you, Mr. Chairman. CHAIRMAN HARDESTER: Thank you very much, Mr. Kearns. And a warm welcome to you from the Council. Dr. Silvestri? DOCTOR SILVESTRI: At the medical directors meeting we had an extensive panel discussion focusing on the area of medical director reporting requirements to the State. And, basically, what came out of that is we were looking for the Department initiating some sort of rule making to clarify the Department's interpretation of medical director reporting disciplinary requirements, what the requirements are. I believe it falls under 401.265, the Statute for, Medical Director Reporting Disciplinary Actions. And we discussed a couple of scenarios. Scenario one being, a paramedic misses two intibations. We do a Q/A, remediate it. But if you look by the letter of the Statute, it says any deviation from minimum standards of care require the medical director to record that to the State. And we're sure that's not the intent, to report every event like that. Another item, another scenario is the scenario on the Department's side where a paramedic chronically comes into work late and the agency themself discipline that paramedic. Is the medical director then required to report that to the Bureau? And, basically, we had a rather extensive discussion relating to these items. And we're all looking for clarification. Everybody wants to comply. The consensus is we want to comply. We'd just like to know exactly what to report. CHAIRMAN HARDESTER: Thank you, Doctor Silvestri. And I would recommend that a portion of our agenda here on committee assignments, if you would encapsulate those issues that you want clarified, we would then ask the Bureau to issue a report on it at the next meeting. MS. ALMAGUER: I have no report at this time. MS. SWISHER: I'd like to comment on a few things that happened at the constituency group. At the EMS Educators' Meeting discussion focused on the development of the test bank that would be evolving around the new paramedic curriculum. All the EMS educators would be offered the opportunity to provide some input in the hope that the questions would more accurately reflect the competencies that are to be required. Also of concern was that so many of the current test banks lack security. So, this project was going to focus on test security, as well. The educators are being requested to write the objectives that have been identified by frequency and importance so that the questions can be developed based upon the educator ranking. A two-day seminar is going to be held down in Fort Myers to begin the development of this test bank. The educators also agreed to establish a committee to investigate the feasibility -- and I point out feasibility -- of EMS educator bidding for the next contract to conduct the exam for certification. Then we had Rob Coburn (ph) of the community colleges. And he led what I guess could be described as a healthy discussion on the pros and cons of national accreditation versus State approval. And this discussion actually was initiated by our Bureau Chief. And the community college is seeing -- their biggest concern seem to be around the fact that the State approval meet the same standards, of course, that national accreditation meets. So, that was primarily what occurred in the constituency groups. And, again, I'll request additional training later in the agenda. Thank you. CHAIRMAN HARDESTER: Thank you, Dr. Swisher. Mrs. Conlin? MRS. CONLIN: Judy Conlin, the Department of Education. I just have a short report. We have given out four more human patient simulator grants, just meeting the June 30th deadline for them to spend that money. I also will be getting information out regarding the MTA/ATT to educators. This was at their request at the Educators' Meeting. I will be meeting with Freda Travis in private schools, prior to my technical advisory committee meeting in October, to discuss how we can better support each other. The Division of Work Force Development purchased sixteen pages in Florida Trend Next to promote vocational education. And there will be one page in there on health occupations education. This is another healthy sum, but this magazine will be going to all students 9 through 12 in Florida this fall. And I also am getting a new practitioners' group, which will be made up of health educators, occupational themes, vocational directors and supervisors. And they're also going to get, for the first time, and it's not legislatively mandated, some money. And this group will decide upon needs in health science education. And then we'll have some money to try to carry out some of those needs. And I have nominated an EMS educator to that group. Thank you. CHAIRMAN HARDESTER: Thank you. Captain Gaston? CAPTAIN GASTON: No report. CHAIRMAN HARDESTER: Thank you. MR. FUGATE: Good morning. Craig Fugate, Florida Division of Emergency Management. I now introduce myself as the Governor's Emergency Management Director. I'm not sure if that's a good thing in hurricane season. But if anybody has been following emergency management, you know that Joe Myers has been our director for seven years. He has left to go to the private sector. The Governor asked me to run the division through hurricane season. And since we're in hurricane season, I'll not deliver the forecast. I'm just going to ask you this little question, Irv. If I went up to the newest member on your crew and I asked them, What are the hazards of a hurricane? What do they mean for you? And what's your department's plan? Can they tell me? Do you think so? How many people here have stations or crews that you'll have to move in a hurricane? When do you implement your plan? When do you shut down operations when the storm's hitting your county? And does everybody know that? And has that been agreed to by the political leadership? You then have to answer after the storm why you shut down operations, because it was too dangerous. What's your plan after the storm to get back into those areas? How are you going to respond to calls when there's no street signs and 911 is not functioning and your towers are on the ground? It's hurricane season. Answer three questions, What are the hazards? What do they mean for your agency? And what's your plan? And does the newest member on B shift know the answers? Thank you. CHAIRMAN HARDESTER: I thought it was only members of the fire service that picked on B shift. Thank you, Mr. Fugate. We congratulate Joe Myers on his retirement as we welcome you into that position. Mrs. Pieratte? MRS. PIERATTE: Pat Pieratte, DOT Safety Office. Our office is currently finalizing the grant selection for next year's grants, which will begin October 1st, the traffic safety grants. So, if any of you applied for a grant, you should be hearing from our office by the end of the month. And if any of you are doing traffic safety fairs or educational outreaches, you can give me your card afterwards and note what type of topics you want to cover. I'll give you some educational materials and probably some promotional items, too, to go along with them. I brought to you today some copies of two brochures that were done by grants we currently have under contract. This is a redoing of one of our brochures called, Bicycles are Vehicles. It was redone for children, to make it more appealing to children. It was done right here in Orlando at the Orlando Children's Safety Village. And I have some samples on the table there and also some more back in my car if you want more. And then this one was just the Walk Alert brochure, which also was redone for children to make it more appealing. So, if any of you want more than are on the table, I have some more in the car. The parking lot's just too far from the hotel to get everything here easily. I have some copies on the table also of the Florida Bicycle Messenger, which is the publication of the Florida Bicycle Association, which is located here in Orlando. And I wanted to announce that the Florida Bicycle Association, the Bike Florida and the traffic bicycle education program out of the University of Florida, have partnered this year to present the share the road rally and the Florida bicycle summit, which will be in September, September 13th through 16th at the Greenleafe resort in Polk County. That's going to be a really unique event. We've had to share the road rally for several years, but now we're adding the serious educational component to it. So, we think it's going to be a real successful event. Some of the seminars include law enforcement for bicycles and pedestrians, clowns put on a bicycle rodeo, safe ways to school, train the trainer, middle school bicycle safety, bike action workshop, bicycle repair and maintenance courses. I know a lot of the EMS agencies are going toward using bicycles to go into fairs and other crowded events where a bicycle can get to an incident faster than a motor vehicle. So, I think some of these would be real useful for you. Also, updates on the Green Ways and Trails office, the Florida Bicycle Association Board meeting. So, if you're interested in any of these, pick up the Florida Bicycle Messenger and right in the middle there's information on the share the road rally and the bicycle summit. And we think it's going to be real successful. Announcements have only been out for about a week and already there are seventy registrations and we're two months out from the event. Also, Greenleafe is a beautiful resort if you've never been there. And they've provided very good rates for the hotels. And if you're going to do any of the rides, it's twenty-five dollars. If you're just coming to the educational events, there's no charge for those. So, I think it's going to be good. Thank you. CHAIRMAN HARDESTER: Thank you very much, Mrs. Pieratte. Mr. Gillespie? MR. GILLESPIE: I have no report at this time. CHAIRMAN HARDESTER: Thank you very much. Thank you very much and welcome again, Council members. Before we move into old business, we have had two outgoing members join us. The Bureau Chief and I will move to the podium. Just as a reminder to the audience members, if there are any constituency groups that wish to announce or actually do an annual award from their organization, we'll pick that up under the public comment portion of the agenda. Please get speaker cards. MR. BEMENT: At this time I'd like to ask Andrea Barber and George Fox to come forward, please. George and Andrea, we'd like to thank both of you for your dedication to the EMS Council over the last four years. Your contributions have really, really made an impact in the state of Florida. And we encourage you to please remain as active leaders in Florida EMS circles, as well, you'll always be welcome. Thank you. CHAIRMAN HARDESTER: Just as a reminder to the Council, we will hold off on our presentation of the annual EMS awards because most people were notified that it would be a little bit later in the morning than it is right now. So, we'll move from the work group section into old business. And the first item is announced versus unannounced inspections. Of course, this was quite a lengthy topic at our April Advisory Council Meeting. The Bureau Chief has some comments about that. MR. BEMENT: Yes. Announced versus unannounced inspections have really been an issue that I've been sorely made aware of since I attended my first Council meeting in Jacksonville in January. And we've equated a great deal of consideration in the office. While the Department hierarchy has made it clear to us that unannounced inspections will not go away, we can, however, concentrate on a focused inspection. As most of you are aware -- that have anything to do with annual services -- when we do an inspection, we have about ten or twelve sheets we fill out and we do a comprehensive inspection. What the Bureau has offered is that we can do a focused inspection to concentrate on a specific sheet or two, something that's less impactive to your organization. When we come in on an unannounced inspection, that will pretty much give us a snapshot of what is occurring within an organization during an unannounced inspection. The constituency itself have asked that we develop an internal operating procedure and bring it back in October for perusal, so you can see just how this is going to work. And that's really all there is on that issue right now. CHAIRMAN HARDESTER: If I could just invite any Council members if they have any questions on that topic? Yes, Chief Brown? CHIEF BROWN: Chuck, when you talked about the availability of focusing the inspection, would that be a subjective -- at the discretion of the inspector which of the ten or twelve sheets they would use or would there be guidelines set down that said unannounced inspections would focus primarily on vehicles, equipment and personal certification versus training, records and documentation in the administrative office? What's your thought on that? MR. BEMENT: Good question. My thoughts on it currently are that we would maintain our randomness of agency and randomness of what we would choose to inspect. However, what we are willing to offer is that it would be a limited focus inspection and not comprehensive. Does that answer your question? CHIEF BROWN: No. I guess yes and no. It doesn't change the scope or the depth of the inspection, other than the fact that you're saying that an unannounced inspection wouldn't be complete. It could be any part of or multiple parts of the system, instead of the entire system, still including trucks, equipment, training records, administrative documents, just not all of them? MR. BEMENT: Yeah. What I'm anticipating is one of our sheets is an ALS ambulance sheets. Another one, for example, is administrative records. If we would just concentrate on, let's say, one ALS ambulance, two ALS ambulances, one ALS ambulance, a BLS ambulance. I would envision it would be some kind of a combination, maybe just one vehicle. But it's going to be less comprehensive, and less time demanding than it is now. CHIEF BROWN: And the reason I say that, that's what the unannounced inspection is now. They don't check every permitted vehicle we have. They pick certain vehicles. They pick a certain percentage or number of training vehicles. And they pull them randomly or pull names at random. I mean -- MR. BEMENT: But they complete twelve documents, which are different parts of the inspection, approximately ten or twelve. And there's a lot of them. We could just focus on -- we could potentially just come in and do one ambulance. And that's what we'll define in the policy and procedures and bring back for a review. CHIEF BROWN: Okay. CHAIRMAN HARDESTER: Mr. Kopka? MR. KOPKA: Are the compendiums up to date and can those be made available on the web-site? MR. BEMENT: As far as I know, the compendiums are up to date. If there are any changes at all, they're minus the recent rule changes. However, what we do have, we've been advised internally that we can make it -- if you ask for it, we'll give it to you. But we're not going to post it on the web. And the reason I say that is because the compendium is essentially a guideline for our inspectors. And what I compare it to is let's say your 1040 long form. You have your form and then you can get the whole booklet and it tells you how to fill out the form. That's exactly what our compendium is. We have our inspection forms and then we have our booklet that tells our inspectors how to fill in the books. That's really what the compendium is. CHAIRMAN HARDESTER: Are there any other questions on this topic? So then what I hear then, Chuck, is that in October you would be prepared to have more detail on this? MR. BEMENT: We'll bring an operating procedure -- it will require an operating procedure change. We'll bring you abreast. CHAIRMAN HARDESTER: Thank you very much. The next item under old business was the Plant City Funding Organization. This was a resounding success for the community. Again, this was a very lengthy topic at our April meeting. We found out there was authorization before the legislature. We found out at the eleventh hour. Many people worked very hard to turn that around. Some comments from the Bureau Chief. MR. BEMENT: I pretty much covered it in my report, but yes, it was defeated by the Governor because there is a process established and that's the process that everyone needs to go through. I think the Governor's clear message that EMS trust fund is not open to member projects, other than what's currently defined to access that trust fund money through grants. CHAIRMAN HARDESTER: Thank you very much. It was a great verdict to the community that that was turned around. Yes? MR. KEARNS: An additional comment on that topic, if I may. I had the pleasure of having breakfast with Representative Burg (ph) about two or three weeks ago. And you should have seen the look in his face when he asked me what I did. Oh, and I made some of you guys kind of angry. So, anyway, in the spirit of cooperation, I offered to him that there are procedures to follow we and would be happy to help his constituents or him in navigating through the established procedures. CHAIRMAN HARDESTER: Thank you for that comment, Mr. Kearns. The next item is a blood draw kit. MR. BEMENT: Yes, Mr. Chairman. It was directed by a Tara Galensky that the Bureau explore the blood draw kit issue. What we've currently found is that troop commanders on the Florida Highway Patrol have a list of all the vendors which they have available to them for blood draw kits. And I believe the directive was to come up with a standardized blood draw kit that we could use in the field? CHAIRMAN HARDESTER: Yes. MR. BEMENT: And that's as far as we've gotten. That's as far as we've got at this point. And we'll have additional to report to you in October. CHAIRMAN HARDESTER: Thank you very much, Chief. I do notice that there's a representative from the city of Winter Park who originally brought this topic up. I encourage him to have a speaker's card and bring it up in public comments and we can talk about it further. And thank you very much for making some progress on this. I'm sure it's going to be quite a long road though to be able to get a standardized kit out into the field. The diversity recruitment retention ad hoc community showcase. MR. BEMENT: I believe the diversity recruitment retention folks did not meet. And I don't believe that there is anything we're aware of to showcase this Council. CHAIRMAN HARDESTER: Okay. We'll strike that from the agenda. And you did touch upon the second rule certification in your report. With that, now we'll move to presentation of the annual EMS awards. If I can be joined at the podium by our Bureau Chief and our Medical Director, Doctor Slevinski. We're still pretty ahead of the time that people were notified about this. We'll delay that a little further and move on to new business. The first item under new business is the State disaster plan and weapons of mass destruction pattern. Our Bureau Chief has quite a lot of comments about this area. MR. BEMENT: Thank you, Mr. Chairman. The Bureau was tasked by the ASFA group, Department of Health with coming up with a weapons for mass destruction, EMS Annex to the state weapons for mass destruction plan. As such, we brought this information to the disaster committee EMS Council. And, so, there were not -- I don't believe there were any, other than Mr. Almaguer, who is brand new. I'll give the report, as we kind of lead the discussions. Essentially, what the disaster committee came up with is they would like us to pursue a plan -- whereby, let me give you a brief overview of what was addressed in that meeting and what they would like in the plan. Is this a little better? Okay. A few things that came out of the disaster committee meeting regarding our efforts to draft a template for a mass destruction response plan was to address number one, training for personnel, to include the medical director. Training of personnel, medical director training and incident recognition. Use of any equipment that will be needed during a response to such an incident, and protective equipment that may be required. Also instruct personnel, medical directors and incident command, medication, drugs, any antidotes that would be required and any vehicle protection. The second thing that came out of the committee meeting was equipment medication requirements. Again, the protective suits, respiratory equipment, drugs and medication requirements, again the vehicle protection, equipment medication requirements. The third thing was communications. Awareness training for public safety answering point personnel dispatchers. State and local, Federal, other agency communications coordination. Web-site for a single source of information and dispatch protocols. The fourth thing that they asked us to address in the state plan was medical facilities. Address hospital overload issues, hospital decontamination and the potential for contamination of a hospital, and outside resources who would come in to assist such a DEMAS. Other areas discussed were regional teams, striking unit team formation, interaction with other agencies such as National Guard, county health departments, stock piling of drugs and supplies and transporter set up of on-scene treatment areas. Essentially, with the Councils, I guess, we'll look for a recommendation later on in the meeting to proceed. I also wanted to advise the Council members that we originally hit a ninety- day time frame to complete this plan. It has been since narrowed down to thirty. So, there is an emergency in at least getting a draft into the Department. I guess we'll look for a motion later on in the meeting. CHAIRMAN HARDESTER: Any questions for the Bureau Chief on this topic, weapons of mass destruction and EMS disaster plan? MR. FUGATE: Well, no questions, but a lot of answers, I think. And my apologies because I'm not able to get down for those meetings. The Florida Division of Emergency Management has been charged by the Governor with this act through this process and that's where your assignment came from, through Eleanor Gray of DSFA. A lot of the issues that you're raising are issues all the instant response agencies are having to deal with. And I can tell you some good things and I can tell you some even better things. First of all, next week the Chairs of the Fortune group, which is made up of representatives from the public safety agencies, will be meeting in Tallahassee next week to go over the equipment lists. One of the things that's happening for -- the best news is that there is funding out there. The carrot is money. The stick is they came up with a -- and this is nationally -- a standardized EMS package that we reviewed against the current staffing and packages that are required of our rules. And we're currently working on the concept of regionalizing response. Several issues were raised, such as hospitals. They can receive and decon patients in large numbers. EMS strike teams, because if this happens, obviously, mass casualty patients will be a major consideration. Those things are happening. They're happening through that working group. But I can offer this. I think we're going to get to the point where we start talking about training and things like that. Most of the money from the Federal government has been focused on the very few specific communities, some of which are represented here. And those were the original hundred and twenty big cities. And if you weren't a big city, I guess you weren't a terrorist target. That's what Congress thought. But there is additional follow-up money coming, particularly for training. And, so, what I would recommend, Charles, is that if you have somebody that we can get over next week with my folks. And the second thing, I would recommend the EMS Advisory Council -- I won't make this motion because I can't do it. It would be conflict of interest. But I would recommend that the EMS Advisory Council make a motion to, through the Division of Emergency Management, apply for a Department of Justice grant to address some of the issues. And I would focus on the training for medical directors. I think there are a lot of other areas. You mentioned dispatchers. If you have a dispatch center, we have made up a dispatch tape for 911 centers as first responders to a terrorist incident. We do have that available. The medical directors have been left out of a lot of these discussions. Since it's their writing protocols and giving direction on treatment, I think that's one area that through the EMS Advisory Council can have a very specific focus. I think that you would be successful in getting that. So, my recommendation, when you do go to new business -- which I cannot vote and I cannot make the motion because it will go through my agency to DOJ. But I would specifically recommend that the Council through EMS go for a justice trend in developing a training curriculum for medical directors. CHAIRMAN HARDESTER: Thank you for those comments. If any Council member would care to make that motion or a similar motion under that pertinent portion of our agenda. Although, I think -- Dr. Slevinski, correct me if you think I'm wrong -- I think that would be most appropriate for the medical directors to take up that initiative, rather than through the Advisory Council. DR. SLEVINSKI: We'll get someone there next week. DOCTOR LOTTENBERG: Just to add to that bit of information, the America physician and trauma recognizes that training for trauma services in weapons of mass destruction is a priority. In the next few years they will be -- actually, at this next meeting in October, they will be putting out a training course for trauma surgeons in weapons of mass destruction. At our last COT meeting that we had earlier in the year, we did have a presentation on weapons of mass destruction. And Florida committee on trauma recognizes this as continuing education. And I can't agree more that we can't leave the physicians out of the loop in this situation. CHAIRMAN HARDESTER: Thank you for those comments, Dr. Lottenberg. Any other comments on this topic? CHIEF ALMAGUER: Ruben Almaguer. I was in that meeting myself that Chuck actually mentioned. A couple of other issues came up. And I definitely support Mr. Fugate on the issue of training, which is probably the most critical issue. We could spend a couple of million dollars to buy equipment. We have the EMSTs around in some of the large, metropolitan medical strike teams. But, ultimately, the first responder of the first twelve hours, the first twenty-four hours is going to be the EMT, the paramedic, the fire fighter, the police office with very basic skills, with not a lot of updated skills on weapons of mass destruction. So, I think training is critical. The committee decided that -- or at least discussed, at least in the basic curriculum. For EMT and paramedics it might be something that we may want to look at, to actually add that in the basic curriculum for future paramedic and EMTs at the State level. The second issue that was discussed was CEUs. We have a recertification requiring CEUs for both EMT and paramedics. And some of those requirements, at least the historical perspective, SIDS training as well as AIDS training. And we might want to look to encourage agencies at the State level to require or at least give an option that agencies would have to have so many CMUs in training their EMTs and paramedics on mass destruction, by not just adding it, but maybe saying either or. You know, every other year do your AIDs, but definitely in the next two years you have to do some basic training on weapons of mass destruction. And third, we discussed a lot of federal agencies out there. They have a lot of this material. A lot of it's on the website. We're not going to reproduce anything new for the most part, especially if EMS has got a lot of information and has some good workbooks. Workbooks that are really, for the most part, waterproof, you know, check off lists for the first responding vehicle to respond to any incident and be able to not remember what you learned two years ago, but to go through a flow chart and say, what do I got to do until I get help here? And the State will probably disagree with DOT. DOT will require an apparatus out there that are licensed until 2000 plus. We could look at requiring those also. To allow the first response to actually handle the incident more appropriately. And those are my comments. CHAIRMAN HARDESTER: Thank you very much, Chief Almaguer. Any other comments on this topic? Thank you. Let's see. I've been informed that for the EMS awards, folks were supposed to be here at 10:00 a.m. I'm hesitant to do it, you know, any before 10:00 a.m. since there may be some arrivals between now and then. I think what we'll do now is I have just about 9:30. Why don't we take a break until say quarter to 10:00 and then we can move right into public comments. Thank you very much. We stand adjourned. (There was a break in the meeting.) CHAIRMAN HARDESTER: If the Council members will all take their seats. In the interest of getting our agenda back on track, will delay EMS annual awards just for another two minute until all of those folks have shown up. What we're going to do is move into the -- really kind of split the comment period into two parts. One is I have three speaker cards from organizations who would like to announce and actually give their annual awards. We'll do that first and move directly back to the agenda for the EMS annual awards. So, at this time I would call Andrew Farber to the podium. MR. FARBER: Good morning. My name is Andrew Farber, the Executive Director of the Florida Association of Professional EMTs and Paramedics. I'd like to introduce Dr. Tom Sword, our President, who will be making the presentation. DR. SWORD: Good morning. Thank you, Andrew. I'd like to ask some of the executive Board members who are present here to join me up at the lectern. I'd ask you to come on up. On behalf of FATEB I'm pleased to present our 2001 Legislator of the Year award to Senator Debbie Wasserman-Schultz, representing District 32, including parts of Broward and Miami-Dade counties. At twenty-six years old she was the youngest woman ever elected to the Florida Legislator. She has served in the Florida House of Representatives from 1992 to 2000. And her constituents must have thought that she was doing a great job because they elected her again to the Senate in November of 2000. The Miami Herald called her one of the top forty to watch. The Wall Street Journal called her a rising star. South Florida Magazine named her as one of the six most unstoppable women. She's been on ABC Nightly News, CNN's Crossfire, MSNBC's Hardball with Chris Matthews, the News with Brian Williams and in the USA Today, to name just a few of her national appearances. We agree with her constituents and those who call her dedicated, courageous and, yes, sometimes unstoppable and we thank her for it. She has championed several issues in the Florida Legislature important to EMTs and paramedics. Most notably as Representative Wasserman-Shultz a few years ago, she was the prime sponsor for the special risk bill that included EMTs and paramedics into the special risk classification of the Florida Retirement System. For that alone, we thank you immensely. She continues to support EMTs and paramedics in the Senate, most recently as co- sponsor to legislation that places EMS field supervisors into special risk and to increase benefits of those in FRS special risk that retired before July 1st, 2000. Beyond her work for EMTs, paramedics and firefighters she has fought for the public health and safety of the children in Florida. This past session we worked with her to support the Florida Infant Crib Safety Act, a bill that she championed through the Legislature. In spite of the Governor's veto, we applaud her efforts and look forward to working with her on this bill again in the next session. With Florida leading the nation in drowning deaths for toddlers, the Senator decided to do something about it. After three years of hard work, the Senator was able to get the Pool Safety Bill passed last year. We were proud to work with her on this one, as well. As most of you know, this went into affect July 1st and will undoubtedly result in lives being saved. The list certainly goes on as she has focused on education, children's issues, insurance and gender equity. Her awards are too far numerous to list here today. Suffice to say that we certainly respect and acknowledge her efforts on behalf of Florida's EMTs and paramedics. Please extend a warm welcome with us to Senator Debbie Wasserman-Shultz. Senator, on behalf of the Florida EMTs and paramedics in the state of Florida we award you this plaque that says, Presented to Senator Debbie Wasserman-Shultz, Legislator of the Year, in recognition of your outstanding leadership on behalf of Florida's EMTs and paramedics during the 2000 legislation session. Thank you. SENATOR WASSERMAN-SHULTZ: Thank you very much. Thank you so much Todd, Andy and David and everybody with the Florida Association of EMTs and Paramedics, Professional EMTs and Paramedics. Let me get the full title correct. This is without a doubt the biggest honor that I have received in my time in the legislature and that's because it's from the men and women who are in the front lines. And that sounds like a cliche, but literally on the front lines of public safety every single day. The ones that truly ensure that the public remains safe, is knowledge about how to stay safe and makes sure that when they run into problems they become safe once again. And what I've tried to do in the last few years is raise the profile of both children's safety and public safety in general, with the help of the Association. Andy has been a tireless advocate, forming every committee meeting that I've needed him to be present at. He's come. He's juiced up all the members. We've gotten e-mails and calls from my colleagues. And frankly, children's safety issues have had much smoother sailing in recent years through the legislature due to the assistance of EMTs and paramedics. And this is a tremendous honor for me. I'm going to -- without being partisan at all -- I'm going to issue a challenge to you and ask for the people in this room's assistance. We have educated the legislature about the importance of children's safety. They have passed legislation on drowning prevention and pool safety, scooter safety, crib safety, booster seats to ensure that older children who don't fit in adult sized seatbelts don't get strangled by those seatbelts when they're in a car and in an accident, God forbid. Unfortunately, we have not quite penetrated the Governor's psyche when it comes to awareness on the importance of these issues. That's about as nice as I can be about it. And I would appreciate it if you would help me in educating him. I think that the difference between his approach to children's safety in general and ours is that he believes that education is where it should start and stop. And I think we in this room know that education is not the only answer. It's important. It's an important piece of the puzzle, but you need prevention. You need obstacles in the path of toddlers when you know that supervision and other safety measure you have taken are lacking. And we need legislation. You can legislate safety. You can legislate some degree of responsibility when parental supervision lapses. And that's what we've been trying to do in the last few years. And I would ask for your help in the future. And thank you so much for this honor. I appreciate it. CHAIRMAN HARDESTER: Thank you very much, Andrew and congratulations, Senator. I call now to the podium Diane Flagg of the Florida Association of County EMS Services to give out the EMS Administrator of the Year award. MS. FLAGG: Good morning. Thank you. The Florida Association of County Emergency Medical Services annually presents an award to the EMS Administrator of the year. The recipient of this year's award is known by all of us, has been here for a very long time. We didn't make hardly any comments about his gray hair and his years of service to the EMS industry. But this is an individual that we turn to both for guidance in development of legislation for someone to -- if we need someone to arrive at a House or Senate committee meeting, to assist us in that legislation. This is also a person who comes up with many ideas in terms of where EMS needs to go in the future. And with that, I'd like to present the EMS Administrator's Award named in honor of Mark Fingerett (ph) to Mr. Robert Bailey. MR. BAILEY: Thank you, Diane. I guess being recognized by your peers is about the best thing that ever happened to you. I'm lucky to be associated with a great group. They've always been supportive of me over the years. When I first started coming to these meetings many years ago, we had leaders like Chief Ward and people like that, that you looked up to. And it's kind of scary to think that I'm at that level now. That's kind of a frightening thought. I don't appreciate the age comparison too much. I'm not quite there yet. I'm only forty-six. But I do appreciate the recognition. I have the best friends in the world. I look forward to seeing them. Thank you very much. CHAIRMAN HARDESTER: Thank you very much, Diane and congratulations, Mr. Bailey. AUDIENCE: Mr. Chairman? CHAIRMAN HARDESTER: Yes? AUDIENCE: Would you ask the sound man to give us some relief over on this side of the room. It's awfully hard to hear a lot of the comments. CHAIRMAN HARDESTER: I think he heard you. All right. Next we would call to the podium a representative from the EMS providers of Florida, Randy Vick. MR. VICK: Good morning. My name is Randy Vick. I'm the Vice President of the EMS Providers Association of Florida. Each year the EMS Providers gives a special award. This award is special because it honors one of our field personnel, one of the people that really puts it on the line every day, that represents EMS in the state of Florida. Yesterday, the EMS Providers presented an award to a member of the Tamarac Fire Department. I'm going to ask him to come forward at this time, Mr. Chris Dickson. In addition to his field duties, Mr. Dickson has been an important asset to the department by providing community education, giving back to the community, 911 access, trip and fall programs, CPR for family and friends. And his Chief wrote up that he responded to a call in a toll booth. A lady was in active labor and she had twins. One of the babies delivered -- she was five months pregnant, was in cardiac arrest. Mr. Dickson successfully resuscitated this baby, transported the mother to the hospital where she delivered the second child. And we're pleased to say that all are doing fine today. And on behalf of the EMS Providers Association, we're very pleased to present to you the Providers' Paramedic of the Year. CHAIRMAN HARDESTER: Thank you very much, Mr. Vick. We're moving to that portion of our agenda now where the State Bureau awards its annual EMS awards. I'll be joined at the podium by our Bureau Chief. CHIEF BEMENT: Welcome to the 2001 Statewide EMS Awards. This is the eleventh year the Department has honored outstanding EMS organizations and individuals through our statewide EMS Awards Program. We'll begin with the photo and video competitions and then proceed with the rest of the awards. I ask that each recipient come forward to receive your award and then there's reserved seats in the first two rows for a group photo following all of the presentations. One of our staff members will give you a release form, so that we can use your photo on our web page. In judging the photos and videos, principal criteria was a reflection of this year's theme for the National EMS Week: EMS: Answering the Call. The black and white photo awards is the first category. The first place, second place and third place will be Pinellas County EMS, photographer, Eddie Sperling. Please come forward. MR. KEARNS: Eddie's not here and he asked that we pick them up for him. So, Michael did. Some of the photos are (inaudible). Many of you old timers know Mike Gutze from his days in Alachua County Fire Rescue. We're very pleased that he's on board with us now at Pinellas County Fire. CHIEF BEMENT: Congratulations, Pinellas County. Color photo awards. First place, St. Lucie County Fire Rescue, photographer, Paul Milette, Palm Beach Post. Second place goes to Miami Dade Fire Rescue, photographer, Roman Bas. Accepting for Mr. Bas will be Chief Almaguer. Third Place, Pinellas County EMS, photographer, Eddie Sperling. And honorable mention goes to Miami-Dade Fire Rescue, photographer, Roman Bas. The next category is video awards. And this year for first, second and third place is Pinellas County EMS. The next category is EMT non-administrative awards. This award honors an EMT whose primary job responsibility is direct patient care and who has demonstrated independent initiative in the area of quality assurance. In addition to quality assurance, patient care, public access, medical control, disaster preparedness, public education and has demonstrated support, involvement and dedication to their EMS community and profession. The winner of the EMT non-administrative award is Jeff Young, Pinellas County EMS, Sunstar. Jeff is a gifted EMT with the ability to see the big picture. These attributes lead to his selection as the Sunstar 2001 Star of Life and the Pinellas County EMT of the Year. He is an all around most valuable player and has had direct impact on ambulance operations, billing, materials and public education. Jeff's knowledge of quality assurance led him to the position of alternate supervisor. He maintains a great relationship with medical control in the field due to his attention to detail. He maintains a high level of efficiency in ensuring each ambulance complies with all regulations. Jeff is the driving force behind Sunstar's, Sunny Sunstar robotic ambulance. He uses Sunny in public education and training. This outreach program has been given over thirty times this year to age groups ranging from pre-school to senior citizens. Jeff's first-hand knowledge of both field medicine and the logistics of supply enable him to introduce a new trauma bag to all Sunstar personnel. The new bag is now a standard on all ambulances. Jeff is a cornerstone of Sunstar. He serves as a mentor to others entering the profession. His upbeat personality goes a long way in dealing with difficult situations. His leadership has enabled others to have fewer difficult situations and learn from those they do have. For these reasons, we recognize Jeff Young as the 2001 Florida EMT of the Year. The next category is paramedic non- administrative award. This award honors a paramedic whose primary job responsibility is direct patient care and who has demonstrated independent initiative in the areas of quality assurance, patient care, public access, medical control, disaster preparedness, public education or training and has demonstrated support, involvement and dedication to their EMS community and profession. The winner of this year's award is Chris Dixon, Tamarac Fire Department. Chris has committed himself to his profession, as shown through his active involvement in the city, the community, the American Heart Association, as well as the fire rescue department and all the EMS constituency groups that he interacts with. He consistently develops programs that are utilized by their department including orientation programs, quality assurance programs and community health programs. Chris assisted with the development of county-wide protocols through his knowledge of pharmaceuticals and algorithms. He also reviews all patient reports generated on his shifts for quality improvement and brings patient care issues to monthly QA committee meetings for review. His primary responsibility is direct patient care. He has, on his own, rewritten implemented and delivered the most comprehensive QI program the service has ever had. Chris goes out of his way to assist the public in recognizing the 911 system. He is currently working on a brochure for citizens entitled, When to call 911. He is also developing public satisfaction forms to be mailed to citizens using their service. Tamarac Fire Rescue had no qualifying practical evaluation of potential employees. Chris developed a mega code evaluation scenario to ascertain the competency of candidates and also volunteered to administer the program. Chris is also actively involved in numerous community education and safety programs. These are just a few of the reasons why we present Chris Dixon with the 2001 Florida Paramedic of the Year Award. The next award is the injury prevention award. This award honors a group or individual for outstanding achievement in an injury prevention initiative in Florida. And the winner of this year's award is Community Health Initiatives Program, Orange County Fire Rescue. Orange County has a large population without access to basic and affordable health care. To address this problem Orange County Fire Rescue created the Community Health Initiatives Program. The program reports to the EMS division and is comprised of a team of three paramedics known as community health specialists. These individuals are trained personnel with extensive skills and specialized equipment to address the challenge of providing health care screenings for early detection of health abnormalities. It is anticipated that these citizens will seek treatment after a preventable medical condition is identified. The goal is a healthier and more health conscious public, reduced emergency responses, reducing spending of state and county taxes on health care and a reduction or elimination of possible future medical costs that might otherwise be passed on to the insured or uninsured public over the longer term. The team is also involved in many community projects such as health fairs, Head Start physicals and safety events, cool school shots program, community sharps disposal program, immunizations and car seat safety checkpoints. CHI and Orange County Fire Rescue firmly believe in education to prevent injuries to children. Their participation in numerous public education and safety events reflects their commitment to caring for the safety of children in their community. These are only a few of the reasons why Orange County Fire Rescue's Community Health Initiatives Program was chosen as this year's recipient of the 2001 Injury Prevention Program of the Year. The next award is for emergency medical services for children. I want to make you aware this is the first year for this award category. This award honors a healthcare professional or organization for outstanding achievement in the care of ill or injured children eighteen years of age or younger in at least one of these areas: education, clinical care, community service or disaster management. The winner of this year's award, the first award for emergency medical services for children is Dr. Lou Romig. Florida has a distinguished record in its contributions to emergency medical services for children at both the state and national levels. Current ongoing efforts address aspects of the pediatric emergency care spectrum from pre- hospital to hospital-based resources and training. A clear leader in these contributions is Dr. Lou Romig. Dr. Romig is one of the pioneers in the specialty. She participates on national task forces and committees that define pediatric emergency care designs and implements training curricula for EMT, paramedics, family physicians and pediatricians, as well as the lay public. Dr. Romig's ability to shed new light and new perspectives on what can be tedious basic training has made her one of the most sought after lecturers in EMS and pediatrics. Her pediatric adaptation of the classic Start Triage System is taking the nation by storm. More importantly, she has the ability to get her students excited and confident, creating new disciples who help to spread much needed pediatric education to places where she can't go. The south Florida area specifically benefits from Dr. Romig's activities in a number of ways. Dr. Romig is an active volunteer instructor for various basic life support programs, including a fire rescue explorer post and local national park rangers. She is also at least partially responsible for the training of the majority of south Florida paramedics in PALS through Miami Children's Hospital. As medical advisor to the Miami Dade Fire Rescue Department, she oversees protocol development and training for pediatric issues, frequently rides and takes primary care of EMS patients, both pediatric and adult and is always ready with a word of advice, a referral, or a personal ED or house call visit. It is with great pride that we award Dr. Lou Romig with the first annual EMS for Children Award. Congratulations. The next award is the EMS Dispatcher of the Year. This award honors a dispatcher for outstanding effort in processing a Florida emergency medical call. The winner of this year's award is Sandy Walker, Pinellas County EMS, Sunstar. On February 25th a call came in from a frantic parent over his young daughter being found floating face down in his swimming pool. Sandy professionally and skillfully handled the call, which turned out to be a tremendous save. Following emergency medical dispatch protocol and using the concept of repetitive persistency, Sandy was able to gain control of the father on the telephone, get him to focus on her questions and relay information to and from his wife who was attempting to rescue the child. Luckily the child had not been unattended very long and the mother was formerly trained in CPR. Sandy was able to get the parents to bring the child into the house, lay her down, open and clear the airway and begin the rescue breathing process. The child, who had been limp and blue, began to cough and breathe on her own. Sandy showed tremendous self control and exhibited laudable professionalism in the handling of this near tragedy, turning it into a tremendous save. Perhaps nobody can address the emotion of a call like this better than the child's mother. She mentions all her hopes, dreams and thoughts of seeing her daughter going to her first prom flashing through her mind as she held a limp, lifeless body in her arms. Due to Sandy Walker's skill and training, those dreams are still alive. For her efforts in saving the life of this child, we recognize Sandy Walker as the 2001 Florida EMS Dispatcher of the Year. The next award category is the EMS Educator of the Year Award. The award honors an EMS instructor or course coordinator who has made a positive contribution to EMS education in the state of Florida. This year's winner is Rick Prokop, Niceville Technical School. Rick Prokop's primary responsibility is providing CPR training and first responder certification for the city of Niceville firefighters and workers. Through his vision for improving emergency medical response and with the blessings of the City Manager, Rick established one-of-a- kind technical schools to train EMT-B students. He developed, gained state approval, licensing and instituted a top quality educational course for city employees and other personnel desiring EMT-B certification. Coordinating with the County's EMS director, Rick offered CEUs and refresher training for EMT personnel. He assures continuous quality assurance measures by reviewing the EMS patient transfers. As liaison for city emergency responders, Rick has the ability to institute improvements in training and standardization of procedures. Patient care has improved with the availability of EMT-B responders on all fire department crews. This has extended to surrounding communities within a thirty-five mile radius. Rick's main concern remains the development of EMT-B personnel. He continues to improve each course and looks forward to developing an EMT paramedic program. He is truly dedicated to the EMS community and professional development of highly qualified providers. For this we recognize Rick and present him with the 2001 EMS Educator of the Year Award. The next category is EMS First Responder of the Year Award. This award honors an individual who made a positive impact on a patient's outcome through interventions provided prior to the arrival of emergency medical services. The winner of this year's award is Steve Pigott, Crawfordville, Florida. Steve Pigott is an extraordinary man and his contributions to EMS are an accumulation of years of unwavering dedication. The first citizen-based first responder class was originated in Wakulla County twenty- seven years ago. Steve was in that class. Since that time, he has been giving of his time and energies in responding to medical calls in that county. Over the years it is estimated that Steve has gone on approximately sixty-six hundred first responder calls since he took that first class. In addition to his efforts as a first responder, Steve has also served with the Volunteer Fire Department almost as long as he has been a first responder. For twenty-four years he has served as Chief of Medart Volunteer Fire Department. He has also served approximately thirty years with the Florida Highway Patrol Auxiliary. Steve has always been a key player in helping with the improvement of emergency medical services for the county. His long tenure of displaying outstanding commitment and dedication as a first responder are recognized here today by awarding Steven the 2001 Florida First Responder of the Year Award. It doesn't appear that Steve is here today, but we did recognize him before the County Board of Commissioners about a month ago. The next award is Friend to EMS Award. This award honors an individual or group who by exemplary efforts, supports and enhances emergency medical services within their community. The winner of this year's award is Jeanne Nadle, Brevard County Public Safety EMS Reservist. Jeanne Nadle has been in the medical field since 1957. In 1999 she became a member of the EMS reservists in Brevard County. As a reservist, she has been active in participating in every event that her schedule will allow. Whether it's EMS Week or blood pressure screenings for senior citizens, Jeanne is there with a smiling face and friendly attitude. She has donated a large amount of her time during disasters. She has also been involved in the planning and staffing of special needs shelters. Jeanne stays involved in the public education events throughout the year. Whether it's the task of handing out flyers or answering various EMS medical questions, she is cheerful and eager to promote EMS in Brevard County. In recognition of all her efforts, we present Jeanne with the 2001 Friend of EMS Award. Congratulations. The next award is the Raymond H. Alexander, M.D. EMS Medical Director of the Year Award. This award honors a physician who has served as a medical director for either a BLS, ALS or air service and who has demonstrated excellence in the areas of quality assurance, medical control and who has demonstrated promotion and utilization of new medical trends and technologies. This year's winner, Dr. Greg White. DR. WHITE: Just a couple of comments. First of all, of course I want to thank the Advisory Council, many of whom I have known for a long time and I appreciate that, generally and specifically. I also have to thank the Advisory Council to continue to issue as a part of your old business this morning to promote the defeat of the COPCN. That clearly is double taxation, et cetera, et cetera, et cetera. And we thank you for that. In fact, I'm grateful that you've allowed me to continue as a benevolent dictator in a county of two thousand square miles and thirty stations. That we truly can get things done and I thank you. But my other thanks, of course, has to go to the paramedics and EMTs of our department. They are terrific. My director, Ray Chapos, my training staff, Betty Lou, Bob Clayton, John Allis and Harvey Graven (ph). They've been with me almost my entire duration of seventeen years. We truly get things done. They're tremendous folks. We all know the EMTs and paramedics extol their virtues all day and they should be. They're terrific. Lastly, it is really an honor to receive an award from Raymond Alexander. I met Ray back in the early 80s. My second or third interaction with him I was in Central Florida Hospital. I looked after a twenty-six year old boy who had a gun shot wound in the spine. He was paralyzed from the waist down. I treated the patient at 9:30 p.m. at 6:00 a.m. I looked after him all night long and called, I think considerably twelve neighboring hospitals and trauma centers, I still was not able to affect a definitive transfer. I got Ray and he said, I'm not really supposed to do this. It's one of these County unfunded issues that we're dealing with, blah, blah, blah. He said, but someone's got to stand up to the plate and that was Ray Alexander. It's because of him, a lot of this program that we have today in the trauma community in Florida. And it's a great honor to receive an award that has Ray Alexander's name on it. Thank you very much. CHIEF BEMENT: We're not done with you yet, Dr. White. Dr. White has been the medical director for Polk County EMS since 1984. During his tenure he has brought numerous advances to that System. Dr. White has had numerous accomplishments during his seventeen years as medical director. One in particular was the implementation of the current trauma evaluation criteria. This was accomplished due to Dr. White serving on the Trauma TAP, promulgating the guidelines which are now being used. Another recent accomplishment is his advent of transporting patients known with myocardial infarction to cardiac intervention centers in order to save heart muscle and decrease death. Dr. White has been an active member of the Florida Association of EMS Medical Directors for over a decade. He has contributed towards the goals of the organization, which include identifying cutting edge QA programs to be embraced by the Florida EMS community. He has shared his knowledge regarding increased access to automatic defibulators to the organization to demonstrate the benefits of EMS involvement and support. For several years Dr. White served as the Chief Judge and Chair for the International Air Lift Competition and the ClinCon Program. In this capacity he brought forth promotion of demonstration of skills based on the skills station concept of education via the Clincon program. For these and many, many more accomplishments, we award Dr. Greg White the 2001 Raymond H. Alexander EMS Medical Director of the Year Award. The next award is the Larry S. Jordan EMS Hall of Fame Award. This award honors an individual for lifetime achievement in the field of emergency medical services. This year's winner, Juan Botino, Madison County EMS. Juan's EMS career began in 1973. He received his EMT certification -- I guess at that time it was a license -- in 1974 and has been an important asset to the EMS profession ever since. Juan worked with Madison County EMS before moving to Miami in 1975. While in Miami Juan worked as an EMT with Randle Eastern Ambulance Service. After returning to Madison County, he was appointed as the EMS Director. During his tenure Juan has constructed one of the best and most respected rural EMS services in Florida. Their ambulances have continually received exemplary vehicle awards. In 1992 Juan was responsible for enabling the service to upgrade from BLS to ALS, which greatly improved patient care in their rural setting. Juan monitors and pursues available grants. His grant writing skills have allowed them to purchase several new ambulances and other essential equipment. Juan is also the 911 coordinator for Madison County and maintains their enhanced 911 equipment and database. He has also assisted in the development of the county's local mitigation strategy and comprehensive emergency management plan. Juan speaks fluent Spanish and his interpretation skills are often needed by EMS crews and law enforcement agencies. In short, the exemplary standard that Juan has set is recognized here today by our awarding him the prestigious 2001 Larry S. Jordan, EMS Hall of Fame Award. MR. BOTINO: Good morning. I am very honored to be here today. I never in my wildest dreams thought this would happen. My guys went around behind my back and kind of sneaked this in. I'd like to thank the Bureau and the EMS staff for all the support they have given me throughout the years. Without their help we could not have accomplished these things. And to the Madison EMS team for the job that they do. You're the best and I'm proud of all of you. We share many tears and sorrows, as well as laughter throughout the year. And I'm glad to know all of you and I'm blessed to know all of you and can count you as my friends. I'd also like to thank the Madison Board of County Commissioners, the Chair of the Police, Fire Department, dispatchers. We are an emergency management role and the assistance and support they have given us. And to the citizens of Madison County for allowing me to serve them. To my wife, Karen, and my children, Juan, Michael, Christiana and Brittany, thank you for being there for me and understanding the stresses that comes with this job. You're a ray of sunshine in my life and there's no word I can give you that will show you how much I love you. Tomorrow is our anniversary, so I told her I would bring her to Orlando. To my dad and mom who risked everything by leaving Cuba so my sister and I could grow up in this, the greatest country in the world, and enjoy the freedoms and opportunities that we take for granted. Papa, Mommy, gracias. Most of all, I would like to thank God and my savior Jesus Christ for allowing me to do what I do and being with me on every ambulance call and for letting me be part of your EMS family. You're all a family of heros. And may God bless you and keep you all safe. Thank you. CHIEF BEMENT: The final award today is the EMS Provider of the Year Award. This award honors an EMS service which assumed a leadership role in EMS by achievement in areas of quality assurance, patient care, public access, medical control, disaster preparedness, public education and training in Florida. This year's winner for the EMS Provider of the Year goes to Pinellas County EMS, Sunstar Ambulance Service. The Pinellas County EMS Authority is a special district, government agency created by a special act of the Legislature in 1980 and endorsed by a county-wide referendum. The EMS Authority was designed to oversee all aspects of emergency medical services provision within the boundaries of Pinellas County. By regulation the EMS Authority is charged with providing the highest level of patient care, a high degree of ambulance response reliability and managing the EMS system in the most fiscally efficient means possible. Sunstar is a busy, all-paramedic ambulance service with one hundred and fifty-six thousand responses and one hundred and seven thousand ambulance transports last year. They are the third largest multi- jurisdictional EMS agency in the United States and the largest public utility model ambulance service in the nation. Sunstar has brought recognition to EMS in Florida because they are an international leader in the provision of high quality emergency medical care. In the last year Sunstar received accreditation status from the Commission on the Accreditation of Ambulance Services. This was the result of a three thousand forty-four page application and a two-day on- site review by a three-member team. Also within the past year they were accredited by the National Academy of Emergency Medical Dispatchers, bestowing the Accreditation Center of Excellence Award on all their paramedic, medical dispatch programs. The receipt of these two accreditations within the same year brought further international recognition to Florida since Sunstar was only one of three ambulance services in the entire world to hold both accreditations awards. In early March EMS Magazine chose Sunstar as their recipient of the Gold Award, 2001 EMS Service of the Year Award. Recently they received an unannounced inspection from the State EMS office. This was the third unannounced inspection in the service's history and for the third time, no deficiencies were found in their operation. The Authority's leadership believes in the value of team work and group thinking, delivering better decisions and outcomes. These are just a few of the highlights of what this outstanding ambulance service has accomplished. They have historically demonstrated a high level of education, team work and commitment to extraordinary EMS and excellent customer service within their community. We congratulate Pinellas County EMS, Sunstar Ambulance Service for being chosen as the 2001 Provider of the Year. MR. KEARNS: Thank you, everyone. This award is really for the men and women of Sunstar, where the rubber meets the road. On behalf of them, thank you. If we could have all the award recipients to please come forward. We're going to get a group photo before you leave. Thank you. In a few short minutes we're going to turn the remainder of the meeting back over to Dan. CHAIRMAN HARDESTER: What we did before we moved into the awards was to basically split up the comments into two and to allow the constituency groups to give their awards. Now we move into that portion of the agenda for public comment. And I do have four speaker cards. And if there are any additional members of the audience who would like to address the Council, please secure any speaker cards. The first person that I would call forward is Charles Bracewell (ph) of the Winter Park Fire Rescue Department. MR. BRACEWELL: Hello. I'm Charles Bracewell, Winter Park Fire Rescue. I think I can speak for most of us that we're all in favor of getting the drunk drivers off the road. And one of the things that's come to our attention is we're getting a fair number of requests in Winter Park Fire Rescue to draw blood for DUI. We don't have a problem with that. But we're looking at the kits and the kits are not safe. They come with the needles, the bag containers and the sealed container. And you cannot use anything but what's in the kit. And try to hold that into a patient's arm, especially if they're not very cooperative, and this happens on several occasions. And the police can actually restrain the patient if there is serious bodily injury or death and we're to draw blood from those people. Well, you can see the problem with trying to hold those in the patient in the first place and then they expect us to -- you've got contaminated needles. You've got the paramedics as risk, as well as police officers trying to restrain the patient. The other problem is trying to hold this in the vein of the person. It's kind of difficult to manage. I've come up with a system that I presented to a couple of manufacturers, Tri-Tech and the other one was -- it was Tri-Tech. It was T-I-K, two of the manufacturers of these kits. And they can put these together, but they said the problem is getting the state and the city to purchase these things. It wouldn't be effective to have as just something that we changed in Winter Park. It needs to be nation wide. But if a Protect IV needle is used to binucleate the vein like this, (inaudible). And then with this apparatus, it's got a plug that fits right onto the back of the IV catheter. And once you contract the needle, and then when the needle is protected like this, there's no sharps on the scene. And you're able to easily hold this in the patient's vein while you actually put the blood tubes in there and then get the blood samples. But doing it that way there's no exposure to anyone on the scene. Anyhow, what I was hoping to get support with the Council is I don't know how -- what it's going to take to get this changed, not only statewide, but it should be addressed nationally. I know that Florida Department of Law Enforcement, they're not resistant to this change. It's just that this is the kit they've got, somehow we've got to get the ball rolling to get everybody interested in changing this. And I propose it's not adequate just to say that these kits should be used up by attrition. We should say, okay. Those kits are no longer safe and take those out of the field and start using something safe. Now, some of the other manufacturers have shown me this one, which this is another type. But this one, once you've binucleated the vein and you draw the blood, then you pull this back and it locks the needle out of place. But, again, it's safer to use this type so you don't have that trying to pull apart the needle in the vein. But anyhow, I would just like support in getting this changed to make it safer for everybody concerned. We are supposed to get our needles in October. And this doesn't meet the standards . . . CHAIRMAN HARDESTER: Mr. Bracewell, stay there. And I'd invite any comments or questions from the Council members. Dr. Slevinski? DR. SLEVINSKI: None of us would disagree with having a safer needle system. I think it's been submitted to FDLE for regulation. Keith, is that approved? MR. GASTON: It's been approved by FDLE. I think they're waiting on the medical directors at this point. MR. BRACEWELL: I talked to these manufacturers and I don't know anyone who has actually produced them. But I sent these apparatus to these manufacturers and they are actually going to send me some prototypes and the cost. MR. GASTON: What FDLE did recently they changed their rule making, since we are a rule- driven state, and they allowed the rules to the point where anything that the medical director authorized, as long as it follows a certain procedure and it dealt with non-contamination issues or blood alcohol tests, they're going to approve. MR. BRACEWELL: What's the next step? MR. GASTON: I think we're going to go to Dr. Slevinski for that. DR. SLEVINSKI: The next step is for me to contact the medical directors and let them know that they have this available to them. Let them carry it out on an official basis. MR. KEARNS: I'm just curious. Are these new kits available? Are they being mass produced? MR. BRACEWELL: No. That's why I sent this to these two manufacturers. They have this and they're going to send me some prototypes and a cost for that. This Tri-Tek, there may be others, but I contacted two. They researched it and they couldn't find anybody that was making things like this. MR. KEARNS: I'd certainly support that. CHAIRMAN HARDESTER: Dr. Silvestri? DR. SILVESTRI: I have a question. So, we will have the authority to say within our jurisdiction, we can authorize a needle assistance? MR. GASTON: That's my understanding. I need to get back -- the FDLE rule does not actually go into affect until July. I have not seen a hard copy of the completed rule. So, I'd like to have a chance to look at it. I'll distribute it through the state office and you can look to see how you need to work your system. DR. SILVESTRI: My only concern would be if Charlie's on the scene using some alternative device that's not in the package. The law enforcement officer might object to them doing that. I just wanted to know that the authority is truly authority. And if we allow him to use something other than in the kit, would they allow them to do that? CAPTAIN GASTON: Let's look at the rule and make sure we're correct in that, because I think on my side of the house I need to have some training of what you're saying so that everybody knows this is an authorized procedure. CHAIRMAN HARDESTER: Perhaps, Captain Gaston, could talk with Dr. Slevinski and see if we can make this a uniform safe law act. What I'm hearing is that -- what you're saying is do you need to double check? It appears that the individual medical directors have the authority to declare which kit needs to be purchased within their jurisdiction and law enforcement would adopt that, from what I hear you saying. And, of course, a larger issue is we would want to make one standard kit that's needleless statewide. DR. SILVESTRI: I can pretty much speak for all the medical directors. I think unanimously we would adopt using a needleless system across the board. CHAIRMAN HARDESTER: So, I guess the other issues on that -- Mr. Bracewell has gone a long way in speaking to the manufacturers and they declared they would make these components available. But as of yet, it's only a prototype. So, a lot of work still needs to be done to get it adopted statewide to the medical directors and then to have the manufacturers to adopt that and actually make it available in all the jurisdictions. MR. BROWN: I'd just like to say that we need to be careful about adopting a standard we're unable to meet. Like I said, it wouldn't be the best thing in the world to have the -- medical directors get out and make a statement that we want a needleless system when there's not a needleless system available on the market for the blood draw kits. DR. SILVESTRI: What we would stand by is adopting the option to use the needleless system. CAPTAIN GASTON: There is -- let me clarify. There is not a kit on the market, so FDLE did not approve the kit. What they cautioned me about was they are not going to approve a kit because it's a competitive marketplace. They're going to approve a procedure for a design. And they agree with us a hundred percent as far as the safety and everyone's safety is involved. CHAIRMAN HARDESTER: Perhaps under that portion of our agenda we could just appoint a short-term ad hoc committee of you, Captain Gaston, and Dr. Slevinski. And invite Mr. Bracewell, as well, to join Captain Gaston and Dr. Slevinski to try to resolve the issue. It seems like you've got the ball line-ways down the field. Thank you very much, Mr. Bracewell. Any other comments from the Council members? Thank you very much. We call to the podium now Suzie Davis from the Bureau of EMS. MS. DAVIS: Good morning, Mr. Chairman, ladies and gentlemen of the EMS Advisory Council. We have come before you today to ask for your endorsement of the Florida Emergency Medical Dispatch Resolution. In your packets are copies of the Sunrise review questions and answers and a copy of proposed EMT legislation, answering the questions proposed in this exercise and completing the twenty-nine attachments of the combined talents of the people I have standing with me. These efforts could not have been achieved without their support. EMT has been in the planning stages for the past five years. And we are proud to present the information to you. This is our chart that we have. And I welcome anybody to look at it if you choose to. And, therefore, we ask for the resolution of the Advisory Council to support a statewide standard for the practice of EMT, including training, certification of EMT personnel, with the appropriate medical direction and quality assurance, coordination with their local emergency medical services. With that, I would like to turn this over for just a moment to Jim Leneer(ph) who helped me in this, to read the resolution. MR. LENEER: Thank you. Good morning. The resolution for the Florida Emergency Medical Services Advisory Council, July 2001, Orlando, Florida. Whereas, the key component of the EMS system is emergency medical dispatch EMT. And, whereas, the essence of EMS providing the first response for immediate action can significantly reduce the format gap when intervention occurs while the patient awaits the arrival of the EMS team. Medical dispatching has been the last major in the EMS system to be identified and developed. And, whereas, other components of the EMS system have had the standard enacted of training and certification of emergency medical technicians and paramedics to function on the EMS response units. And, whereas, there has been significant development in the field of EMT to guide the emergency medical dispatcher to proper calls, professional ethics, EMTs to A, identify the level of need and resource allocations and response modes, thus enabling more effective and efficient dispatch, B, identify the situations that might require pre-arrival instruction, C, gather information to be related to the EMTs to help them manage the situation on arrival and D, obtain information regarding scene safety, the patient by the standards and responding personnel. And, whereas, there is an expectation by the public that when they call emergency medical help, a properly trained dispatcher will handle their call, regardless of where they're located in Florida. And, whereas, the recent surveys on some systems leave all the decision on the dispatcher on a case by case basis, may or may not use a protocol and may or may not provide EMT training, thus resulting in a liability for the Agency. EMT programs provide appropriate standards that result in more effective dispatch and the savings of lives. And, whereas, organizations such as the National Association for Emergency Medical Services Physicians, the National Institute of Health, the National Highway Traffic Safety Administration and the American Society of Testing Materials have approached development in adoption of standards for EMT. And, whereas, Florida has not enacted standards for EMT. And, whereas, there is a need to take affirmative action in order to ensure the betterment of EMT practice, separate standards in order to function in a critical way between the public and emergency medical personnel. Now, therefore, be it resolved through this resolution of the Emergency Medical Service Advisory Council expresses its support for statewide minimum standards for the practice of emergency medical dispatch, including the training and certification of EMT personnel and the appropriate medical direction and quality assurance in coordination with the local emergency medical systems. Thank you. MS. DAVIS: And with that, we do thank you for your time in listening to us, for your support in our EMT legislative acts. Thank you. CHAIRMAN HARDESTER: Thank you, Suzie. Would you just stand at the podium? I just ask you to stand at the podium for a moment. And I ask for the Advisory Council members for their comments and any questions. Starting on my left, does anyone have any comments or questions? Looking to my right, Mr. Kearns? MR. KEARNS: Do you have specific legislative language already developed? MS. DAVIS: There is language we have developed in your packet. It is mainly definitions of what this group has hoped to achieve. We answered two questions that we summarized review had with twenty-nine attachments there that I did mention. And if anybody's interested, they can -- if you have insomnia, you won't after reading this. There are legislative definitions in those. MR. KEARNS: But no actual draft language? MS. DAVIS: No. Not in draft language, no. MR. KEARNS: Essentially, I guess we're being asked to support the concept? MS. DAVIS: Support the concept, yes, of EMT. MR. KEARNS: I just want to say personally, this is long overdue. I'm a big supporter. The time had come years ago. I congratulate you all for helping on this. MS. DAVIS: Thank you. Any other questions that we might can answer? There is no I. We're a team. And without the people standing behind me, this would not have been achieved. CHAIRMAN HARDESTER: We'll take this up under the voting portion of our agenda, the resolution. And I would concur with Mr. Kearns. When you said five years, I think it was more like about fifteen. But for a start, it had been talked about five -- I guess real seriously in the last five years. It's incredible to me that it's gotten to this point with this much substance. There are actually men and women who do this job around the state. Any other comments or questions from the Council? Seeing none, thank you, Suzie. MS. DAVIS: Thank you, ladies and gentlemen. CHAIRMAN HARDESTER: I do have another speaker card, Diane Flagg, who was up before with the Administrator of the Year Award, when she gave that award on behalf of our organization. She has some comments in regards to legislative issues. Diane? Thank you. MS. FLAGG: Thank you, Mr. Chair. For the record, Diane Flagg, President of FACEMS. I just want to brief you on some legislative issues that FACEMS will be looking at in the upcoming session. But first, to thank you all for your support in achieving the line item veto for the Plant City appropriation. A lot of the constituency group members pulled together throughout the state to address that issue. Also, that special risk for EMS command staff was approved this year. And that I want to thank the constituency groups for their support in helping get that through. And more importantly, the COPCN bill, statewide bill was defeated in committee. I want to thank all the constituency groups who were called upon to testify in Tallahassee. And with that I'd like to, Mr. Chair, leave you with a question. Is there a need to have the EMS Advisory Council take a position on the COPCN legislation for the upcoming session because it will, once again, be coming out? In addition, FACEMS is going to evaluate the feasibility of legislatively pursuing funding for Associate's and Bachelor's degrees for EMTs and paramedics. We're right now evaluating the feasibility of changing existing statute that would create additional funds for EMTs and paramedics with an Associate or Bachelor degrees. In addition, we're going to evaluate the feasability of pursuing the legislation of retroactive special rates for EMTs. And don't get excited. That takes a lot of work. But we are going to look at the feasibility of that. And what we will be doing is providing an update in October and also looking for the EMS Advisory Council's support on some of these legislative issues, specifically in the legislation that is being worked through by the Department of Health, which is the emergency medical dispatch, the second level of paramedic certification and EMT training centers. We certainly applaud the Department of Health EMS Bureau, their efforts in all these areas and know that many of the members of the constituency groups have worked long and hard. And we would just like the opportunity that when the draft language is completed, that we have the opportunity to review that language. Then we'll provide a position at the October meeting. We would also ask in regards to the temperature control rule, there has been some I would say extensive conversation, some rather loud conversation in regards to that rule. And FACEMS voted to formally request the Bureau to repromulgate their rule for temperature control, to give the providers the opportunity to workshop this again and gather additional data. Finally, FACEMS is going to reestablish the Medicaid task force. Several of our member agencies are undergoing audits. And we decided we should probably take a proactive role in this to keep some of these special members out of jail. So, we are going to see if we can work with Medicaid to help them reach a more feasible resolution to these condition codes and see if we can get them to stay in our perspective, appropriately, for EMS care of the patients. And just as a final note, FACEMS will be evaluating the recent discussion in terms of lab licenses and pharmaceutical distribution licenses that some of the agencies are being told that they need to have in order to provide EMS services. Thank you. CHAIRMAN HARDESTER: Thank you very much. And that then concludes the public comment portion. Of course, further on in the agenda we do ask for any additional comments from the contingency groups. But at this point, we'll move into the committee reports portion of the agenda and hear reports from our Council members assigned to the various committees. First, training and education? Ms. Swisher? DR. SWISHER: Thank you. Rita Travis at our committee reported as of September 1st, 2000, all training sites should have implemented the new paramedic curriculum. With that in mind then, the Bureau announced that beginning September 2001, the new exam will be available. A window period will be available from September 2001 to September 2002, when graduates can elect to take either the old exam based on the old curriculum or the new exam. The Bureau is still investigating the possibility, as well, of implementing a computerized testing system, for testing in the future, of course. Rita also reported that we are seeing overwhelming growth in training facilities, with twelve new applications being received for program approval. And this growth and of course the retirements have created a necessity for two vacancies in training and education. And it was reported that the job description had been reevaluated and there's been a salary increase, because it's been deemed appropriate with the new application description. Our Bureau Chief stopped by and he held some discussions regarding State approval versus accreditation and certification versus licensure. And it was suggested that we begin gathering some research from various states and explore various options over the next few months. And, finally then we have assigned a subcommittee to the end of life, an ad hoc committee to explore a national trend in end-of- life care. CHAIRMAN HARDESTER: Thank you, Dr. Swisher. Any comments or questions from Council members? Seeing none, we'll move to the state plan and turn to the Vice-Chair, Janet Livingston. And she will defer to Jamie Caldwell. MR. CALDWELL: Come back to us. CHAIRMAN HARDESTER: Trauma is listed next. Dr. Lottenberg, you made some comments on issues Do you care to expand on the issues? DR. LOTTENBERG: Yes, I'd like to make some comments. Yesterday between 2:00 and 5:00 the State facilitated a meeting of the EMS access to trauma care group. We had -- basically, we looked at four different recitations. We had recitations from the Federal Government representing INTALA (ph), explaining to the group the guidelines for INTALA offenses in reference to whether or not transfers from trauma centers -- into trauma centers and non- trauma centers would constitute INTALA violations. The presentation was comprehensive and educational for all. At the end it appeared to most of the group that Impala issues were minimal, if any. But all of the paperwork that we seem to be generating now relating to transfer criteria, I believe will be forwarded by the Bureau to the Baltimore office so that they can look at the criteria that we set about -- it appears that our State criteria will be able to satisfy INTALA to the point that violations would not occur when patients are transferred from non-trauma hospitals into trauma centers. We had a presentation from Dr. T. Bass related to the impact of regionalizing trauma care on trauma centers. And he basically showed us some information from the regions surrounding Shands Jacksonville and that new helicopter from Lake City, reaching out to acquire more patients. And he showed us a minimum decrease in patient volume with virtually no real increase in length of stay and cost. This data is not complete and only shows one region. And, of course, we're looking at other regions. But we're impressed to see that at least in that area, in the north-central area, there was not really an impact when they reached out into rural areas. Then we also looked at the transfer criteria guideline sheet and approved that sheet, which is basically an adaptation of the Palm Beach County transfer guidelines from non- trauma centers. Then the final thing we looked at was the capabilities of trauma centers and non-trauma centers. We tabled that issue for further discussion in that some of the wording looked like it needed to be revised. And I believe we scheduled our next meeting in October 4th at the EMS Advisory Council. And that ends that report. Thank you. CHAIRMAN HARDESTER: Thank you very much, Dr. Lottenberg. Returning to Jamie Caldwell for the report on the State plan. MR. CALDWELL: Thank you. A lot of the information we discussed, because they're so closely linked, is included in the transformation of EMS update, which if you haven't gotten a copy, please see the appropriate State office personnel to get one. Having said that, there are a couple of other issues that we discussed within our group that require me to talk to you now. One is under quality management. There was a desire on the part of the quality management work group, that we consider adding a quality management position to the EMS Advisory Council, as quality management becomes a more integral part of our everyday operation. Quality management group thought it would be a good thing to have a quality manager as far as the EMS Advisory Council as we deliberate on issues, which definitely have a quality impact. The EMS response subgroup had not met. And that was of concern, but we will be getting with the members of that group. One of them was George Fox who recently has retired to greener pastures from the Council, which means that we'll be working harder. So, I will make that point of talking to him first thing on Monday to ask how much more of his time he's going to give to us. Pure public information, education, the State office reported that they have added an epidemiologist to their staff who is working on developing local injury profiles to be used in the context of the county public health units. Many of you may not know that the Department of Health does a statistical abstract of all the areas that they talk to the public health unit about, in terms of many disease processes and what they are now adding as the disease process of injury. So, that is a very positive thing. That process has started. They've done some draft of development of indicators and that's an ongoing process. And I don't see anything else on my sheet of notes that would be any different than what we have gone into in the transformation report CHAIRMAN HARDESTER: Thank you very much, Mr. Caldwell. Any questions or comments from any of the Council members? Yes, Chief Brown? CHIEF BROWN: Generally, if you would, in some of the contingency groups, when the issue of QI and QN representation on council was brought up, it was also discussed, while we're looking at that, it would require a statutory change. Then we look at the inclusion of emergency medical dispatch, also. MR. CALDWELL: If I may, Chief. I thought about it. Certainly, we have the ability to proceed statutorily and add to the Council if that's the desire of the Council and the industry. I was wondering if in the interim we couldn't look at the operative rules of our bylaws and see if our bylaws couldn't be changed to add a non-voting position to the Council. That might do it. Add these people in a more immediate fashion, as opposed to waiting for the much more deliberative statutory process. Then we don't even know if we start the process if we'll get what we want in the end. So, that would require asking the Bureau Chief if he would assign staff to see if that's a possible. CHAIRMAN HARDESTER: Just for the sake of the organization of the meeting, Mr. Caldwell, perhaps you would bring that up again at community assignments so we can keep track of the assignments of the Council members to the Bureau. Moving then to ad hoc committees. Disaster response? Did disaster response have a meeting? MR. ALMAGUER: Disaster response did have a meeting. I was in the short term -- this is Ruben Almaguer. In short, I'm replacing George Nast (ph) who chaired that committee and was asked to definitely attend that and at least listen and learn. Also, the Bureau Chief attended. And I think, for the most part, the focus was on finishing the State plan. There's eleven days left. Focus all our efforts to the preclosure of that. Other than the discussion on the State plan and weapons of mass destruction, how this disaster response fits into State plan was the only focus. And there was no other discussion other than the State plan. CHAIRMAN HARDESTER: Thank you, Mr. Almaguer, for stepping up to the plate. We appreciate it very much. Injury prevention? MS. PIRATTE: Yes. We had a very successful meeting Wednesday afternoon focusing on bicycle and pedestrian issues. Steve Dearwater(ph), an epidemiologist from the Department of Health, gave an overview of the bicycle/pedestrian statistics. Then I gave an overview of the traffic safety grants, the bicycle/pedestrian grants that we have in place to try to address some of those problems. And then Mike Wilson, who is the local bicycle/pedestrian coordinator, gave a presentation on the research that he's done as to what's happening in the Orlando area. And he also gave us another perspective on the statistics and cautioned us against using statistics so much with the general public because he's afraid that if we publicize bicycle/pedestrian statistics are high, it's scaring more people away from those healthy activities and he wants to try to look at it the other way around so we can have an impact on the obesity and the diabetes problems, which have been skyrocketing over the last ten years or so as bicycle/pedestrian activities and other activities have that decreased. So, that was really helpful. And then Laura Halam(ph) from the Florida Bicycle Association gave an overview of what their programs are and what Bike Florida has been doing with their programs. And then Tammy Corvell(ph) gave us a presentation on the Arnold Palmer Children's Hospital, which is located here in Orlando, what they're doing with bicycle/pedestrian activities, as well as a few other activities. It was a very successful program. We had about twice the number of people we usually have attending. And we thought this was a good format and we're planning to continue doing single topic programs in the future. It hasn't been decided for sure of what the topics will be in October, but one of the possibilities is water safety since we'll be in the Keys. We'll keep you updated. Thank you. CHAIRMAN HARDESTER: Thank you very much, Ms. Pieratte. Any other comments from the Council members? Thank you very much. Moving to EMS transformation. I'll turn to our Vice Chair, Janet Livingston. MS. LIVINGSTON: This one I won't turn over to Jamie. I'll do it. The transformation committee, two of the groups met on Wednesday, and those were medical direction and clinical care and education and human resources. From the medical direction committee, the members of the group will contact hospital organizations and accrediting bodies concerning the sharing of clinical data for quality and improvement reasons. The group also proposes the establishment of the formal authority for the State EMS medical director and they will be working on putting that together through job descriptions and formal responsibilities. The group is to begin the development of a QI template for the use of EMS providers in the state QI requirements and goals. And they will review the status of medical direction and inter-facility transfers. And we'll receive the status on the scope of QI programs concerning clinical and administrative aspects of the QI process. From the education and human resource committee it was noted in the discussion that there should be a non-statutory change in the titles of paramedics, similar to fire personnel for advanced degrees. The committee reviewed the crash 2000 radar report, which was submitted by Alex Castrol (ph) and his subcommittee. This report is comprehensive and has been completed over a four year period of time. Alex has put together an impressive report, which all of you should have received in your packets for your review. The following changes were made to the report, page ten under B, number six, the wording was changed to, Must train in a vehicle of service, vehicle of similar dynamics. Also on page ten, under C, number one, the number of years of driving experience has changed from one to five years. These changes were voted on and approved by the committee. And there's also two motions that go with this information that we could discuss later on the agenda. That's the completion of the report. CHAIRMAN HARDESTER: Thank you. Any questions, comments from the Council members for our Vice Chair? Seeing none, we move to, I believe, improvement and prevention. End-of- life care, I think you mentioned that, Dr. Swisher. Any other comments? DR. SWISHER: Actually, this committee met twice. It met on Tuesday as a work session. Got quite a bit accomplished. And then we had a general meeting on Wednesday. I'm going to report on the general meeting. The end-of-life committee shared with the EMS community its initiatives with the curriculum to date. An overview of the committee's work was reviewed, at which time Dr. Slevinski addressed the idea of a state-wide recommendation. He suggested that what evolves from the State should be a broader view of the end-of-life care, with perhaps a designation of a commission that would address how people died in Florida and what can be done to accommodate this process. The meeting was then opened for discussion and several discussions were addressed. It was discussed that end-of-life education should not be limited really to the providers, but also to the public and the physicians, that the rights of dying need to be protected. Many providers are also concerned about avoiding conflict between family members. And it seems to be a real issue that came on that we really had not addressed up to this point. The committee recommended, including in the curriculum, suggestions of how EMS providers can train community members to assist in the dying process with the patient and the family. And this includes the exploration of changing the DNR form to include a signature from the patient and his or her physician saying that end-of-life counseling and discussion has occurred with the patient and his or her family, and that they acknowledge and that they accept the patient's decision. This seemed to be a real issue. And Dr. Slevinski suggested adding this additional portion to the DNR form. The committee will continue to explore how the network resources in the community do support the families of EOL patients within their community. And the group is hoping to launch a pilot testing in the fall quarter curriculum. We have already begun a Powerpoint presentation and have quite a bit of it completed. Jeff Miller and Jessica Swanson are really doing a lot of hard work on this, as is Frieda. And we hope to have a real professional presentation for you in the fall. Thank you. CHAIRMAN HARDESTER: Thank you very much, Dr. Swisher. Any questions, comments from the Council members on the end-of-life care? Seeing none, safety issues for EMS is an ad hoc committee. Was there a meeting? Seeing none, temperature control for medications? Okay. At this time in the agenda then I would ask for any additional comments from our constituency groups. I don't have any speaker cards, but I'll put my glasses on and if you wave your hand, I'll recognize you. And I don't see any. Thank you very much. And we'll move to that portion of our agenda where Council takes up business from which we may make motions and take action. I was making some notes, as usual, as we went along, perhaps to get the easy stuff out of the way first. Some of the things that surfaced about asking the Bureau to look into and report back to us. Dr. Silvestri raised an issue early on to gain written clarification about when and in what settings, the details about disciplinary -- or medical directors reporting disciplinary actions and what exactly are those requirements to the State. So, without that being the motion, we would ask the Bureau to provide a letter to the Council clarifying that issue. Thank you very much, Dr. Silvestri. The other is the Bureau Chief spoke about the streamlined process for unannounced inspections. And I believe he went -- he did a great deal to address the concerns that were raised in the April EMS Advisory Council meeting. I want to thank him for that. We would like some written documentation on what that streamlined process would look like, what those twelve focus areas would be, what's exactly involved in the inspection process. So, we would look to the Bureau for that. And then the issue that Mr. Caldwell raised about if we could have some reclarification about the logistics involved in adding positions to the Advisory Council, whether they be voting or non-voting. The two that were mentioned were positions of medical dispatch and quality improvement. Does anyone else have anything? One thing I wrote down was create an ad hoc committee for the Advisory Council, one that would subset, hopefully, in a very expedient manner. And that would be an ad hoc committee for the blood draw kit standardization. I would ask Dr. Slevinski, and Dr. Silvestri and Captain Gaston and an invitation extended to Mr. Bracewell of the Winter Park Fire Department, and ask Chuck from the Bureau to lend support to those members in order to address the issues that it would take to make those needleless blood-draw kits standard statewide. I believe it would take a motion from the Advisory Council to create that ad hoc committee. Mr. Caldwell? MR. CALDWELL: Jamie Caldwell, so moved. CHAIRMAN HARDESTER: We have a motion to create an ad hoc committee for the blood-draw kit standardization issue. Do I hear a second? DR. SWISHER: Second. CHAIRMAN HARDESTER: Seconded by Dr. Swisher. Thank you very much. All in favor? Opposed, like sign. The motion carries unanimously. The other one that I wrote down as we went along would entertain a motion to support the emergency medical dispatching resolution as it was read to us. And I think since it was verbally reported to us, each individual had gotten copies, does anyone want to discuss the resolution itself and its implications? Any questions on that? It's pretty straight forward. Mr. Kearns, do you have a comment? MR. KEARNS: I'm just willing to make a motion. CHAIRMAN HARDESTER: Okay. We do have a motion in support of the EMT resolution. The motion would be to direct the Chair on behalf of the Council to sign the resolution showing the Council's support. I have a motion from Mr. Kearns to support the EMT resolution. Do I have a second? MR. DOUGLASS: Second. CHAIRMAN HARDESTER: Mr. Douglass has seconded. And all in favor? And opposed, like sign? Seeing none opposed, the motion carries unanimously. Those are the things that I jotted down along the way. Does anyone else have any other issue? Yes, Mr. Kearns? MR. KEARNS: I heard Chief White say something about the Council possibly taking a position on the COPCN issue again. CHAIRMAN HARDESTER: And the Council has traditionally, I think twice in my memory anyway, taken positions against revisions to the COPCN statute as it exists now. Would you care to make such a motion, Mr. Kearns? MR. KEARNS: Yes. I would make the motion that we yet again renew the past position against COPCN laws. CHAIRMAN HARDESTER: We have a motion for the Council to reiterate its opposition to any changes in this COPCN statutory language. Do I have a second? Mr. Douglass has seconded. Any discussion on this item? Seeing none, I would move to -- yes, Chief Brown. CHIEF BROWN: I will say that I think there is the ability to work toward that. Although I do agree with Chuck that I think it's certainly a potential for a bad legislative change. I don't know that it may be a little premature for the Council to take a stand against nothing. There is no proposed legislative change language out there right now. And taking the position of not wanting to change the statute, if we find the need to change it to benefit all of us, it may not be a position we'd like to find ourselves in. So, I don't know that there is -- obviously, we've all heard that it's possibly going to be a hot issue again. But I think we need to see what the actual language is and what the issue is before we take a position on it. Those are just my comments. CHAIRMAN HARDESTER: I think your point is extremely well taken, Chief Brown. It's very early yet. The legislature doesn't meet until January. And, certainly, in the next couple of months or so we would see if something were to emerge, which is virtually certain. When we see it emerge, we will review the language. Based on that -- yes, Bureau Chief? CHIEF BEMENT: Just to let the Council members know and the folks that are here, again, I want to reiterate that we were put on an accelerated legislative schedule for 2002 legislation, and as such we really didn't get a chance to consult with you folks. I wanted to let you know that while you have plans for us to review any draft legislation you have right now and report in February, we begin work shopping and we'll begin drafting analysis and language whenever it gets approved in September. So, what I will offer is that when we do get approval on items that come out of Council, that we're going to move forward with, I'll make sure they get forwarded to the Council members. I'll make sure that the constituents and their presidents get notified. And any comment that you have or changes, we're going to get back as soon as possible. So, I just wanted to stress, as we are on an accelerated schedule due to the legislature meeting early. As soon as you see any draft bill language that we have out there, get your comments back as soon as possible, please. CHAIRMAN HARDESTER: Any other comments about the motion before us with COPCN? Chief Brown, I think, has made a vitally important point that there is no legislation in front of us now. Based on that, Mr. Kearns, would you consider withdrawing your motion? MR. KEARNS: Yes, I would. And I think we can take it up again in the October meeting. CHAIRMAN HARDESTER: Thank you very much. Other issues Advisory Council members want to bring forward for possible motion? Yes, Chief Brown? CHIEF BROWN: Again, something that came up in several of the meetings in the past few days and I think we'll see it here again. It's the first -- it's more a housekeeping item. Obviously, there is one day of subcommittee and ad hoc and attribute team meetings and another day of constituency groups meetings. And then we conclude our quarterly meetings of the Advisory Council. There is a lot of good progress being made in a lot of different areas. There is going to be a lot of different organizations and entities, whether it be subcommittees or attribute teams, asking the Advisory Council for a position in our coming meetings. I think it would be in the Advisory Council's best interest to adopt a procedure that would allow us to receive written information thirty days prior to a scheduled meeting from any subcommittee or entity wishing for formal action by the Advisory Council at that scheduled date. And that the Respondent would provide to the Advisory Council members, the twenty-four constituent presidents and the State EMS office of this in writing. I'll make that in form of a motion. MR. CALDWELL: Second. CHAIRMAN HARDESTER: We have a motion Chief Brown and seconded by Mr. Caldwell. Basically, just to reiterate that, it would be a thirty day leave period. I think that's a good idea. Other comments from Council members and discussion about the issue? CHIEF BEMENT: Could we have a summary of the motion, please? A summary of the motion? CHIEF BROWN: A summary would be that any entity subcommittee or attribute team wishing for formal action by the Advisory Council would provide a written position paper and data thirty days prior to the scheduled Advisory Council meeting, to all twenty-four constituency presidents, all Advisory Council members and the State EMS Chief. CHIEF BEMENT: Thank you. CHIEF BROWN: You're welcome. CHAIRMAN HARDESTER: Thank you. The motion is seconded. Other discussion points? MR. KEARNS: Just an idea. In some of these meetings in the last few days, I've heard some people say they were kind of surprised by the speed of which some things showed up. They would like a little move advance notice to get it out to their constituency members. CHAIRMAN HARDESTER: Thank you for that comment. Seeing no other comments, move the question. All in favor of the motion? Opposed? Seeing none opposed, the motion carries unanimously. Thank you very much, Chief Brown. Other issues to be brought before the Advisory Council? Yes, Chief Brown? CHIEF BROWN: I've got one more after this, actually. Again, I'd like to bring forward to you -- and this comes from the transformation of team that helped the attribute committee dealing with a recommendation on the EVOC. I would like to bring forward a motion that the Council accept the Crash 2000 Radar Report and recognize the dedicated work from this group. Request comments to be forwarded to the committee chair from all constituency presidents. And Council members and commit to take formal action on these recommendations at our October meeting. MR. CALDWELL: I'll second. CHAIRMAN HARDESTER: The way I understand that, if you go for a friendly amendment, how about the comments going to the Secretary, Chief? CHIEF BROWN: I'll consent. Thank you very much. CHAIRMAN HARDESTER: Will the seconder accept that? MR. CALDWELL: Yes. CHAIRMAN HARDESTER: Thank you very much. We have a motion and a second on the table concerning the Crash Report, as forwarded to us by those involved with EVOC. And we would just interpret your comments a little bit. We would make it a scheduled agenda item for the October meeting. We have a motion and a second on the table. Any other discussion points on it? Seeing none, move the question. All in favor? Opposed, like sign? Seeing none opposed, the motion carries unanimously. Thank you very much, Chief Brown. MR. CALDWELL: Mr. Chair? CHAIRMAN HARDESTER: Yes. MR. CALDWELL: Before Mr. Brown -- I feel slighted over here. He's got closer access to the Chair. We need to deal with the issues of adding additional statutory positions to the Advisory Council. I would like to offer up three motions in that regard. The first motion is to move to establish a statutory EMS quality management position on the EMS Advisory Council. CHAIRMAN HARDESTER: Mr. Caldwell, though, I did mention it under the Bureau Chief directives for the Bureau to come back to us and report to us on the logistics involved in adding positions to the Advisory Council, both voting and non-voting, and specifically with an eye to admit emergency medical dispatch and quality improvement. MR. CALDWELL: Two different issues. One is a statutory position that would be an official member of the Council, versus my third motion which would be to ask the Bureau Chief to see in the interim if he could not look at our operating bylaws to see if we could add those positions as non-voting members. CHAIRMAN HARDESTER: So, your first motion, would you state it again? MR. CALDWELL: Certainly. I move to establish a statutory EMS quality management position to the EMS Advisory Council. CHAIRMAN HARDESTER: There's a motion on the table. Do I have a second? CHIEF BROWN: I'll second the motion. CHAIRMAN HARDESTER: There's a motion and a second to add an additional Advisory Council position. Any discussion on that? CHIEF BEMENT: Yes, Mr. Chairman. I've also heard from additional folks within our EMS community and constituencies that possibly, as we move toward trying to solve some of this Medicaid and Medicare reimbursement issue, it might be of some benefit to have ACHA as a representative on the Council, as well. I'm just throwing it out there for consideration. CHAIRMAN HARDESTER: Who from ACHA would be crazy enough to want to -- it's a great idea. Perhaps that could be another motion. The motion on the table before us -- any comments on the motion on the table? Seeing none, I move the question. All in favor? All opposed? Seeing none then, the motion is carried unanimously. Yes, Mr. Caldwell? MR. CALDWELL: I have to get equal with Robby. I move to establish an emergency medicine dispatch position to the statutory position to the EMS Advisory Council. CHAIRMAN HARDESTER: A motion on the table. Do I hear a second? MR. BERRIOS-TORRES: I second it. CHAIRMAN HARDESTER: Mr. Berrios-Torres, thank you very much. There's a motion and a second to add an additional position on the Advisory Council for emergency medical dispatching. Do I hear any comment, any discussion points on that motion? MR. KEARNS: I do have a question for the folks in the audience from the EMT group. Do you folks have an additional constituency group? Do you meet regularly and so on? MEMBER: Yes, we do. CHAIRMAN HARDESTER: Thank you. Any other questions or comments on the motion? Seeing none, we'll move the question. All in favor? All opposed? Hearing none opposed, the motion carries unanimously. Your third motion, Mr. Caldwell? MR. CALDWELL: Move to request the Bureau Chief to determine if the Council's bylaws can be amended to add these non-voting members to the Council, pending final legislative attack. CHAIRMAN HARDESTER: There's a motion the table directing the Bureau Chief to supply certain information. Do I hear a second. MS. WATKINS-BLYTHE: Second. Shirley Watkins-Blythe. CHAIRMAN HARDESTER: Yes. Thank you very much, Ms. Watkins-Blythe. There's a motion on the table and a second. Any discussion? Yes, Chief Brown? CHIEF BROWN: Yes. Assuming that the Bureau Chief finds that he can create the non- voting positions on Council pending legislation, what would the process be as far as appointment to those positions? CHAIRMAN HARDESTER: I would venture to say that that's part of the information we'll look to get back from the Bureau Chief, the logistics involved in that. Any other discussion points on the motion before us? Okay. We have a motion and a second. All in favor? And opposed, like sign? Seeing no opposed, the motion carries unanimously. Thank you very much, Mr. Caldwell. Any other business to come before the Council? Yes, Chief Brown? CHIEF BROWN: I had one more small motion to make. Again, it was the second point with the Crash Radar 2000 report from that committee. I would move that the Advisory Council ask the State office to move forward in the area of doing research development in the crash reporting criteria and provide all Council members and constituent presidents a written proposal in this area, thirty days prior to our October meeting. MR. CALDWELL: I'll second. CHAIRMAN HARDESTER: There's a motion and a second on the table. Discussion? CHIEF BROWN: In the actual report -- in the Crash 200 report you'll see that one of the difficulties this team ran into was collecting accurate crash data involving emergency response vehicles in crashes where there are not significant injury or death, DUI, hit and run. Those are accidents that require a long form. There's not a data collection system for short- form accidents involving emergency response vehicles in Florida. And, obviously, the EVOC team felt like for us to be able to adapt our training to meet trends in accidents in driving, they would need to collect that data. So, the gist of the motion is to direct the State office to look at if there is the ability to collect data that the attribute team could not find. But to do some research and development and report back to this body a proposal as far as tracking and trending crash data involving permitted emergency response vehicles. CHAIRMAN HARDESTER: That would have been the clarification I would have asked for. We're talking about permitted units under the purview of the - CHIEF BROWN: Permitted emergency vehicles, yes. CHAIRMAN HARDESTER: Any questions on that, Bureau Chief? CHIEF BEMENT: No. CAPTAIN GASTON: Mr. Chairman? CHAIRMAN HARDESTER: Yes, Captain Gaston? CAPTAIN GASTON: Not to let these two get out done. But I suggest that maybe an amendment to that as, why don't we just ask for a legislative change that all emergency vehicles require a long form. And then we're not just tracking certain ones. We're helping everybody that operates an emergency vehicle. We already do that with the police service. Why not do it for fire/rescue. CHAIRMAN HARDESTER: And what statutory change would that be, Captain Gaston? CAPTAIN GASTON: It's just a matter of adding a comma and emergency vehicle to the existing language of the statute. Because there's an exception. All of them have to be on a long form crash report, except for -- and we'll just delete it from the short form and add it to the long form, requiring that the long form be completed on all emergency vehicles. CHAIRMAN HARDESTER: And I think part of Chief Brown's motion would get us the information you've just supplied us and I would think some additional comments, because you asked for a report about what would be involved in gathering this information. CHIEF BROWN: Again, if Keith is willing to communicate that with Chuck, I think that Chuck's report to us could be that FHP is willing to move forward. I have one question and it's just from lack of knowledge, Keith. Obviously, in those jurisdictions not covered by the Highway Patrol, are other law enforcement agencies bound to follow the same reporting criteria as the Florida Highway Patrol involved with this statutory change? Would all law enforcement agencies have to report permitted emergency vehicle accidents on a long form? CAPTAIN GASTON: That's why I suggest we put it in statute. It's already in our policy. So, if you call the Highway Patrol, we're going to do it on a long form. But if we put it in Florida statute, then any agency -- and the advantage that we have by putting it in Florida statute and required it to be collected, it will eventually get to NITSA, which gets into grants and other issues which I think is extremely important to us. CHIEF BEMENT: Captain Gaston, can I put you on the spot and ask you if you have the section off the top of your head? CAPTAIN GASTON: I don't have the statute. CHIEF BEMENT: Okay. We'll research it. CHAIRMAN HARDESTER: There's a motion and a second on the table about directing the Bureau to gather crash reports involving permitted vehicles under their purview. Any other discussion points? Seeing none, we move the question. All in favor? All opposed, like sign? Hearing none, the motion carries unanimously. Thank you very much. Any other business to come before the Council? Yes, Dr. Silvestri? DR. SILVESTRI: Just one more motion. I would like to make a motion to work with the Florida Division of Emergency Management to work towards obtaining Federal grants money for the development of training and developing a curriculum for weapons of mass destruction and for EMS medical grants. CHAIRMAN HARDESTER: So, your motion would be that the Council would support the creation of such a curriculum? DR. SILVESTRI: Or to work with emergency management to apply for grant money to do that. CHAIRMAN HARDESTER: Then your motion would be that you would have the full Council support for the creation of that, working through the office of Emergency Management to create a curriculum for EMS medical directors and apply for grant funds through the Department of Justice. Mr. Almaguer, do you have a comment? MR. ALMAGUER: Yes. I would ask for support to allow both EMT and paramedics, within and without the fire service, to try to allow us to be in the same realm of knowledge, at least try to seek these type of grants to provide at least the basic training that the EMS medical directors are seeking, also. DR. SILVESTRI: I support that. CHAIRMAN HARDESTER: Let me see if I can summarize. The motion is that you would simply seek -- you're seeking Advisory Council support. So, whatever support the Council can provide in those initiatives. There is a motion on the table. Is there a second? MS. WATKINS-BLYTHE: Second. CHAIRMAN HARDESTER: Second by Shirley Watkins-Blythe. The motion, I guess, has two parts. The Council supports the development of curriculum for emergency medical services, medical directors, as well as EMTs and paramedics, as it was stated, both within and outside the fire service, and especially in the area of their acquisition of Department of Justice grant funds. Motion and seconded. All in favor? Opposed, like sign? None seen, the motion carries unanimously. Any other issues, motions, business to come before the Advisory Council? MR. KEARNS: Mr. Chairman, I have a couple of items to discuss that may result in motions. And being the new guy at the table, you know, I hope that I'm following protocol appropriately here. The first issue kind of stems from my being appointed. Once you're on the Advisory Council, people start calling you in every which way, out in the hallway to tell you about their concerns and issues. And the sensitivity thing is this issue I'm about to discuss was already voted on by this Council at its last meeting. It's an issue of developing legislative language for a second level paramedic certification. Several groups have come to me expressing concern and I've talked with several of my colleagues on the Advisory Council today. Again, they have shared their concerns, as well. So, I spoke with the Director of the State office and he suggested maybe a motion might be appropriate to table this particular piece of legislative language that the Department has begun work on at the direction of this Council. CHAIRMAN HARDESTER: Thank you, Mr. Kearns. The way I understand it is that Mr. Bement took the initiative to get some stuff on the table for us legislatively, since the session is going to be early this year and quite a bit of it is conceptual at this point. So, Mr. Kearns' motion is for the Advisory Council to take the position for the Bureau office not to pursue any further this legislative session, action as regards to an additional level of certification for paramedics. Do I understand you correctly? MR. KEARNS: Yes. CHAIRMAN HARDESTER: Thank you. There's a motion on the table. Is there a second? MR. BERRIOS-TORRES: I second. CHAIRMAN HARDESTER: There is a second by Mr. Berrios-Torres. Motion and a second for the Advisory Council to take a position basically of not support in this legislative session for the Bureau to pursue legislation that will enable an additional level of certification for paramedics. MR. CALDWELL: Mr. Chair? CHAIRMAN HARDESTER: Yes, Mr. Caldwell? MR. CALDWELL: Also, as we have further discussions on the issue, the people would support it, but they weren't certain as to what they were voting for. And I think there was just a desire to get further clarification on that point. MR. KEARNS: And additional background on it, if I may. FACEMS had a Board meeting and a very interesting discussion about it. And what essentially came up is if we all agree, we want to promote higher education among the EMTs and paramedics, then there ought to be some type of incentive to do that. We were all in support of that. What surfaced was a program that apparently fire fighters and law enforcement officers get financial incentive if they get elevated degrees. So, that's what I think -- what the Bureau Chief said he was working to pursue that avenue. And for a second level to make the funding available to encourage them to get higher degrees. CHAIRMAN HARDESTER: Yes, Dr. Swisher? DR. SWISHER: I think the intent, though, is lost here. This support was garnered, whatever you would like to say. It was simply acknowledgment. It wasn't anything to do with -- it had no responsibility on the part of the employer. If you go back, historically we had two very opposing views. We had mandated as and then we had people who adamantly opposed any mandation. And, so, this was kind of a middle of the road just acknowledging it. The legislation really is, as we have been told, rather ineffective, as our Bureau Chief has said, because we aren't lending any meat to it. But it's a step. It's kind of a little baby step to say, hey, we're acknowledging it. We think that there should be some form of recognition. We don't have that form yet, but it's a start. Because we hope that in time to come, that there will be something attached to that. But it's a beginning. And I think that was the intent of the educators and various constituency groups. It was not meant to stir anything up as far as mandating or responsibility to employers or anything like that. It was misunderstood, I think, perhaps. And maybe this was a good point to bring out. We have -- Robbie has brought up that maybe we should have probably done something thirty days in advance. And we brought that up last time rather quickly. We brought it through and maybe there wasn't enough actual discussion that took place. But I don't think there is anything in the actual legislation, as was Chuck's concern. There really wasn't anything there that anyone need be concerned about. CHAIRMAN HARDESTER: Yes, Chief Brown? CHIEF BROWN: Obviously, I think from listening to the State EMS Chief in discussions with this, they're already having discussions internally in the office about the problem with asking for a legislative change for nothing but the matter of semantics. I just want to clarify, was the motion to table or not support? Because there is a big difference. MR. KEARNS: To table. CHAIRMAN HARDESTER: Motion to table, which would table for this legislative session, to table consideration by the Council or to direct the Bureau to table their efforts for this legislative session? MR. KEARNS: I think one of the big concerns that I have is if the Bureau proposed legislative language and then members of this community show up in Tallahassee to lobby against it, then it's going to look like we're not together on it. CHAIRMAN HARDESTER: Other comments? DR. SWISHER: I think one of the concerns was -- and I understand this so well being in the midst of all this -- was the mandate. And it was very clear that this was not any form of mandate. It was all volunteer. And I think you're right. The EMS community, fire chiefs, et cetera, would be very concerned if anything was mandated. The whole intent was kind of to acknowledge and recognize. CHAIRMAN HARDESTER: Yes, Chief Brown? CHIEF BROWN: The question as far as timing -- and maybe Chuck Bement can answer this at our October meeting. If the State looks at getting support for some type of advanced recognition and follows the procedure that we approved earlier in this Council meeting and provide the information to our members thirty days -- is the October meeting too late to take action to support or not support legislation for the coming year? CHAIRMAN HARDESTER: Mr. Bement? CHIEF BEMENT: It's hard to tell. I want to clarify that by saying, we find ourselves in a difficult position now because essentially, the state EMS community has already told us as a Council that there is support for this. That's why we're having trouble here regarding this issue. So, as far as a time frame -- and I used the wrong terminology earlier. We don't workshop legislation. But when we're directed by the Department to begin analysis and language formally on stuff that's been approved, on legislation that we've been approved to pursue, that's when we will have formal language. Right now we've distributed draft bill language to several of the constituency groups. I don't think I know all of them. But at this point we're in a difficult position because we have an accelerated legislative schedule. We were asked to move forward, what we thought were valid directives for recommendations from the Council. And had we not drafted legislation at this point, we'd be out of the ball game again for 2002. I would ask that the Council maybe modify -- I think we can work together and modify the process for this particular legislative session, whereby we can -- as soon as we have something formally recognized by the Department that we're going to be pursuing specifically those three items, we can get out the language as soon as possible to everybody and then begin work on it. I'm getting the sense that language is the issue here. The language we could probably come to some kind of consensus on between now and October. Once we're directed to begin working on it, we're probably going to begin doing analysis in September. So, October might be a little bit too late. MR. KEARNS: And FACEMs again had talked about that they wanted the time to study it. It affects the non-fire paramedics that I represent. And I've spoken to a lot of them and they've said this means nothing to us. What we would like is money to be able to go to school. We would like scholarship money. CHIEF BEMENT: I'm curious why these issues weren't raised before it was a Council motion. MR. KEARNS: Like I say, I - CHIEF BEMENT: The able Council can explore the logistics involved in created another level of paramedic. DR. SWISHER: I'd like to suggest too to -- at least first if we recognize the area. And then if we want to attach something later, at least we've got the area recognized. It's not something that has to come in one package. CHAIRMAN HARDESTER: Mr. Bement, what's involved if this motion were to pass? What I'm thinking of is if you'd rather not see this motion pass, let's let the issue go and they'll further get that information out to us. Is that essentially it? CHIEF BEMENT: Absolutely. When it comes right down to it, if there's not consensus, it probably won't pursue it. And I'm just saying October, unfortunately, will be too late to get any changes in going. However, I believe I have an alternative to October. But we just have to communicate back and forth with e-mails and phone calls. I think it's achievable, but if you're not comfortable pursuing it at this point, we can put it on hold. CHAIRMAN HARDESTER: Thank you. Okay. So, there's a motion and a second on the table. MR. TRENT: I have another comment I'd like to make. CHAIRMAN HARDESTER: Yes, Mr. Trent. MR. TRENT: It involves the process. This has come through the positive vote of one of the constituency groups. It has been discussed at several points. I've been involved in some of these discussions. The objection to this is not coming through the constituency group. And I find that outside of the process, so I intend to vote no on the motion. CHAIRMAN HARDESTER: Any other comments as to the motion? The motion essentially is for the Advisory Council to recommend to the Bureau of EMS that legislative issues dealing with an additional level of certification for paramedics be tabled for the 2002 session. There's been a motion and a second, discussion. Any other discussion? Seeing none, all in favor of the motion vote, aye. And opposed, vote no? Are we capable of taking role, staff role? Role call vote. Thank you, Mr. Caldwell. Let's have a show of hands. All in favor of the motion which then would recommend to the Bureau to table the issue until 2002. All in favor of the motion that those efforts be tabled and abandoned for this session raise their hand. One, two, three, four, five, six, seven. Thank you. I count seven. All opposed to the motion, which would ask that we would pursue that endeavor? I have one, two, three, four, five, six, seven. I think the Chair -- I would allow those initiatives to proceed at this point, as outlined by Mr. Bement. He will report back to the Council as soon as things develop. The Bureau can always -- this is a very formative and early stage of the process. The Bureau can abandon those efforts, if that's the proper action just a little bit down the line. Isn't that correct, Mr. Bement? CHIEF BEMENT: Correct. CHAIRMAN HARDESTER: So, then I would vote against the motion, which would allow the Bureau to proceed at this point. Any other issues or motions? MR. CALDWELL: Mr. Chair, I would also like to reflect that the community is equally divided, except for one vote on this issue. CHAIRMAN HARDESTER: Yes. Understood. Any other issues, discussions? Yes, Captain Gaston? CAPTAIN GASTON: Just as a point of clarification. It's Florida Statute 316.066, written reports of crashes. Currently there is five situations that require a written report of a crash, known as the long form. That's involving death, personal injury, leaving the scene, DUI or if the vehicles are damaged to the point that they require a wrecker to remove them from traffic. My suggestion is that we add a sixth for an emergency vehicle that would require a report. The concern I would have is, is the emergency vehicle in operation or is that the case where the guy is at the gas pump and he backs into the pole? You need to be real careful in the wording there because I'm not sure we want to get all of those into the traffic data. Thank you. CHIEF BEMENT: Do you want me to report by the next meeting on that? CHAIRMAN HARDESTER: Yeah. Thank you. Any other items of business to come before the Council? Mr. Kearns? MR. KEARNS: My last item. I promise. CHAIRMAN HARDESTER: That's okay. MR. KEARNS: An issue started to percolate at our last meeting in Tallahassee. I see Jim Judges, I think, left the room. He is personally involved with this. As a licensed EMS provider, we pay a licensure fee every two years to the Bureau of EMS. And then we also pay a per vehicle permit fee. And what that buys us is also to have the opportunity to have the State come in and inspect us. The way that the Department of Health is set up with different bureaus, some of our services are being affected by the Department of Health, Bureau of Pharmacy. And some of our services are being told, you have to get a second license from the same Department of Health, Bureau of Pharmacy. And that gives them the right to come in and inspect your operation, with regard to how you store, distribute inventory, pharmaceutical products. So, I guess what I'm trying to focus in on here is the possibility of some type of motion to seek from the Secretary of the Department of Health, since the EMS office comes in and we all know they can come in and inspect us any time they want. And they look at those areas of our operations. And now we're supposed to be double licensed, with as many as two inspections a year from the Bureau of Pharmacy. I'd like to see that kind of double taxation end and trouble inspections be limited to one or the other. I think the EMS office can go ahead and inspect our drug storage and record keeping and so on. Why do we have to pay this second fee and have other inspections? It's the same Department of Health. So, I don't know if it's statutory. I don't know if it's procedural. I don't know if it's an administrative code. And I'd like to see if we could get the Secretary of the Department of Health to go in and see what needs to be done, since it's his department and different divisions are ganging up on us. CHAIRMAN HARDESTER: We certainly, I think just by directive we can ask the Bureau Chief to look into that, provide us a written clarification on that. I think that's what essentially you're asking. MR. KEARNS: I know that it would affect possibly all nineteen of the providers in my county. All of our fire departments and trucks come into one central location. Then when they start getting distributed to different trucks at different stations, we're supposed to have those licensed. I know that there's a lot of trucks in the state that don't have that. CHAIRMAN HARDESTER: Any other issues, comments to come before the Advisory Council? CHIEF BEMENT: I've got a point of clarification. Mr. Caldwell, your first motion that you made regarding Advisory Council, did that include the ACHA? We didn't have any discussions on that. MR. CALDWELL: (Inaudible). CHAIRMAN HARDESTER: Any other comments, concerns, questions? Yes? MR. CALDWELL: Would we need a motion to consider that? CHAIRMAN HARDESTER: Yes, we would. So moved by Mr. Caldwell. CHIEF BROWN: Second. CHAIRMAN HARDESTER: Second by Chief Brown. The motion is to include in the possible additions to the Advisory Council, someone from ACHA. The motion is seconded. All in favor? Opposed, like sign? Motion carries unanimously. Thank you very much. Any other comments, concerns, questions to come before the Council? Seeing none, we stand adjourned. And we'll see you in South Florida in October. (Whereupon, the Meeting was concluded at 12:15 p.m.) C E R T I F I C A T E STATE OF FLORIDA ) COUNTY OF OSCEOLA ) I, JOYCE LANGE, PROFESSIONAL REPORTER, CERTIFY THAT I WAS AUTHORIZED TO AND DID BY STENOMASK REPORT THE FOREGOING PROCEEDINGS AND THAT THE TRANSCRIPT IS A TRUE AND COMPLETE RECORD OF MY STENOMASK NOTES. DATED THIS DAY OF , 2001 JOYCE LANGE, COURT REPORTER, PR
"Advis Council July transcripts1 9-01 - Florida Department of Health"