DHR Northwest Georgia Emergency Medical Services Council
Georgia Office of Emergency Medical Services/Trauma – Region 1 ·
1309 Redmond Circle, · Rome, Georgia 30165-1391
(706) 295-6154 · Fax (706) 802-5292
Redmond Regional Medical Center
April 9, 2009
MINUTES
Bud Owens welcomed everyone and introduced three vendors who were present. Harold Jones of Custom Truck and Body Works, Tommy Sanders of Southeastern Emergency Equipment, Stephen Northington and Patty Friery-Little of Ambulance Insurance Solutions, LLC. Also presence Marty Billings, former Georgia Office of EMS Director and currently employed by Metro Atlanta Ambulance Service.
Robert Early welcomed everyone to Redmond Regional Medical Center. A meal was served compliments of Redmond Regional Medical Center. He also invited thos present to attend an EMS Week celebration at Redmond Regional Medical Center on May 19, 2009. A meal will be served in appreciation of EMS personnel.
After the meal, Stephen Northington of Ambulance Insurance Solutions, LLC gave a brief description of their insurance programs for ambulance services.
David Loftin determined that a quorum was present. [The chair excused the absence of Larry Ballew and Rick Cobb, reinstated membership of Robert Tester and reappointed midterm vacancies with the following personnel: Gilmer County – Kelly Buddenhagen; Murray County – Johnny Cowart; Paulding County – Captain Kevin New; Pickens County- Russell McDaniel. These actions were done just prior to the rollcall]
The first item of business was approval of the minutes of the January 21, 2009 EMS Council minutes. Matthew Crumpton made a motion to insert the words “for Dade and Walker Counties” to page 2, paragraph 2, line 2 so that the minutes would read “The Region 1 EMS Transportation Committee has recommended that zoning be open for Dade and Walker Counties at a meeting on November 10, 1008 followed by the passage of a motion to open zoning by the Region 1 EMS Executive Committee on December 11, 2008. “ A motion was made by Russell McDaniel to approve the minutes as amended, the motion was seconded by Steve Lawson and the minutes were approved as amended. Matthew Crumpton also noted that the attendance roster did not include Jeff Putnam as absent for the committee meeting. Mr. Loftin agreed to change this on the minutes of the transportation committee held on April 6, 2009.
The next item of business was a report from the transportation committee by Matthew Crumpton. Mr. Crumpton stated that a letter received from Dr. Elizabeth Ford indicated approval of the recommendation to assign the Dade County Zone to Dade County EMS and to assign the Walker County zone to Walker County Fire and Emergency Services. However, she instructed the Council to take both zoning issued through the zoning process again due to not meeting the time lines and other requirements in the first zoning process. Mr. Crumpton stated that it would have been impossible to meet the time lines dur to the late notification by Hutcheson Medical Center that they would be ceasing operation on December 31, 2008. Therefore, the zoning process for Dade and Walker counties was again began and considered by the transportation committee at the April 6, 2009 meeting.
Catoosa County also requested that the western, northern and southern zone boundary for the zone assigned to Angel EMS as primary provider and Catoosa County EAS as a secondary provider be changed to the Catoosa County line. [Catoosa County was not part of the original issue with Dade and Walker Counties. ] [Both Lana Duff of Angel EMS and David Ashburn of Walker County reviewed a map to identify the boundary line change]. A motion was made by Matthew Crumpton and seconded by Curtis Vincent to change the zone the western, northern and southern zone boundary for the zone assigned to Angel EMS (GA Ambulance license 023-05) as primary provider and Catoosa County EAS (GA ambulance license 023-04) as a secondary provider to the Catoosa County line and to assign the Walker County zone as bounded by the north, south, east and west Walker County line to Walker County Fire and Emergency Services (GA Ambulance license 146-10). Mr. Loftin read the following description of the new zone boundaries for the western shared zone for Catoosa County
“North Boundary – Catoosa County Line
West Boundary – Catoosa County Line
South Boundary – Catoosa County Line
East Boundary – From the Tennessee State Line east to the Boyd Highlands/Morris Estates Subdivision to Wooten Road to Old Georgia Highway 2 to include the roads and businesses not accessible from Old Georgia highway 2A west to Van Cleve Road. (This area should also include Interstate I-75 southbound to Georgia Highway 2A) Interstate northbound to Georgia Highway 146/Cloud Springs Road is not included due to better acdess from the Ringgold area.”
The motion passed.
The next item of business was the consideration of the following amendment to the Region 1 zoning plan “All providers who apply for a zone within a county and are refused may submit another zone request only after 1 year from time of original zone request decision.” This proposal would be added to the zoning plan on page 11, line 21. The transportation voted to table this issue for further discussion.
The next item of discussion was the second proposed amendment to the Region 1 EMS Zoning Plan. The transportation committee rejected the original proposed amendment and approved the alternative amendment which Mr. Crumpton read as follows:
“All calls into a PSAP including 911 centers are to be routed to the zoned provider except calls, which request non-zoned providers. The requests for emergency response for non-zoned providers shall be routed to the requested non-zoned provider and they shall respond immediately in emergency status. If the caller makes no requests or is not immediately available then the zoned provider will respond in emergency status to these emergency calls.
The zone provider will always be notified of all calls dispatched to non-zoned providers by the PSAP and may run non- emergency status to these calls. If the patient refuses transport by the zoned provider arriving first then the non-zoned requested provider will continue to run emergency to the call and the zoned provider will remain on the scene until arrival of the non-zoned requested provider.”
Mr. Crumpton states that the committee considered assuring that the closest provider responds in life threats while maintaining right of the patient to choose the ambulance service of his/her choice.
Mr. Crumpton made a motion to accept this amendment. This was seconded by Jim Cutcher.
Robert Early, director of Redmond Regional Medical Center EMS, expressed a concern that two units will be responding to one call.
Don Starnes, director of Bartow County EMS, stated that he will not respond unless he is requested. He expressed a concern about the zoned service having to remain at the scene until arrival of the requested non-zoned provider.
Bud Owens was concerned that abandonment could be an issue if the zoned provider responded and left the scene before the arrival of the non-zoned requested provider.
Lonnie Oliver, director of Fannin County EMS, had a concern about an extended response time if the requested non-zoned provider was responding from outside the county.
Robert Early suggested that the amendment should include a requirement for the requested non-zoned provider to report their location to the 911 Center.
Matthew Crumpton stated that it was his assumption that most services will inform the 911 Center if they will have an extended response time and transfer the call to the zoned provider if they were outside the county.
Robert Early requested that this issue be included in the amendment as a requirement.
David Loftin explained that this amendment was the best compromise to prevent extended response times while maintain patient choice of ambulance services. He explained if the requested non-zoned service was responding from outside the county or with extended response times then the zoned provider would always arrive first despite running non-emergency.
Danny West, director of Cherokee County Fire and Emergency Services, EMS Division, stated that he believed that this placed a burden on the 911 Centers and would add to delays because the caller would ask questions about the options to use non-zoned providers when asked which service do you want.
David Loftin stated that it was not the intention of the zoning plan to ask the caller anything about options to use another service. The caller must request another service without prompting in order for the non-zoned provider to respond. The 911 Center should not be asking the caller which ambulance service they want in this plan.
Keith Puckett, director of Clark Ambulance, stated that he believes that if you call 911 then you should not have an option to request a non-zoned service but you should only have the option of the zoned service to respond. He stated that if you want a non-zoned provider then you should call a 7-digit number and not 911. He states that he believes there are instances where the patient does not get the ambulance service they desire because the person calling 911 requests the non-zoned provider.
David Loftin stated that if the non-zoned provider again is accessed though a seven digit number then a number of problems which occurred in the past would again be present such as:
Jumping calls from the scanner while using false phone numbers to justify response
Placing phone stickers on phones urging the caller to call a seven digit number instead of 911 in emergencies, then going out of business causing delay and confusion.
No number or location identification will be available if the caller dials a seven digit number.
Matthew Crumpton withdrew his motion to approve the amendment and Jim Cutcher withdrew his second. Mr. Crumpton asked to table the issue for further discussion.
Keith Puckett expressed his appreciation for the efforts of the transportation committee.
Dr. Mabley stated that she appreciates weighing the issues of individual liberties as compared to the public good and the roles of public safety providers who cover zones. She gave additional concerns about the issue including the risks of running hot to calls by ambulances and the problem of zoned ambulance service units not being in place to cover zones because they were outside the zone answering a private request call. She stated that even though the issue has not been discussed in EMSMDAC she believes that they would favor the public safety against individual liberties.
The next item of business was a request by Centeral EMS to become a secondar y zone provider in Cherokee County. Mr. Crumpton stated that it is his opinion that the committee should not be considering proposals of secondary providers and that that issued is being handled by mutual aid agreements. He noted that upon learning that the Cherokee County zone was not open then Gary Coker, owner of Central EMS, withdrew his request.
David Loftin reminded Mr. Crumpton that the issue of Dade County has not been addressed.
Matthew Crumpton stated that the transportation committee had approved a recommentation that the Dade County zone be assigned to Dade County EMS (GA ambulance license 041-01). He made a motion that that the Dade County zone be assigned to Dade County EMS (GA ambulance license 041-01). The motion was seconded by Don Starnes and was approved.
Matthew Crumpton asked for feedback on the proposed amendments by the members of the Council and EMS community in Region 1. He suggested that the comments be e-mailed to
Russell McDaniel made a mition for the chairman to call a special called meeting of the entire Region 1 EMS Council (not the transportation committee) to give opportunity for further thought and consideration to the matter. The issue will be debated amoungst all members of the council and disposed at that meeting. Dr. Mabley seconded the motion and the motion was approved.
David Loftin gave the Office of EMS report. He introduced David Foster who has been offered the position of Region 1 EMS Training Coordinator. His first day is projected as April 16, 2009.
David Loftin asked any EMS personnel who have been employed in the EMS profession for more than 20 years to come forward to receive medallions. Several EMS professionals were honored.
David Loftin gave the training report. Several National Registry exams have been conducted with a large exam on this Saturday to accomondate several Region 1 courses.
The next large exam will be in September when the next group of EMS courses graduate students. Mr. Loftin states that he is trying hard to promptly approve continuing education courses but does not always know how to provide the approval number to the program because of the lack of information on the forms. He announced that a Critical Care Paramedic program from the Medical College of Georgia will be taught at West Central Technical College befinning on June 15, 2009 and ending on July 7, 2009. Ambucare EMS promoted the stimulus to bring this program to Region 1. Brochures are available through the school, Ambucare EMS and Region 1 EMS. [No definite plans are known for the next EMS Instructor screening at this time in Georgia]
Dr. Mabley gave a report on the school nurse program funding which had been in jeophardy because of the state budget restraints. She reported that the program was saved in the last days of the legislature but will include some furlough days for nurses.
Russell McDaniel asked if the use of paramedics instead of nurses had been considered in schools.
Dr. Mabley stated that she did not know and whether most were Registered Nurses or Licensed Practical Nurses.
Dr. Mabley reported that EMSAC and EMSMDAC have arranged to have meetings at the National EMS Expo in Atlanta on October 29, 2009. The focus of this meeting will be the issue of National Registry exam and improving Georgia’s EMS Education system. She hopes to have the recommendations to improve Georgia’s EMS training program ready to submit by this meeting. Senate Bill 233 was introduced into the Georgia legislature during this session which called for an alternative test for EMS in Georgia instead of the National Registry exam. This bill was withdrawn by the Georgia EMS Association after discussion at the last EMSMDAC meeting. Dr. Mabley explained that the issues of concern for the EMSMDAC were quantity verses quality. SB 233 caused some problems between the EMSMDAC and the EMS Association but she hopes that the groups will work together over the summer to develop solutions. Dr. Mabley announced that the EMSMDAC working group component will be Dr.s Issac Isacoff, Ed Rock, Michael Hague, Robert Cox and herself. Courtney Twilliger will appoint 2 educators, members of the EMS Association and members of the Office of EMS. The meetings will occur beginning in May possibly in Macon, Georgia. The goal will be to have a proposal ready for the meeting at EMS Expo. The proposal should include National goals of using National Standards, National License Levels and National Accreditation for EMS Training Sites. Dr. Mabley agrees that the National Registry does have some problems such as customer service and price. She says that there is very little feedback as to why students are failing areas of the test and there may be a problem with the scope of practice used for the test compared to the scope of practice for Georgia. She realizes that there are alternative National exams for physician licensure in Emergency Medicine. She also realizes that the only currently nationally accredited EMS training program is Gwinnett Technical College and the deadline for the National Registry requirement is 2013. She realizes the problem implemting this in a large number of programs in Georgia given this deadline and that some programs will not be able to meet the requirements causing fewer schools and possibly lower amounts of graduating students. This is in the face of manpower shortages for EMS in Georgia. Dr. Mabley requests input to her e-mail on this issue. Her e-mail address is
Steve Lawson asked if EMSMDAC currently recommends that Georgia stay with the National Registry exam. Dr. Mabley stated that is the current recommendation. However, it another exam meets the National Standards then it will be considered. He realizes that the license exam for Emergency Physicians now has two different exams.
Bud Owens gave the EMSAC report. The last meeting was on February 24, 2009 in Atlanta and the issue of alternative EMS tests was discussed. He hopes that a joint EMSAC and EMSMDAC will be able to arrive at solutions. He also reported on legislation that would fund the Georgia trauma system. The only bill that passed was the Super Speeder bill, which would provide $23 million dollars to the program. The EMS Day at the Capitol held on February 19, 2009 was a success and he thanked those who attended.