ADIRONDACK - APPALACHIAN
REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL
2920 STATE ROUTE 30
PO BOX 212
SPECULATOR, NEW YORK 12164
TEL. (518) 548-3535
FAX (518) 548-7605
E-MAIL: aarems@frontiernet.net
WEBSITE: www.aarems.org
MINUTES
The regular monthly meeting of the Adirondack-Appalachian Regional Emergency Medical Services
Council was held on Thursday, December 20, 2012, at the Holiday Inn, Johnstown, NY.
Vice - Chairman Howard Hime, presiding.
MEMBERS ATTENDING:
Donald Coy
Patrice Delameter
John Farquhar
Patricia Green, RN
Howard Hime
Richard Kersmanc (alt.)
August Leinhart, MD
Bonnie Looman, RN
David Markowitz, MD
Joyce Mulleedy
Philip Mulleedy
Thomas Pasquarelli
Michael Swartz
Dana Weygand
Gary Wickes
Mark Zeek (adv.)
ABSENT AND EXCUSED:
Sidney Chase
Cynthia Dunham
Jack Early
Jared Gilston
Steve Hood
Brian Knapp
ABSENT:
None
GUESTS:
Richard Beebe, RN
Jill Dunham
Joseph Farrell
Deborah Kufs, RN
Beth McGown
Mary Ramo
Richard Terwilliger
Greg Vis
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Paramedic Educator
Ambulance Service of Fulton County
NYS-EMS
Hudson Valley Community College Paramedic Program
Cooperstown Medical Transport
NYS-EMS
Hudson Simulation Services
Hudson Simulation Services
*
The meeting was called to order at 1:00 PM by Vice-Chairman Howard Hime, acting in the excused
absence of Chairman Lewis Jones.
ROLL CALL
A quorum was present. Mr. Mulleedy explained that Mr. Jones had been present for the Training
Committee meeting this morning, but had been called home suddenly due to the worsening medical
condition of his father-in-law. He asked all present to keep this situation in their thoughts and prayers.
AAREMS Minutes for December 20, 2012 Page 1
APPROVAL OF MINUTES OF THE NOVEMBER 15, 2012 MEETING
The Minutes of the November 15, 2011 meeting had previously been made available electronically to
all members in a timely manner, and in addition had been posted on the regional web site for review
and/or downloading.
Motion was made by Mr. Pasquarelli and seconded by Mr. Coy, as follows:
RESOLVED, that the Minutes of the November 15, 2012 meeting are accepted as amended.
This was adopted unanimously, with no abstentions.
INTRODUCTION OF GUESTS
Our guests, as named above, were introduced and welcomed.
CORRESPONDENCE
For the period from November 15, 2012 through December 19, 2012:
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11/16 – to all AAREMS and REMAC members, the counter-terrorism bulletin from
Crossfire Publications (via email);
11/16 – to a new TEK, a provisional number (via email);
11/19 – to a new TEK, a provisional number (via email);
11/19 – to all AAREMS and REMAC members and others usually receiving them, the
Minutes for the November 15, 2012 AAREMS and REMAC meetings (via email)(also
placed on regional web site);
11/21 – to keypunch, 1939 screened PCRs;
11/21 – to an agency officer, provisional TEK number for a new AEMT, as requested (via
email);
11/21 – to Dr. Fanion , replying about a cardiac arrest protocol question (via email);
11/21 – to all AAREMS and REMAC members, forwarding the email about the SchoWright ambulance donation (via email);
11/26 – to Lisa DeLong, DOH, about voucher payment status (via email);
11/26 – to Robert O’Brien, replying about the intranasal Narcan program (via email)(two
messages);
11/26 – to all AAREMS and REMAC members, the email received from Howard Huth
about SUNY Cobleskill paramedic graduates employment opportunity (via email);
11/27 – to Lisa Delong, DOH, replying about voucher payments (via email);
11/27 – to Oneonta FD Ambulance, Middleburgh, Scho-Wright and Mid-County, supplies
of PCRs, as requested;
11/27 – to Oneonta FD Ambulance, a supply of continuation forms, as requested;
11/27 – to Greg Vis, Hudson Simulation Services, listings of AAREMS agencies and
contact information, as requested for training program;
11/27 – to Dr. Markowitz, Fox Hospital, about the use of Fox Center for PEPP training on
February 09, 2013 (via email);
11/27 – to two neighboring Regional contact persons, a QI issue (via email);
11/28 – to Dr. Markowitz, about classroom inquiry (via email);
11/28 – to John Morrissey, DOH, replying about a QI matter (via email);
11/29 – to Richard Kersmanc, a list of regional instructors, as requested;
AAREMS Minutes for December 20, 2012 Page 2
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11/29 – to Rural/Metro, a provisional TEK number for a new employee, as requested ( via
email);
11/30 – to an agency officer, a QI issue (via email);
11/30 – to CMT, approval letter for the ePCR program (via email);
12/03 – to an agency officer, replying about medical director insurance (via email);
12/03 – to Jayne Putman, replying about her leaving the Regional Council (via email);
12/03 – to Donna Johnson, DOH, replying about SEMSCO and SEMAC meeting dates
(via email);
12/05 – to Lisa DeLong, DOH and Senator Seward’s office, regarding voucher payments
(via email);
12/05 – to Dana Jonas, DOH, replying about an agency level of service (via email);
12/06 – to Dana Jonas, DOH, replying about his follow-up on the above (via email);
12/06 – to Senator Seward’s office, replying about the follow-up email (via email);
12/06 – to an agency officer, a provisional TEK number for a member, as requested (via
email0;
12/07 – to an agency officer, replying about a training issue (via email);
12/10 – to an agency officer replying about a training issue (via email);
12/10 – to an agency officer, about a provisional TEK number for a member (via email);
12/11 – to Dr. Markowitz, replying about agency medical direction (via email);
12/12 – to Dr. Pellerin, replying about his leaving as agency medical director for a number
of agencies (via email);
12/12 – to Speculator, a supply of PCRs and continuation forms, as requested;
12/13 – to all AAREMS and REMAC members, forwarding the notice of laryngoscope
blade recall from Dan Clayton (via email);
12/13 – to all AAREMS members, notice of December 20 meeting reminder (via email);
12/14 – to all AAREMS and REMAC members, the Homeland Security bulletin just
received (via email);
12/14 – to a practitioner outside the Region, returning their TEK number application with
explanation;
12/14 – to Hudson Simulation Services, replying about their providing training in the
Region (via email);
12/17 – to Lisa DeLong, DOH, replying about contract approval (via email);
12/17 – to a PAD applicant, returning their application for revisions;
12/17 – to Dr. Leinhart, about the above (via email);
12/18 – to an agency member, replying about a link on the regional web site (via email);
12/18 – to Jones and Bartlett publishers, a copy of the Region’s tax exemption certificate,
as requested for the PEPP textbooks (via fax);
12/18 – to an agency officer in Otsego County, replying about an intranasal Narcan
program question (via email);
12/19 – to Lisa DeLong, Tom Behanna, Dan Clayton and Lee Burns, DOH, notice of
payment received (via email);
12/19 – to keypunch, 3034 screened PCRs;
12/19 – to CMT and Downsville, supplies of continuation forms, as requested;
12/19 – to Roxbury and Richmondville, supplies of PCRs, as requested;
Received:
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11/16 – from Crossfire Publications, their latest counter-terrorism bulletin (via email);
11/18 – from a practitioner, about the AAREMS CME website (via email);
11/21 – from Dr. Fanion, a cardiac arrest protocol question (via email);
AAREMS Minutes for December 20, 2012 Page 3
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11/21 – from Scho-Wright, about an ambulance donation (via email);
11/26 – from Robert O’Brien, Otsego County EMS, about the EMT intranasal Narcan
demonstration program (via email);
11/26 – from Howard Huth, about SUNY Cobleskill paramedic graduates employment
opportunity (via email);
11/27 – from Lisa DeLong, DOH, about voucher payments (via email);
11/28 – from Dr. Markowitz, replying about classroom reservation inquiry (via email);
11/28 – from John Morrissey, DOH, about a QI matter (via email);
11/29 – from Otsego County EMS Advisory Council, regarding membership changes (see
below);
11/29 – from Life-Net of NY, about a training program (via email)(posted on regional web
site);
11/29 – from Rural/Metro, about a prospective new TEK (via email);
11/29 – from Richard Kersmanc, requesting a list of regional instructors (via email);
11/30 – from Dr. Markowitz, with contact information as requested (via email);
11/30 – from Tom Pasquarelli, the annual GAVAC MFI report;
12/03 – from an agency officer, about medical director insurance (via email);
12/03 – from Jayne Putman, about her leaving the Regional Council (via email);
12/03 – from Donna Johnson, DOH, about SEMSCO and SEMAC meeting dates (via
email);
12/03 – from Hudson Simulation Services, about federal training grants available (via
email);
12/05 – from Dana Jonas, DOH, about an agency level of service (via email);
12/06 – from Dana Jonas, further information regarding the above (via email);
12/06 – from Senator Seward’s office follow-up about voucher payments (via email);
12/06 – from an agency officer, requesting a provisional TEK number for a new member,
and attaching the usual paperwork (via email);
12/07 – from an agency officer, about a training issue (via email);
12/07 – from Albany Medical Center, presenting CME offerings (posted on regional web
site);
12/07 – from an agency officer, about a TEK number for a member (via email);
12/10 – from an agency officer, a training issue (via email);
12/11 – from Dr. Markowitz, about agency medical direction (via email);
12/11 – from Dr. Pellerin, about his leaving as agency medical director for a number of
agencies (via email);
12/11 – from NYS DEC, about a defibrillator use (via fax);
12/13 – from Dan Clayton, DOH, notice of recall of certain laryngoscope blades (via
email);
12/13 – from SUNY Cobleskill, notice of training course (via email)(posted on regional
web site);
12/13 – from a practitioner outside the Region, a TEK number application;
12/14 – from Homeland Security, their latest bulletin (via email);
12/14 – from Hudson Simulation Services, about providing training in the Region (via
email);
12/14 – from Fort Edward Rescue, about a PHTLS course (via email) (posted on regional
web site);
12/14 – from DOH, the approved Program Agency contract for 2012-2015;
12/14 – from Dr. Leinhart, about a PAD applicant (via fax);
12/14 – from Rich Reuther, REMO, about a training course (via email)(posted on regional
web site);
12/17 – from Lisa DeLong, DOH, about contract approval (via email);
12/18 – from an agency officer, a QI issue (via email)(reply by telephone);
AAREMS Minutes for December 20, 2012 Page 4
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12/18 – from an agency member, about a link on the regional website (via email);
12/18 – from Mountain Lakes Region, notice of a preceptor class (via email)(posted on
regional website);
12/18 – from an agency officer in Otsego County, a question about the intranasal Narcan
program (via email);
12/19 - from DOH, voucher payment for Program Agency first quarter;
A listing of the correspondence was distributed before the start of the meeting to each member
present, for his or her perusal. Other handouts distributed to the members present included the
cash flow and balance sheet, and a list of 2013 meeting dates.
CHAIRMAN’S REPORT
There was no report.
SECRETARY’S REPORT
On November 29, a letter was received from the Otsego County EMS Advisory Council, advising
that Mr. Knapp had been reappointed to serve another term as representative, and that Mrs. Putman
had regretfully tendered her resignation. Dr. Markowitz had been selected by the Advisory Council to
replace Mrs. Putman. After a brief discussion that included commendation to Mrs. Putman for her
years of dedicated service to the Regional Council and the cause of EMS in general, Motion was
made by Mr. Kersmanc and seconded by Mrs. Delameter, as follows:
RESOLVED, that the resignation of Mrs. Putman from the Council is accepted with regret,
and the nomination of Dr. David Markowitz as her replacement is accepted. Dr. Markowitz is
named a member of the Regional Council, and shall also continue as a member of the Council’s
Regional Medical Advisory Committee (REMAC). Mr. Knapp is also re-appointed to another
term of office.
This was adopted unanimously, with no abstentions.
On December 03, we received word from Donna Johnson at DOH of the next meeting dates for
SEMSCO and SEMAC. They will be a meeting on January 29-30, 2013 at the Hilton Garden Inn in
Troy.
On December 11, we were advised by Dr. Pellerin that he would be discontinuing his agency medical
direction for a number of agencies in both Delaware and Otsego counties on December 22, 2012,
since he has accepted a position with the Veterans Administration Hospital in Albany. Outreach was
begun to the agencies in question to assist during this transition time. At least 13 agencies are
affected, including: in Otsego County - Oneonta FD, CMT, Middlefield, SUCO Oneonta, Otego and
Wells Bridge, and in Delaware County - Davenport, East Branch, Grand Gorge, Meridale, Pindar’s
Corners, Treadwell and Trout Creek. We have been advised that a temporary arrangement has been
made for him to continue with Oneonta Fire Department Ambulance, as a stop-gap measure. There
was discussion on this, as well as the general issue of the difficulty in obtaining agency medical
directors. This difficulty will be an agenda item for the REMAC meeting in January.
On December 11, we were advised that the Department of Environmental Conservation had used an
AED at one of their offices in this Region. The patient was a 53 year-old male who unfortunately did
not respond to resuscitative efforts.
On December 13, we were advised by Dan Clayton at DOH of a voluntary recall of certain reusable
laryngoscope blades. This was forwarded to all members electronically.
AAREMS Minutes for December 20, 2012 Page 5
On December 17, in a phone conversation, Mr. Farquhar raised the dilemma faced by a number of
controlled substance agencies, since they must now replace and restock by bringing their ambulance
vehicles to the hospital, instead of the agency designated officer doing this using a personal vehicle.
There was brief discussion on this, and this will also be an agenda item for the January REMAC
meeting.
Rich Reuther of REMO has asked for the opinion of the members as to when a CLI course would be
best received, e.g., weekdays, weeknights, weekends, etc. The course is planned for the end of
February - beginning of March. There was discussion on this, and no consensus was reached.
Members’ comments to the regional office are invited.
Mr. Mulleedy noted that TEK booklets for the first six months of 2013 would be sent out after
Christmas. They were not able to be sent out for the previous period (July 01 - December 31) due to
the financial difficulties engendered by the DOH late payment issue. He noted that the appropriate
form may be downloaded from the regional website (“forms and applications” page), and also that a
growing number of agencies are sending a letter with a listing covering all their members’ proficiency
requirements, rather than each member’s making an individual submission. This is quite acceptable,
provided the letter is signed by both the agency chief officer, and the agency medical director.
Notices of enforcement actions have been received, as follows: none were received this month
Name/ DOB/Violation
Address
Cert. Number
Action Taken
A cumulative listing of training courses announced or in progress can be found on the Council’s web
site – www.aarems.org. E-mail links to all of the course sponsors are also to be found with the course
listings on the web site. For further information by phone, contact the following: Otsego County –
Fred Lemister (607) 547-4226; Bassett Hospital – (518) 255-5367; Delaware County – Stephen Hood
(607) 746-9600; Margaretville Hospital – Patrice Delameter (845) 586-2631, ext. 3226; Schoharie
County – Bill Averill (518) 234-2839; Fulton-Montgomery Community College (FMCC) – Mark
Hitchcock (518) 774-0425; Hamilton County – Gary Wickes (518) 548-4380.
TREASURER’S REPORT
For the period from November 15, 2012, through December 19, 2012:
General Accounts
Checking
Savings
Program Account
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1213.47
45867.62
Payroll
C.O.N.
- 3611.14
- 425.33
As of September 04, DOH was up to date in payments due to this Region. On October 03, we
submitted to Lisa DeLong at DOH the Council quarterly deliverables for the period July 01 through
September 30 together with a voucher in the amount of $5826.36. On the same date, we submitted the
Program Agency deliverables and a voucher in the amount of $43891.82 for the same period. We
inquired of Lisa DeLong at DOH as to the payment status on November 09 without receiving a reply.
On November 27, after having sent three emails to her she asked for particulars on past due
vouchers, and stated that the EMS Bureau was pursuing timely payment. The information she
requested was provided. In a telephone conversation on December 03, she stated that word on
payments was still being awaited. On December 05, we sent her an email reminder and also contacted
Senator Seward’s office for assistance. The next day (December 06), we received word that the
Senator’s office had contacted DOH (at a supervisory level) and would actively follow up on this
matter. The check for $43891.82 was received on Wednesday, December 19.
AAREMS Minutes for December 20, 2012 Page 6
On December 14, we received the approved Program Agency contract for the period July 01, 2012June 30, 2015. The contract amount is $153842.00 per year. This is the same amount as the past year.
A printed report of the cash flow and balance sheet was distributed to all members. Mr. Jones and
Mr. Hime first received detailed cash flow, balance sheets and register reports plus copies of
cancelled checks, as per the review arrangements agreed on to meet audit standards. Mr. Hime
reported all was found in order. Mr. Jones had reviewed the documents before being called away and
had also found them to be in order, and Mr. Chase will have the opportunity to review them at the
next meeting.
Motion was made by Mrs. Delameter and seconded by Mr. Weygand, as follows:
RESOLVED, that the Treasurer’s Report is accepted as presented.
Those voting adopted this unanimously. Mr. and Mrs. Mulleedy abstained, as staff members.
COMMITTEE REPORTS
Regional Program Agency Committee
The PCR screening is currently being performed by Mrs. Mulleedy, outside of her regular work
hours. This has been the case since the retirement of our former screener in June. There have been
no new hires, as a cost saving measure. Records show that there has been an average of 40 hours a
month devoted to this duty over and above her regular work responsibilities. Suggestion was made
that a monthly compensation be awarded to her for this extra responsibility, over and above her
usual salary. This would still involve a considerable net saving to the Region over the previous
expenditure. There was general agreement on this and after some further brief discussion, Motion
was made by Mr. Coy and seconded by Mr. Swartz, as follows:
RESOLVED, that a monthly compensation of Five Hundred Dollars ($500.00) be awarded to
the Educational Services Coordinator for her additional duties of monthly PCR screening.
This shall be a payment in addition to her regular salary as recognition of screening duties
performed outside of regular work hours, and such duties shall be documented on her time
sheets.
This was adopted unanimously. Mr. and Mrs. Mulleedy abstained, as staff members.
Training Committee
On November 27, following two conference calls and an exchange of emails, listings of agencies
with contact information was forwarded to Mr. Vis at Hudson Simulation Services at his request, for
his use in arranging training programs as per his USDA grant. Mr. Vis and Mr. Terwilliger were
present at the committee meeting, and made a presentation about these programs, which are due to be
implemented in March or April to 40 randomly selected agencies in this Council area. Agencies
selected may invite personnel from other agencies to join them for the training, and at the end of the
program, there will be county-wide presentations made as well. Mr. Vis and Mr. Terwilliger also
spoke briefly.
Dr. Markowitz has kindly made arrangements for the presentation of the PEPP course on Saturday,
February 09, 2012 at the Fox Center in Oneonta, from 8AM to 5PM. In addition, there will be
another PEPP taught at JAVAC headquarters in Johnstown on February 16, with the same time
frames. There will be a fee of $30.00 per student that will include all books and other materials. A
maximum number of 24 students will be accepted for each class, on a first come, first served basis. A
AAREMS Minutes for December 20, 2012 Page 7
flyer with a registration form will be sent out to agencies and practitioners after Christmas. It will also
be posted for downloading on the regional website.
Mrs. Mulleedy reported that GAVAC is applying to DOH to become a course sponsor in
Montgomery County, to fill the gap created when Amsterdam Memorial Hospital gave up their
course sponsorship. In the interim, they wish to conduct an EMT course at their headquarters, from
March 23 to June 20, 2013. The class would be on Wednesday and Thursday evenings. The Hamilton
County EMS Council is willing to sponsor this training, but Regional approval is needed before a
DOH course application can be submitted. Mrs. Mulleedy then made a Motion that was seconded by
Mr. Coy, as follows:
RESOLVED, that the AAREMS Council approves the initiative of the Hamilton County EMS
Council to sponsor an EMT course in Montgomery County at the headquarters of the Greater
Amsterdam Volunteer Ambulance Corps (GAVAC), on a one time basis, pending GAVAC
approval by DOH as a course sponsor.
This was adopted unanimously, with no abstentions. A letter will be sent to GAVAC affirming this
decision.
There was also a brief discussion on distance learning technologies.
Transportation and Standards Committee
On October 23, 2012, information was sent to the appropriate officer of the Sharon Springs Rescue
Squad, relative to the certificate of need process. On November 14, a phone call was received from
that officer, stating that she had just received the mailing on November 13, even though it had
been signed for on October 31. She wanted the Council to know of her interest in this issue, and
assured us of her cooperation. She called again on December 19, and apologized for the delay in
the submission of the application.
STATE COUNCIL REPORT
Mr. Zeek noted that the next SEMSCO and SEMAC meetings are scheduled to be held in January 29
and 30 in Troy. He spoke about upcoming SEMSCO tasks, and advised that a TAG (Technical
Advisory Group) had been formed to study and deal with the new NFPA vehicle standards. There
was some discussion on this.
At this juncture, Mary Ramo spoke about a fatal ambulance accident on November 27 of this year in
Clinton County. The driver suffered a fatal heart attack at the wheel and the two providers in the rear
suffered serious injuries. They were not wearing seat belts, but the patient, who was secured on the
stretcher, survived with no injury. She stressed the critical importance or wearing belts whenever
possible.
REGIONAL PROGRAM UPDATE
Regional Program Directors Meeting
Next meeting will be in conjunction with the SEMSCO and SEMAC meetings. No further
information received at this time.
Other Program Updates
There were none to report.
AAREMS Minutes for December 20, 2012 Page 8
REMAC Report
Next meeting for the REMAC is scheduled for January 17, 2013. Mr. Zeek noted a growing shortage
of medical directors in the more rural areas of this Region, and has had discussions with Dr. Leinhart
on this. Dr. Markowitz stated that he has agreed to serving as medical director for additional
agencies, but this would place him over the 10 agency limit noted in DOH policies. However, that
same policy allows regions to agree to increase this limit. After some further brief discussion, Motion
was made by Mr. Mulleedy, and seconded by Mr. Wickes, as follows:
RESOLVED, that AAREMS agrees to allow Dr. Markowitz to exceed the agency limit for
medical direction, due to the growing shortage of medical directors in this Region.
This was adopted unanimously, with no abstentions. This issue will also be placed on the REMAC
agenda for January.
Mr. Zeek made note of the fact that a number of new physicians in this Region are requesting that
their contracts (with health care facilities) specifically exclude serving as prehospital agency medical
directors.
County Reports (Reported from North to South in the Region)
Hamilton County – Mr. Wickes had nothing new to report.
Fulton County – Mr. Farquhar had nothing new to report.
Montgomery County – Mr. Swartz reported an upcoming teaching day on December 21.
Schoharie County – There was no representative present form Schoharie County.
Otsego County – Mr. Kersmanc had nothing new to report.
Delaware County – Mrs. Delameter had nothing new to report.
OLD BUSINESS
There was none.
NEW BUSINESS
Mr. Beebe noted that a Wilderness ALS course will be conducted this June at Paul Smith’s College.
A CLI course is also scheduled in the Mountain Lakes Region on January 23. Information on this is
posted on the regional web site. Ms. McGown also advised of an upcoming EMT course at SUNY
Cobleskill. A flyer will be sent to all members; this course is also posted on the regional website.
Mr. Beebe also noted that he had heard of Mr. Averill’s retirement from EMS in Schoharie County
with the New Year. Mr. Mulleedy noted that this was the first the officers had heard of this. He stated
he would inquire into it.
ADJOURNMENT
At 1:43 PM. Next meeting will be at 1:00 PM Thursday, January 17, 2013 at the Holiday Inn,
Route 30A, Johnstown. It will be preceded by a REMAC meeting at 10:30 AM at that same
location.
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AAREMS Minutes for December 20, 2012 Page 9
A MERRY CHRISTMAS AND A HAPPY AND SAFE NEW YEAR,
EVERYONE!
AAREMS Minutes for December 20, 2012 Page 10