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 nonzoned 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 nonzoned 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 cdloftin@dhr.state.ga.us
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 jillmabley@bellsouth.net
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.
Bud Owens gave the dates of the next EMS related events in the next few months:
April 16, 2009 next meeting of the Georgia Trauma Commission in Macon
May 14, 2009 Georgia EMS Awards banquet in Forsyth
May 26, 2009 next meeting of EMSAC in Macon
May 17, 2009 (11 a.m.) EMS Week celebration at Trinity Baptist Church in Calhoun
[a lunch will be served after the services]
Mr. Owens asked for any other EMS Week activities and the following were announced:
May 19, 20 EMS Week celebration at Angel EMS in Fort Oglethorpe
May 19 EMS Week celebrations at Redmond Regional Medical Center in Rome
May 20, 21, 22 EMS Week celebration at new Floyd Medical Center EMS headquarters
located at 500 Riverside Parkway from 11:00 a.m. – 1:00 p.m.
Jim Cutcher expressed his appreciation for the visits, flowers and cards he experienced as
a result of the recent death of his mother.
Jim Cutcher made a motion to adjourn. It was seconded by Steve Lawson and
unanimously approved.
Respectfully submitted,
Bud Owens, Chairman