SIERRA-SACRAMENTO VALLEY EMERGENCY MEDICAL SERVICES AGENCY
Serving the counties of Placer, Yuba, Sutter, Nevada, Colusa, Butte, Shasta, Tehama, Siskiyou
M I N U T E S
JOINT POWERS AGENCY BOARD – BI-MONTHLY MEETING
Friday, September 12, 2014
MEMBERS PRESENT
5995 Pacific Street
Rocklin, CA 95677
916-625-1702
916-825-1730 (fax)
Roger Abe
Denise Carter
Jim Holmes
Leonard Moty
Marcia Armstrong
Dennis Garton
Bill Connelly
Ron Sullenger
Hank Weston
REPRESENTING
Yuba County
Colusa County
Placer County
Shasta County
Siskiyou County
Tehama County
Butte County
Sutter County
Nevada County
MEMBERS ABSENT
REPRESENTING
EX-OFFICIO MEMBER
Victoria Pinette
REPRESENTING
S-SV EMS Agency
LEGAL COUNSEL
Brian Wirtz
REPRESENTING
Placer County/S-SV EMS Agency
OTHERS PRESENT
John Lord
Karl Pedroni
Amy Boryczko
Mark Belden
Jennie Mackney
Kevin Perry
Troy Falck
Karen Crain-Riddle
Steve Guisti
John McEldowney
Alex Bumpus
REPRESENTING
S-SV EMS Agency
AMR
S-SV EMS Agency
AMR
S-SV EMS Agency
S-SV EMS Agency
S-SV EMS Agency
S-SV EMS Agency
AMR
Placer City OES
Bi-County Ambulance
www.ssvems.com
2775 Bechelli Lane
Redding, CA 96002
530-722-6617
530-222-3007 (fax)
SIERRA-SACRAMENTO VALLEY EMERGENCY MEDICAL SERVICES AGENCY
A.
CALL TO ORDER AND PLEDGE OF ALLEGIANCE
Supervisor Moty called the meeting to order at 1:01 p.m. and led the meeting with the Pledge
of Allegiance.
B.
WELCOME AND INTRODUCTIONS
Everyone present introduced themselves.
C.
APPROVAL OF AGENDA
Supervisor Weston moved to approve the agenda as written. Supervisor Holmes seconded.
Motion approved.
D.
PUBLIC COMMENT
Supervisor Moty asked the public if anyone would like to speak to an issue that is not on the
agenda. None was forthcoming.
E.
BOARD MEMBER ANNOUNCEMENTS
Supervisor Holmes announced that in August, the Board of Supervisors in Placer County
approved Laura’s Law. Supervisor Carter mentioned that the Colusa Ambulance Contract is
expiring at the end of the year, and they are working with S-SV on this. They currently have
two full time Ambulances, but the numbers don’t support having two, so they’re looking at all
options.
F.
CONSENT AGENDA
Supervisor Garton motioned to approve the Consent Agenda. Supervisor Holmes seconded.
Motion approved.
G. PUBLIC HEARING
The Public Hearing was to occur at 1:15 p.m. The Committee moved to Item H since they were
ahead of schedule and came back to this item.
At 1:28 p.m., the Board returned to the Public Hearing/Fee Schedule. The proposed fee
changes were highlighted on the Fee schedule. These changes are based on Staff time and
work load. The changes being removed: Policy Manual w/binder, Policy Manual w/o binder,
Returned Check fee. S-SV no longer supplies Policy Manuals since everything is available on
line, and S-SV does not accept personal checks.
•
The Paramedic Accreditation, MICN Authorization, and MICN Re-authorization fees
will all be raised to $100.00. Currently the Paramedic Accreditation and MICN
Authorization are $60.00. The MICN re-authorization is currently $35.00. There is no
cost for re-accreditation for Paramedics.
JPA Governing Board of Directors Meeting Minutes of September 12, 2014
Page 2 of 9
SIERRA-SACRAMENTO VALLEY EMERGENCY MEDICAL SERVICES AGENCY
•
There currently is no fee for EMT/AEMT site visits, and no current set fee for training
program monitoring. The latter fee is currently in the contracts so the fee varies.
There is currently a contract with NCTI and the Regulations read that wherever the
main office is for these programs falls under the local LEMSA. Since NCTI’s main office
is in Roseville, they fall under S-SV. John Poland does site visits all over California for
the different programs. A flat rate is being added plus travel, so that local sites aren’t
paying the same fee as sites farther away. If staff is on site for a Paramedic Program
that also has an EMT program, both will be reviewed at the same time and no
separate fee would be charged for the EMT program.
•
The Aeromedical annual monitoring fee is currently $3000.00. A significant amount of
Staff time is spent monitoring these providers. The proposed new fee will be
$5000.00. There has been some resistance from the aeromedical providers regarding
the change in this fee, which is notably lower than any other aeromedical fees in
California.
•
The Level IV Trauma Center proposed fee is $2500.00. There currently is no fee.
There previously were no site visits but there are now, and more staff time is required.
•
A Board member asked what the justification was for the proposed
Accreditation/Authorization fees being so high. Vickie explained that it’s mainly staff
time.
•
The proposed fee changes will take effect upon operation of the law.
•
The $2500 proposed Level IV Trauma Center fee was also due to Staff time.
•
All providers were notified of proposed changes.
1:38 p.m. The Public hearing was opened to the Public for comments. None was forthcoming.
1:38 p.m. The Public hearing was closed to Public comments.
Supervisor Weston motioned to approve the proposed Fee schedule changes. Supervisor Abe
seconded. Motion approved.
H.
INFORMATION UPDATE
Supervisor Armstrong arrived at 1:07 p.m., during the Response times.
1. Response times –There was compliance from almost everyone. The AMR Shasta data is
still an issue as the data is not in the correct format for S-SV. The ShasCom data is also
in the wrong format. Kristy and Vickie are working to resolve this. At the next JPA
meeting, there will be non-exclusive contracts from providers which will have a data
submission requirement. Colusa’s data was provided to S-SV by the County and was
added to the response times. ShasCom has a new Director from San Diego. Supervisor
Garton asked about St. Elizabeth’s response times in Corning. They have been moving
units around to try and improve their compliance. However, Matt Moser who has been
in charge of Ambulance service there has resigned – which will incur more changes. The
difficulty is that it’s a hospital based ambulance and they’re unwilling to put the
resources into it to improve the service times.
JPA Governing Board of Directors Meeting Minutes of September 12, 2014
Page 3 of 9
SIERRA-SACRAMENTO VALLEY EMERGENCY MEDICAL SERVICES AGENCY
2. Trauma System Status Overview – Vickie asked Karen Crain-Riddle to give the Board an
overview of the Trauma System. All Trauma centers throughout the State of California
are required to follow Title 22 regulations for Trauma centers. Many of the Trauma
Centers are also verified by the American College of Surgeons (ACS) committee on
Trauma. This is a level of verification that states that the Trauma center has met certain
criteria that qualifies them to be experts in delivering care to Trauma patients. For the
S-SV Region:
•
There are no Level I Trauma Centers. The closest Level I Trauma Center is UC
Davis Medical Center. If the need arises, S-SV patients can be transferred there
through a transfer agreement with UC Davis.
•
There are 3 Level II Trauma Centers: Enloe Medical Center, Mercy Medical
Center-Redding, and Sutter Roseville Medical Center.
•
There are 5 Level III Trauma Centers: Mercy Medical Center –Mt. Shasta, Oroville
Hospital, Rideout Medical Center, Shasta Regional Medical Center, and St.
Elizabeth’s Community Hospital
•
There are 4 Level IV Trauma Centers: Colusa Regional Medical Center, Mayers
Memorial Hospital, Fairchild Hospital, and Orchard Hospital.
Level I Trauma Centers are the highest and are required to do research, outreach
education, and injury prevention.
Level II Trauma Centers have the same requirements as the Level I, in terms of
specialty services and 24-hr hospital coverage, but they are not required to do
research, outreach, or injury prevention.
Level III Trauma Centers are not required to have the same full availability of all
specialists. They are not required to have Neuro surgeons, but there are requirements
for Orthopedics and general surgery as well as other specialties to a lesser extent.
Surgeons do not have to be on-site but do need to be within a 30 minute response
time to see the patient.
Level IV Trauma Centers have had very minimal ACS requirements in the past. They
tend to be the smaller, more rural facilities. The nurses and physicians are required to
be trained to a specific Trauma level of training. Their role has been to stabilize, treat
and transfer to a higher level of care facility; therefore, transfer agreements must be
in place with all appropriate higher level of care trauma centers in the region.
At the request of S-SV, The American College of Surgeons conducts an initial
consultative site review at our Level II & Level III trauma centers to evaluate the
current status of their trauma services/program. At the verification site review
(required of Level III and Level IV Trauma Centers) they review the hospital trauma
program, with the expectation that the facility meets established criteria. If there are
any Type I deficiencies they will not be verified.
It is the responsibility of the S-SV agency to look at the system as a whole. This means
evaluating how many trauma centers exist or are necessary based upon: geographic
locations of the centers in terms of available resources in the surrounding area, area
JPA Governing Board of Directors Meeting Minutes of September 12, 2014
Page 4 of 9
SIERRA-SACRAMENTO VALLEY EMERGENCY MEDICAL SERVICES AGENCY
populations, data, and other resources available. Consequently, S-SV is evaluating the
Level IV Trauma Centers and their locations.
A Board member asked about Feather River Hospital in Paradise. It was clarified that
the hospital is not a trauma center and the Agency currently does not see a need in
that area, due to location and proximity to a Level II trauma center, for another Level
IV trauma center.
For Level IV trauma facilities, if they should lose their designation, the cost of
operating as a Level IV trauma center would decrease, but patient traffic would
essentially remain the same.
S-SV recently met with Colusa and Orchard Hospitals due to their lack of
responsiveness and understanding of the necessary requirements to be a Level IV
trauma center. Orchard Hospital is currently having internal discussions regarding
continuing their status as a Level IV trauma center.
A Board member expressed concern for Siskiyou County’s only Level IV trauma center
and was reassured that the Agency had no concerns regarding that facility.
There were questions regarding Mercy Medical Center-Redding, and Shasta Regional
Medical Center, regarding their proximity to each other and their Levels (II & III) as
well as the need for the two trauma centers in such close proximity. It was clarified
that Shasta Regional Medical Center has always been a Level III trauma center.
Additionally, it was asked if we actually have the ability to change the Levels of a
trauma center or take away their designation. It was clarified that, yes, the Board/SSV EMS Agency is the entity that designates and can de-designate a trauma center if it
is not meeting the requirements of the contract with S-SV for trauma services or
fulfilling the obligations as a trauma center. Prior to de-designation, the Agency will
give the trauma facility a timeline by which to guide them toward success in meeting
their obligations, which is attached to an updated contract for approval by this Board.
Tahoe Forest was asked about. Tahoe Forest is not a Trauma Center. A Board
member inquired about Tahoe Forest hospital. It was explained that several years
ago, the hospital was moving in the direction of becoming a trauma center, but there
was a lack of support from the physicians necessary to sustain a trauma program and
become designated as such.
The Board returned to item G1, the Public Hearing, at this point.
3. Public Comment documents – These were sent out so that the Board would know how
the Agency was responding to the State. Going forward, when a response is submitted
to EMSA it will also be forwarded to the Board.
4. Audit update – The annual audit starts next week. All of the financials have been sent
to the auditors. This is a single audit because of grants, which means it’s a more
JPA Governing Board of Directors Meeting Minutes of September 12, 2014
Page 5 of 9
SIERRA-SACRAMENTO VALLEY EMERGENCY MEDICAL SERVICES AGENCY
detailed audit. Instead of them looking at 10% of the transactions, they look at 40-50%
of the transactions. The audit will be conducted over a 3 day period next week.
I.
OLD BUSINESS
There was no old business.
J.
NEW BUSINESS
The State requires a resolution to be signed in addition to contracts being signed. A Board
member suggested the wording of the resolution request items be changed to “...allow the
Executive Director…” instead of ‘Director’.
1. Resolution to allow Director to sign Cal Fire Cooperative – for approval – Supervisor
Garton motioned to approve the resolution. Supervisor Holmes seconded. A roll call
of votes was called: Ayes=9 (Counties of Placer, Shasta, Siskiyou, Yuba, Butte, Tehama,
Sutter, Nevada, and Colusa). Noes=0, Absent=0. Motion approved.
2. Resolution to allow Director to sign the 2014/15 State General Fund (Multi County
Local Emergency Medical Services Agency) Contract – for approval - Supervisor Holmes
motioned to approve the resolution. Supervisor Weston seconded. A roll call of votes
was called: Ayes=9 (Counties of Placer, Shasta, Siskiyou, Yuba, Butte, Tehama, Sutter,
Nevada, and Colusa). Noes=0, Absent=0. Motion approved.
3. Resolution to allow Director to sign the HPP YR13 Emergency Preparedness Office
(EPO) Yuba and Sutter Contracts –for approval- Supervisor Carter motioned to approve
the resolution. Supervisor Connelly seconded. A roll call of votes was called: Ayes=9
(Counties of Placer, Shasta, Siskiyou, Yuba, Butte, Tehama, Sutter, Nevada, and Colusa).
Noes=0, Absent=0. Motion approved.
4. Resolution to allow Director to sign the 2014/15 LEMSA HPP Contract –for
approval- Supervisor Weston motioned to approve the resolution. Supervisor
Armstrong seconded. A roll call of votes was called: Ayes=9 (Counties of Placer, Shasta,
Siskiyou, Yuba, Butte, Tehama, Sutter, Nevada, and Colusa). Noes=0, Absent=0. Motion
approved.
5. Resolution to allow Director to sign the RDMHS contract with EMSA for FY 2014/15 –
for approval- Supervisor Holmes motioned to approve the resolution. Supervisor Abe
seconded. A roll call of votes was called: Ayes=9 (Counties of Placer, Shasta, Siskiyou,
Yuba, Butte, Tehama, Sutter, Nevada, and Colusa). Noes=0, Absent=0. Motion
approved.
K. EMCC/COUNTY COMMITTEE REPORTS
These reports were given to the Board members in writing.
Supervisor Armstrong mentioned that the Butte Valley and Happy Camp airports were being
decommissioned. She also mentioned that 210,000 acres have burned in the fires in Siskiyou.
S-SV provided the following update to all committees:
JPA Governing Board of Directors Meeting Minutes of September 12, 2014
Page 6 of 9
SIERRA-SACRAMENTO VALLEY EMERGENCY MEDICAL SERVICES AGENCY
•
S-SV Agency activity reports provided at all meetings including MCC, Trauma, and
Air Ambulance Committee reports.
Placer County –
•
•
•
•
•
•
There was continued discussion on the 5150/mental health patient impact on the EMS
system that the EMCC is going to be looking into. Eric Angle mentioned that they continue
to receive several law enforcement and EMS transported 515 patients from Sacramento
County because the crews do not want to wait at the Sacramento County hospitals. He
was advised that we would need some specific data related to this issue with the
Sacramento County patients so that we could address it with Sacramento County EMS if
necessary.
Red Cross reported that they are continuing to see an increase in frequency of calls for
service – 2012 – 1 call every 21 hours, 2013 – 1 call every 16 hours, 2014 ytd – 1 call every
10 hours. These numbers are for the 24 county northern California regions.
Placer County Public Health will be holding a closed POD exercise related to an anthrax
release/exposure in October (specific dates tbd). This will be held in conjunction with
several surrounding counties. The goal is to determine how long it would take to dispense
medical countermeasures to response partners.
Sutter Auburn Faith will soon begin a remodel of their front entrance to improve patient
access.
Placer County will receive and maintain one of the 5 water purification trailers that are
being funded by Raleys as part of their improper hazardous waste lawsuit settlement.
This equipment will be available for use in Placer County as well as a statewide asset.
South Placer FD has been in discussions with State OES to receive and maintain one of 18
statewide Type 2 Urban Search and Rescue trailers.
Nevada County EMCC – no meeting. Trying to establish a meeting date since a number of
committee members, notably the Chair and Vice-chair, have retired.
Colusa County EMCC – next week
Butte County- next week
Yuba/Sutter EMCC –
•
•
•
•
•
Yuba and Sutter Counties reported that they are still waiting on CDPH approval of their
year 13 HPP work plans.
Bi County Ambulance held an MCI training class in Wheatland in June which was well
attended and went well
There was a short discussion on the 7/10/2014 Sutter County MCI. Everyone agreed that
it went well with no issues
Yuba County will be holding a Flood exercise in October and both counties will be
participating in the Statewide Medical & Health Exercise in November
Sutter County will be holding their annual drive through Flu clinic/exercise in September
JPA Governing Board of Directors Meeting Minutes of September 12, 2014
Page 7 of 9
SIERRA-SACRAMENTO VALLEY EMERGENCY MEDICAL SERVICES AGENCY
•
The meeting time was changed to begin at 8:30 am beginning with the next meeting in
September
Siskiyou EMAG –
•
•
•
•
•
•
•
Air ambulance dispatch was discussed. Notification was made that REACH will have a
fixed wing aircraft at the Weed airport
CalFire requested that Mt. Shasta ambulance have visible unit numbers and state where
they are coming from.
Mt. Shasta reported that narrow-banding isn’t working, they aren’t getting the
communications
The impact of the drought was discussed
The air ambulance dispatch analysis was discussed with a request to include Siskiyou
County in the discussions
Fairchild hospital announced some staffing changes/additions
Butte Valley Ambulance is actively recruiting volunteers
Shasta EMAG – next week
Tehama EMAG – next week
L. LEGISLATION
Legislation is either dead or sitting on the Governor’s desk. EMSAAC and EMDAC are both in
opposition of AB 1535. They are waiting to see what the Governor does with this bill.
M. MEDICAL DIRECTOR’S REPORT
Dr. Falck provided an update on the Community Paramedicine project. After the last Board
meeting, there was another public hearing with significant opposition from the CNA and others.
They still haven’t heard from OSHPD (Office of Statewide Health Planning and Development),
on whether they will get to move forward with the project. The longer the wait, the longer the
project gets delayed.
Ebola is a really difficult disease because the symptoms are so non-specific. This will get worse
in the winter when many will have fever, nausea, and vomiting. The key issue is travel history,
and contact with other patients with Ebola. We don’t know what the impact will be on this
area. Hospitals can’t screen every patient with a fever, unless the patient offers up an exposure
history. This is not a respiratory disease. In order to get the disease you have to be exposed
through your own mucous membranes. It’s avoidable with proper personal protection.
Regarding the Respiratory Virus that affects children; it mostly affects those that have
underlying respiratory problems like Asthma, COPD and other issues. There haven’t been any
cases yet out here. The nature of this virus is predominant in children.
Dr. Falck explained blood transfusions with antibodies.
JPA Governing Board of Directors Meeting Minutes of September 12, 2014
Page 8 of 9
SIERRA-SACRAMENTO VALLEY EMERGENCY MEDICAL SERVICES AGENCY
N. CLOSED SESSION
None.
O. CORRESPONDENCE
Correspondence is available in a binder for review. Vickie mentioned in the correspondence was
a letter to IOT, a training center, suspending their Modesto campus. The Redding campus is still
open. There is also a letter to Happy Camp, regarding an investigation and the requirements set
up for them to become compliant.
P. S-SV EMS AGENCY ACTIVITIES
Noted.
Q. NEXT JPA GOVERNING BOARD MEETING
The next JPA Governing Board of Directors meeting is on Friday, November 14, 2014, 1pm-3pm,
at the Rocklin office.
R.
ADJOURNMENT
The meeting adjourned at 1:58 p.m.
Respectfully submitted,
Amy Boryczko, Clerk to the Board
Date
Leonard Moty, Chairman
Date
JPA Governing Board of Directors Meeting Minutes of September 12, 2014
Page 9 of 9
K
EMCC/County Committee Reports