County EMS steering committee minutes and memo

On Thursday, September 27, The News Reporter  ran an article titled “County ignored missed calls” and reported information that was based on county emergency services steering committee minutes, a memo to the board of commissioners and letters written  to squads with missed calls.  The story is part of a series of articles (many yet to be published) related to the county’s oversight of EMS services in the county.

Minutes from the Dec. 7 meeting and Dec. 21 memo both state that in one incident a patient died enroute to the hospital after dispatched squads did not respond and a transport company was called . (The minutes and memo are publish below.) 

In a letter to the editor and an article on EMS fines, published today (Oct. 4), the owner of the transport company states the patient did not die.

The original article noted a number of missed calls in the system. While some squads had no missed calls at all one had more than 60.

Only first-out calls are classified as missed calls meaning if a squad was already on or called to one call a second call does not count against them as a missed call. 

Review of dozens of documents, letters and minutes showed that from May 2006 to August 2007 one squad missed 63 calls while from June 2006 to August 2007 another squad (Buckhead) missed 14 calls.

The story reported every missed call documented including that three other squads (Acme-Delco-Riegelwood, Cerro Gordo and Nakina) had missed one call.  See today’s edition for an editorial on the issue,  letters to the editor, and the commissioners’ response to a request that squads be fined for missed calls.

To access the original Sept. 27 story in full go to archives on The News Reporter home page and click on the September 27 edition.    

EMS Steering Committee Meeting Minutes
December 7, 2006
8:45 A.M.

Dr. Obrecht called the meeting to order.  Jim asked that we have a moment of silence in memory of Pearl Harbor.  Dr. Obrecht then introduced Mike Worley, MEDAC Supervisor, and advised Mr. Worley wished to address a complaint with the committee regarding Lake Waccamaw Fire and Rescue Department.

Mr. Worley told the committee that response to calls from Lake Waccamaw is poor, and advised MEDAC is being called as a last resort. His concern is that MEDAC (a transport company) is now transporting critical patients that should be transported by ambulance.  He also stated people are dying from lack of response from emergency responders. Mr. Worley also stated that Whiteville Rescue is handing out business cards that state they provide non-emergency transport (he provided one for Dr. Obrecht).  His concern is Whiteville Rescue does not have a franchise agreement as required by county ordinance.  After discussion, Dr. Obrecht asked that Steve investigate and advise if a franchise agreement is required.

Dr. Obrecht advised we have been discussing unanswered calls and searching for a solution for a long time without success. The committee has discussed the issue with chiefs when calls are missed and we get various answers from them.  Discussion continued and again the potential for county liability was discussed.  Becky advised she reviewed the missed calls since the last meeting and in one particular incident; there was a 30-40 minute lack of response from rescue squads dispatched.  The nurse on duty personally called MEDAC (transport agency) who responded.  This patient died in route to the hospital.  The committee agreed that a $500.00 penalty per missed/delayed call in county contracts is the only way to get departments to respond appropriately.  After further discussion, it was decided Jim will send a memo to the commissioners recommending such a penalty be included in rescue contracts.

The next topic of discussion was PreMis compliance reports.  Dr. Obrecht advised we need to review PreMis reports at each meeting.  Kay advised she will bring reports to all future meetings.  Connie Batson advised that the new PreMis tool kits are really great.  She will work with Kay to get data to present to the commissioners.

Discussion then moved to the final draft of the System Plan changes.  Kay addressed the issue with orientation of other hospitals.  Ms. Batson advised she has examples she will e-mail to Kay.  Becky advised Sections I and II are complete.  Everything just needs to be put together and tabbed.  It is just a time issue.

Ms. Batson then told the committee she is responsible for 7 counties and education liaison for 38 counties. She gave an overview of the state Certification Inventory System (CIS).  She advised the system has been on a server for several years and is now moving to an internet web based service.  This will enable others to access the site online.  Under this system, there will be a data base for Columbus County EMS that can be accessed to see if EMS personnel are credentialed or under investigation by her agency.  She advised there are still bugs in the system, but their goal is to have this site up and running by March 2007.  What she needs from us is a contact person, or system administrator, who will keep our information updated.  She stressed there is so much personnel data on this site; if the administrator shares their password with someone else they will be terminated.  Ms. Batson advised she will send a letter to departments asking for information the administrator will need.  She also advised all credentialed personnel keep the same PreMis id number even when they change providers.

Dr. Obrecht then thanked Kay for her performance during the tornado disaster.  Jim also thanked Dr. Obrecht for his assistance.  The committee then decided that they need at least two commissioners present at these meetings so they will understand what is going on with emergency medical services. 

With no further discussion, the meeting adjourned at 10:15 A.M. 

EMS Steering Committee Minutes 120706.mydocuments

M E M O R A N D U M

• This is a very serious memo containing confidential information which needs resolution as soon as possible.

MEMO TO:   Sammie Jacobs, Chairman
                        Columbus County Commissioners
                        Kay Worley, Deputy EMS Director
                        Steve Fowler, County Attorney
                       
FROM:           Jim Varner, County Manager
           
DATE:            December 21, 2006

SUBJECT:     Missed/Delayed Calls

For more than a year, the EMS Steering Committee has been meeting routinely to discuss and implement changes to better serve the citizens of this county. As noted in all minutes you have received, a serious issue with missed/delayed calls has been a primary focus for the committee.  The committee has worked with departments involved to resolve this situation, but as of today, it is still a very serious issue with several departments in the county. 

Last month a patient expired during transport after waiting approximately 30-40 minutes for medical attention.  A nurse had to personally contact a transport agency after several county departments had been dispatched and never responded to this serious call. The county does not need to be held responsible for a non-response such as this. 

Due to the seriousness of such, along with potential liability for Columbus County, the committee recommends financial penalties be included in county contracts with rescue departments.  The committee is hereby recommending a penalty of $500.00 be assessed for every missed/delayed call a department has.  The committee feels such a penalty will reduce the amount of missed/delayed calls tremendously, thereby reducing county liability.

Please contact me to discuss this most important issue at your earliest convenience.

Thank you.

/gee