EMSA DISPATCH - March 2010
By Dr. Steve Tharratt, EMSA Director
Over the past year, our EMS service providers and participants have made significant progress toward improving the EMS system statewide. Many of those efforts are ongoing and I foresee that our collective accomplishments will make a difference for people every day. But our goal, as always, is continuous improvement. With that in mind, we are now looking ahead to anticipate how EMS will change nationwide and statewide over the next decade or so, and how we can best ensure we are positioned to use these changes to benefit the people of California.
I’m asking my staff and our partners to take a broad look at some of the basic components of our system and identify where they can be made better and where we can make the most improvement. Although we are in continuous and fruitful communication on a variety of issues with our broad range of partners at all times, I would like to encourage everyone to consider these questions and send us your thoughts.
How do we train the EMS professional of the future? I want to take a critical look at the way we develop and deliver EMS education in California and ask the hard questions about whether we are keeping up with cutting edge educational techniques, curriculum and standards. Nationally, EMS training standards are increasing and EMS education is becoming more complex. While California EMT students have above average pass rates on the National Registry of Emergency Medical Technicians’ (NREMT) examinations, there are always opportunities for improvement. Educational standards are expected to increase with the new National EMS Education Standards released in 2009. How we meet these standards, especially in rural areas, will be important.
How do we leverage the state/local partnership in the next era to best support local EMS agencies? Particularly in an era of limited resources, we have an imperative to evaluate how we can best maintain or improve our existing EMS delivery model.
We must continue to explore how regionalization complements our existing systems and determine how to share regional resources, particularly for time sensitive conditions such as trauma, STEMI and stroke. EMSA is dedicated to preserving the continuity of EMS care for the regions and we are aggressively pursuing options to redirect federal funds to the regions.
Although this is the final year of the current administration, and we all continue to labor with an unprecedented lack of resources, we can expect forward progress and support for our work nonetheless. At EMSA, we are energized and ready to dive into the challenges ahead. I hope you will be beside us, as always, as we work together to tackle the ongoing process of improving emergency medical service and disaster medical service to the people of California.
New members are Bruce Barton of Riverside County EMS, Eric Rudnick of NorCal EMS, and Dave Teter of Cal Fire. Former Commissioner Chuck Baucom of Merced County EMS will now hold a seat as a public member. In addition, current commissioners Sheldon Gilbert, Dave Herfindahl, Colleen Kuhn, Matt Powers, Chris Van Gorder, and Lew Stone have all been reappointed to continue serving in their representative capacities.
We are also saying farewell to outgoing Commission Chair Bruce Lee who has served with distinction. The Governor's announcement, which includes a bio of each new or reappointed commissioner, is online at http://gov.ca.gov/press-release/14295/. The staff of the Emergency Medical Services Authority looks forward to working with the new and returning commissioners to improve emergency medical services on behalf of the people of California.
EMSA Schedules EMS Stakeholder Workshop
Please mark your calendars and plan to attend “.201 Today & Tomorrow: A Workshop on EMS System Coordination” Tuesday, May 4, 2010 from 8:30 a.m. to 5 p.m. at the Radisson Hotel, 500 Leisure Lane in Sacramento. The workshop will provide an opportunity for a variety of EMS stakeholder groups to discuss possible impacts of Health and Safety Code Division 2.5, Section 1797.201 in EMS system design and administration. For more information, contact Tom McGinnis, Transportation Coordinator, at (916) 322-4336, Ext. 424 or email@example.com.
Invitation to Comment on EMSA Guidance Documents
The Emergency Medical Services (EMS) Authority is proposing to amend EMSA Document #141- Review Criteria and Policy for Transportation and Exclusive Operating Area Component of the EMS Plan Guideline. EMSA has the statutory responsibility to review and approve local EMS plans, which includes EMS transportation. This involves approving exclusive operating areas. EMSA#141: Competitive Process for Creating Exclusive Operating Areas guideline dated 1987, provided information related only to requirements for ambulance zone exclusivity established by competitive process. The document is now being expanded to include greater detailed information about EMSA’s longstanding review process for all transportation-related elements of a local agency’s EMS plan. The revision is in response to requests for a clear written guide to EMSA’s evaluation process. The public comment period has been extended through September 1, 2010. The draft guideline and instructions for commenting can be viewed on the EMSA website at www.emsa.ca.gov/about/Public_Comment.asp.
In addition,EMSA is proposing revisions to the Prehospital EMS Aircraft Guideline. The draft guideline and instructions for commenting can be viewed on the EMSA website at www.emsa.ca.gov/about/Public_Comment.asp. The public is invited to submit written comments on the proposed changes by 5 p.m. on March 12, 2010. For more information, contact Tom McGinnis, Transportation Coordinator, at (916) 322-4336, Ext. 424 or firstname.lastname@example.org.
CFED.West Conference Registration Open
The California Fire Chiefs Association CFED.West Conference and Expo 2010 is scheduled for May 10-14 at the Palm Springs Convention Center. CFED.West is an "all risk" responder symposium developed by and for emergency response providers in EMS/Emergency Medicine, Fire Service, Law Enforcement, Disaster Management/Preparedness, Public Health, and Homeland Security wishing to stay on top of the most current industrial information concerning their individual field of practice. EMSA is leading the Disaster Management/Preparedness track for the conference. In addition, CFED has graciously invited EMSA staff to present a two-day pre-conference training on EMT 2010 implementation May 10 and 11. For details or to register, visit www.cfedwest.com/index.cfm?section=1.
CEMSIS-Trauma Data Report Released
EMSA has released its first report resulting from this new system to collect data on EMS and trauma activities throughout the state. The data collected from local EMS Agencies is linked with other statewide data systems, including hospital emergency department and discharge data from the Office of Statewide Health Planning and Development, Statewide Integrated Traffic Records System, and Vital Statistics. The first report incorporates information provided from Alameda, Contra Costa, Los Angeles, Orange, Santa Barbara, Santa Clara, San Diego counties and Northern California EMS Agency. The report is available at www.emsa.ca.gov/systems/CEMSIS/files/TraumaDataReport1.pdf
EMS Award Nominations: EMSA is now accepting nominations for the EMS Awards for activities during the 2009 calendar year. The EMS Awards are intended to honor and recognize noteworthy or exceptional acts and service while working as EMS certified or licensed personnel, administrators, trainers, or volunteers within the EMS systems. For complete information about award categories, past recipients, and to obtain nomination forms, please visit the EMSA website at www.emsa.ca.gov/about/awards/default.asp.
National Poison Prevention Week is March 14-20, 2010.
Approximately two million cases of poisoning occur nationwide each year, with more than 330,000 of those incidents occurring in California. More than half of them involve children under five years old. In many cases, parents don’t know how best to react when their child eats or drinks something they shouldn’t. That’s why the highly trained men and women of the California Poison Control System are standing by 24-hours a day to answer questions and help parents determine whether their child needs immediate medical care or not. When it comes to poison prevention and treatment, “Don’t guess. Be sure.” Poison Prevention Week reminds all Californians to make their homes safer by making dangerous substances inaccessible to children and to call 1-800-222-1222, the 24 hour, toll-free number for advice and information in case of exposure.
EMS Week: Dates for National EMS Week 2010 are May 16 thru May 22 with May 19 set aside as Emergency Medical Services for Children (EMSC) Day. Make sure your public knows the important role EMS responders play in the health and well being of the community. Get more information and request resources for EMS Week on the American College of Emergency Physicians website.
Grant Opportunity: Sierra Health Foundation is continuing its Responsive Grants in 2010. Applications for first round funding are due by March 22. This year, grants up to $25,000 each will support projects that improve health and quality of life. Of the $1 million available this year, at least 30 percent will be available exclusively for projects serving rural areas of Sierra Health Foundation's funding region. The remaining funds will be available for projects serving urban areas or urban/rural areas. There will be two funding rounds in 2010, with $500,000 awarded in May and $500,000 awarded in October. Get details at www.sierrahealth.org/doc.aspx?129.
CPHD Conference: The 8th UCLA Conference on Public Health and Disasters (Revisited) will take place May 16-19 in Torrance. It is a multidisciplinary conference of academicians, researchers, practitioners, and policy-makers from public health, mental health, community disaster preparedness and response, social sciences, government, media, and non-governmental organizations. CPHD is offering BRN, MICN, Paramedic/EMT and CHES credits. The conference offers keynote addresses by Linda C. Degutis, DrPH, MSN, Associate Professor, Emergency Medicine and Public Health, Yale University and AndreaYoung, PhD, Associate Director of the Learning Office, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention. Sessions will be offered on Haiti Earthquake, Pan Flu, Hospitals as Victims of Natural Hazards, Infection Control in Mass Shelters, and Hospitals and Community Clinics as Partners in Disaster Response. Visit www.cphd.ucla.edu for information and to register.
EMSA Employment Opportunities: EMSA is recruiting to fill several critical positions and we are looking for the best and brightest, most committed individuals to join our team. Applicants must meet state eligibility requirements. If you would like to become eligible for a state position as a Health Program Specialist I, apply for our open examination. Details on open positions and the HPS-I open examination are available at www.emsa.ca.gov/jobs/default.asp.
- Health Program Manager I, Personnel Standards Unit, EMS Personnel Division
- Health Program Manager I, Plans and Training Unit, Disaster Medical Services Division
- Special Investigator (non-peace officer), Enforcement Unit
- Supervising Special Investigator I (non-peace officer), Enforcement Unit
- Technical Help Desk, Information Services, Staff Information Systems Analyst
The EMS Authority is working diligently to prepare for July implementation of AB 2917, known as EMT 2010, which requires creation of a statewide EMT certification process and procedures, development of a centralized database, and criminal background checks on all EMTs.
Currently, we are focusing much of our attention on the technology component of developing the Central Registry. We estimate that there are 60,000 EMTs certified by 69 different certifying entities. The data for those EMTs is maintained on a wide variety of systems that include systems based on paper, word processing, spreadsheets, Microsoft Access, Microsoft SQL Server, and others. The EMT 2010 software will replace the software currently used to manage the certification of EMTs and will allow certifying entities to issue renewal notices, deficiency notices, reports, temporary certificates and final certificates. With the participation of our partners, we are testing the web-enabled system. By the end of February, all certifying entities will have provided EMSA with initial certification data to be uploaded into the Central Registry.
We are also moving forward with our rollout plan, which will enable us to hit the ground running on the implementation date. We have scheduled a series of two-day training workshops throughout the state to provide a thorough introduction to the new process.
Los Angeles – April 13-14
San Francisco – April 21-22
Sacramento – April 26-27
Palm Springs – May 10-11 (CFED West Conference)
In addition, we will offer a series of “webinars” for certifying entities in April and May. Further information for the workshops and webinars will be available soon on the EMSA website. For more information, contact Sean Trask, EMT 2010 Program Manager, at email@example.com or call (916) 322-4336.
Because the investigations component of the EMT 2010 changes will be new to most certifying entities, EMSA recommends that those persons conducting investigations complete the following courses in order to assist you with investigations:
- Council on Licensure, Enforcement and Regulations (CLEAR)
The program takes the investigator through every step in the investigative process: from planning the investigation to writing the report. Clear offers a Basic and Specialized training and certification program.
- Regulatory Investigative Techniques
Regulatory Investigative Techniques is a 40-hour course designed to provide training in the basic principles, methods, and techniques used while conducting a regulatory investigation. Emphasis will be on the practical application of the participant’s ability to plan, organize and conduct an investigation in a professional manner. Subject areas that will be covered: Role of the investigator, source of information, other civil and criminal remedies, subpoenas and warrants, the administrative hearing process, planning your investigation, legal aspects of investigation, giving testimony and expert witness, investigative note-taking and report writing.
- Interview & Interrogation
Interview course are available around the State. Most of these courses will cover the areas of: human behavior, body language, detecting deception and cognitive interviewing.
- Courtroom Testimony/Administrative Hearings
This is a separate course or can be obtained covered by CLEAR training or the Regulatory Investigative Techniques course.
- Public Records Act
Learn the statutory and case law requirements in the dissemination of public records to protect your agency. It will also allow you to know what records are available for an investigator to obtain.
Countdown to Narrowbanding Deadline!
In December 2004, the Federal Communications Commission (FCC) mandated “narrowbanding of frequencies below 512 MHz” (megahertz = a unit of bandwidth in the overall range of bandwidth). Very high frequency (VHF) range includes the Hospital Emergency Administrative Radio (HEAR) frequency and ultra high frequencies (UHF) range that includes the MedNet frequencies. This mandate will require all EMS participants (at a minimum includes EMS provider agencies, emergency departments, and city/county administration) to move to narrowband voice channels and highly efficient data channel operations by January 1, 2013.
The purpose of narrowbanding is to relieve congestion by creating new, narrower frequencies. Using narrowband channels will ensure that agencies take advantage of more efficient technology and, by reducing channel width, will allow additional channels to exist within the same spectrum space.
Every EMS participant is potentially affected by narrowbanding and must comply with its provisions by January 1, 2013. Because the narrowbanding rules may require the replacement of portable and mobile radios, as well as hospital and other radio consoles and other infrastructure, the need to plan and budget for these changes in the budgetary cycles of most affected agencies and the municipalities that support EMS means starting now. If you have an EMS frequency radio, this means you! This does not affect 700 and 800 MHz systems.
Key Points about FCC Narrowbanding Requirements
- Most current EMS and public safety radio systems use 25 kHz-wide channels.
- The FCC has mandated that all non-Federal frequency licensees using 25 kHz radio systems migrate to narrowband 12.5 kHz channels by January 1, 2013.
- Agencies that do not meet the deadline face the loss of communication capabilities.
- Agencies need to start planning now to migrate to narrowband systems by assessing their current radio equipment and applying for new or modified licenses.
To phase in the migration deadline of January 1, 2013, the FCC has established interim deadlines. The first important deadline is January 1, 2011, after which:
- The FCC will not grant applications for new voice operations or applications to expand the authorized contour of existing stations that use 25 kHz channels. Only narrowband authorizations will be granted.
- The FCC will prohibit manufacture or importation of new equipment that operates on 25 kHz channels. This will reduce the availability of new equipment for legacy radio systems and will affect how agencies maintain and upgrade older systems.
Planning for the Move to Narrowband
Verify that your agency or facility has a current and valid FCC Part 90 radio station license. Your service tech should be able to help you with this and, if necessary to contact your FCC certified frequency coordinator (the list of them, and they vary by type of EMS or public safety agency, is at http://www.fcc.gov/pshs/public-safety-spectrum/coord.html).
Assess current equipment and start planning. To prepare for the migration, EMS participants should start assessing their radio systems and planning for replacements or upgrades. Along with their service tech, they should inventory current equipment to ascertain what can be converted and what will need to be replaced before January 1, 2013. Most new equipment has the capability for both 25 kHz and 12.5 kHz operation because any VHF/UHF radio equipment accepted by the FCC after February 14, 1997, had to have 12.5 kHz capability. Local governments should develop contingency plans to accommodate system changes for both public safety and nonpublic safety systems.
Obtain new or modified licenses. To move to narrowband operations, agencies must apply for new frequencies or modify existing licenses. An agency that is licensed for a 25 kHz-wide channel is not guaranteed two 12.5 kHz channels. Licensees will have to justify to the FCC why they need additional channels. Consideration of applications for new narrowband licenses will follow the same process as a new license application. As agencies migrate to narrowband operation, however, the pool of available frequencies will increase.
Budget figures for services and equipment. Establish the necessary budget figures to cover the services and equipment required for narrowband transition, including all licensing fees. Make sure that the budget cycle supports complete transition and re-licensing before January 1, 2013. Again, given the long and difficult budgeting processes that most of us have, this process needs to have started yesterday --- wait no longer!
The following are some additional resources that may be of help to you as you address the FCC narrowbanding mandate:
- International Association of Fire Chiefs (IAFC)
- FCC “refarming” history (with jpegs)
- FCC's "narrowbanding" mandate
(2008 6.25 KHz Migration Clarification)
- Yahoo Forum – this is an on-going forum on NB
- Understanding Narrowbanding
- General Questions – Tonya Thomas, Communications Coordinator, State EMS Authority, (916) 322-4336, ext. 441.
With excerpts from: “Guide to Emergency Medical Services Information Communications Technology (ICT) Systems for EMS Officials” and FCC Website- Reproduced with the permission of the publisher. All rights reserved.
The Department of Motor Vehicles has issued a specialty license plate to honor and recognize healthcare professionals who work in the emergency setting.
In order for this program to go forward, we must collect 7,500 pre-paid applications. We have been granted an extension on the time limit to collect applications, but time is still of the essence.
Declare your pride in the important work you do and help recognize the EMS field... order your EMS plates today! Apply TODAY...