Loading...
HomeMy WebLinkAboutMinutes Council 060892nnr_r_ rCAT r . EMERGENCY MEDICAL '5ERV=S UP O�ITY: a U% CITY COUNCIL WORKSHOP MEETING CITY OF PALM BEACH GARDENS JUNE 81 1992 The Workshop Meeting of the City Council of the City of Palm Beach Gardens, Florida, was called to order by Mayor Martino at 7:30 P.M., in the Assembly Room of the Municipal Complex, 10500 North Military Trail, Palm Beach Gardens, Florida. Present were Mayor Martino, Vice Mayor Russo, Councilman Aldred, and Councilwoman Monroe. Vice Mayor Russo arrived at 7:40 p.m. Councilman Kiselewski was not in attendance as he was out of town. Mayor Martino stated the purpose of the workshop was to have an educational session on the Emergency Medical Services Program in Palm Beach County. The Mayor introduced Ms. Linda Rasmussen, Emergency Medical Services Specialist with the Palm Beach County Department of Public Safety; and Ms. Heather Edwards of Inter - City Emergency Medical Services. The Mayor noted Councilwoman Monroe had asked for the meeting. Councilwoman Monroe requested Ms. Rasmussen give an explanation of the relationship between Emergency Medical Services and private ambulance companies, and which organizations are legally required to respond to emergency calls. Mr. Orr clarified that the first - response memorandum he distributed pertained only to sick calls being handled by Inter- CITY COUNCIL WORKSHOP MEETING - JUNE 8, 1992 Page 2 City with all other agencies responding to accident -type calls. Ms. Rasmussen stated the major laws regarding emergency medical services (EMS) overall are Federal and State. She said State Statutes 401 and 10(D)66 are the statute and rules governing emergency medical services in the State of Florida. She gave a detailed explanation of how Palm Beach County's EMS ordinance is a miniature version of the State law but also has additional rules and regulations. She explained the State requires an emergency service within a county to have a certificate of necessity to operate within the County in which it will be doing business. She stated the office of Emergency Medical Services issues all certificates for operation of emergency services in Palm Beach County and regulates and inspects ambulance, paramedic, and fire - rescue services. She explained Palm Beach County has a two - tiered system which means the Fire Departments for the most part provide the advance life support, and the ambulances are considered a secondary responder to the emergency and are only required to be BLS (basic life support) permitted. She further explained a paramedic unit requires only two people, an EMT (emergency medical technician) and a paramedic. Ms. Rasmussen had additional comments as follows: In Palm Beach County there is a Trauma Transport Ordinance which requires an ALS (advance life support) truck to have three people on board. In Palm Beach Gardens there is a private primary provider under contract to provide ALS because the Fire Department does not CITY COUNCIL WORKSHOP MEETING - JUNE 8, 1992 Page 3 perform this function. She explained the County's ordinance requires Palm Beach County to assure there is basic life support ambulance service available to all citizens in Palm Beach County regardless of where they are. The provision of advance life support is believed to be between the councils or commissions and the citizens. Thus, there is no interference in the contract between Palm Beach Gardens and Inter -City because it is a private matter. Emergency Medical Services' role is to monitor the services being provided by the private ambulance service to ensure they are in accordance with State statute and County ordinance. Ms. Rasmussen continued with the following statements: Palm Beach Gardens is contracted with Inter -City to provide advance life support response. Inter -City is the transport agency for Zone 2 of which Palm Beach Gardens is a part. Inter -City is required by ordinance and their certificate to respond to 95 per cent of all emergency calls within the boundaries of Zone 2 on a monthly basis, and she is responsible for ascertaining that all criteria required by statute and ordinance are met. In the event all the Inter -City trucks are busy and there is a call, a backup agency is usually sent in by the County Dispatch Center (Med Com). The advance life support provider must have another advance life support agency provide backup. She mentioned mutual aid agreements, if desired, are between agencies; and Emergency Medical Services does not require knowledge of such agreements CITY COUNCIL WOR�<SHOP MEETING - JUNE 8, 1992 Page 4 between agencies. Responding to questions from Council regarding response time, Ms. Rasmussen had comments as follows: Emergency Medical Services has no way of knowing when any city receives a 911 call until the call is transferred to Med Com which dispatches the appropriate service. Some municipalities which have the 911 system and need an ambulance will call directly to their ALS agency which has interaction with Med Com, emergency rooms, each other's dispatch centers, etc. In Palm Beach Gardens, as soon as a 911 call is answered and is ascertained to be an emergency, it is transferred to Med Com which takes the information and immediately contacts Inter -City. From the time Med Com receives the call from Palm Beach Gardens, it is being tracked in their system, and this is how response times are determined. The County's ordinance requires the ambulance services and the paramedic agencies meet certain criteria. The fire rescue agencies are required by law to provide their own tracking. If there are complaints to EMS concerning response times, they will perform a statistical analysis using information from the past month to see if they are meeting the requirements of the ordinance. For advanced life support, it is required that the unit be on the scene in seven minutes after receiving the call although this may change when a new ordinance is implemented later this year. For ambulances, the time is ten minutes from receipt of the call with some exceptions. Concerning a method CITY COUNCIL WORKSHOP MEETING - JUNE 8, 1992 Page 5 to confirm the ambulances are actually on the scene at the time they report they arrived, she stated her experience has been other units will let them know of any discrepancies. It is very common and acceptable for ambulances to report they have arrived on the scene when they gain visual contact. Heavy radio traffic can delay a unit in reporting its arrival time for a few minutes. If complaints are received about a particular service or a pattern develops, those services are investigated and watched more closely. However, for the most part, Palm Beach County simply does not have that kind of problem, she stated. Ms. Rasmussen then gave an overview of the various state and local requirements the services must meet in order to become and remain operational within the County. She stated all her records are open to the public and available for copying. In response to a question from Councilwoman Monroe concerning exterior markings on ALS and BLS vehicles, Ms. Rasmussen had the following comments: The law does not allow a BLS vehicle to have any wording or graphics on it to indicate it is a paramedic service if, in fact, it is not. There is a State sticker in the front windshield on the passenger side which indicates whether it is BLS or ALS. It is legal for BLS backup trucks to replace an out -of- service ALS vehicle provided it is logged into their books and the proper paramedic gear and personnel are transferred to the replacement truck. Ms. Heather Edwards further explained how Inter -City has equipment available in the station ready for CITY COUNCIL WORKSHOP MEETING - JUNE 8, 1992 Page 6 transfer to vehicles in order to answer ALS calls. Ms. Rasmussen continued with her comments as follows: Changes are now being proposed in the County's draft ordinance, and the State has issued a legal opinion which, if it later becomes a rule, will greatly affect Palm Beach County. This opinion states in order to put an ALS patient on an ambulance, it must be an ALS permitted ambulance. Councilman Aldred asked if it is a violation of Federal, State, or County rules and regulations for a member of the Palm Beach Gardens Fire Department to disable an ALS vehicle using a stink bomb. Ms. Rasmussen responded it is against the law to interfere with on -duty emergency vehicles or personnel. Councilman Aldred then urged Council to request the City Manager to provide them with the minutes of the Merit Board meeting. Mayor Martino asked for the meeting to remain educational and referred to the structure of the Emergency Medical Services Division. Ms. Rasmussen responded as follows: the Public Safety Department of Palm Beach County has several divisions, one of which is the Emergency Management Division; and Emergency Medical Services is under this division. Palm Beach County Fire Rescue is another entity altogether. All rules which apply to Inter - City also apply to Fire Rescue. Inter -City is a private company and is not a part of Palm Beach County government. Palm Beach County Emergency Medical Services investigates complaints against the emergency agencies as well as Fire Rescue. CITY COUNCIL WORKSHOP MEETING - JUNE 8, 1992 Page 7 Mayor Martino asked for an explanation of the number of personnel required on the vehicles to which Ms. Rasmussen responded three personnel are required on the truck only if it is a trauma transport, otherwise two people are required. On an ALS truck, a paramedic and an EMT are the basic minimum requirement for personnel. One of those is the driver with the paramedic tending the patient. It was noted by Mayor Martino that all Inter -City vehicles are ALS. Mayor Martino asked if the City of Palm Beach Gardens paramedics who are licensed and certified would be allowed to work for Inter -City on their days off. Ms. Rasmussen responded this would be an agency decision, but EMS would have no problem with that. He stated he believes Palm Beach Gardens is receiving service from Inter -City which is superior to that of a public agency. Ms. Edwards addressed the Council concerning the inspection process for Inter- City's vehicles and records by Emergency Medical Services, stating that spot checks are performed unannounced. She stated the results of these inspections are public records. Ms. Rasmussen stated if Council would like to have copies of any of these records they may send her a letter of request. Councilwoman Monroe suggested asking the City Manger to request quarterly reports of Inter- City's inspections. However, Ms. Rasmussen stated it was not unusual for three to four months to pass before she performs an inspection because CITY COUNCIL WORKSHOP MEETING -- JUNE 8, 1992 Page 8 of the number of trucks involved. Ms. Edwards stated the State recently performed unannounced inspections on Inter - City's vehicles, and they were given an excellent rating because they exceeded County and state requirements. Ms. Rasmussen and Ms. Edwards mentioned there are certain areas such as the Acreage within Zone 2 which are very difficult to reach by emergency vehicle which can naturally result in high response times. Ms. Edwards had additional comments as follows: On certain emergency calls they are advised the scene is not secure, meaning it is not safe to enter the area. In such instances, the vehicles stop at a "staging" area to await instructions from the law enforcement agencies. She noted in such cases the emergency vehicles are not always visible to bystanders. Ms. Edwards brought out these additional facts: a backup vehicle is always moved into Palm Beach Gardens as calls are received in order to have an ALS vehicle available should another call be received; last year Inter -City vehicles placed fourth in a national competition, with those placing first and second being from out of state; and Inter -City is a training facility for CPR. Mayor Martino inquired if the "heart monitor" insignia is being placed on the units being upgraded from BLS to ALS. Ms. Edwards responded they will have an identifying sticker in the front window. Further discussion followed concerning various CITY COUNCIL WORKSHOP MEETING - JUNE 8, 1992 Page 9 identifying markings on emergency vehicles. Councilwoman Monroe asked for clarification of "first responder" qualifications, the proposed legislation, and the term first provider. Ms. Rasmussen stated there are no regulations concerning first responders. She further stated the only proposed regulation she is aware of at this point is that cities will have to put in writing who their first responders are, such as police officers, and what equipment they will be carrying. City Manager Orr stated it will also be put into writing that when an ALS unit responds to a sick call, the Fire Department will respond as backup only if called by the ALS unit. Councilwoman Monroe asked if it would be advantageous for the `J Fire Department to respond to a potential drowning to which Ms. Rasmussen and Ms. Edwards responded such a victim is considered a trauma victim and requires special procedures. Councilwoman Monroe asked how the Council could know if they want to stay strictly with Inter -City for all calls or if they have something to gain by having the Fire Department be a first responder. Ms. Rasmussen gave a further explanation of her definition of a first responder and mentioned where classes are taught on the subject. Councilwoman Monroe stated if there were qualified people available who could respond to a call before Inter -City arrives, she would like to have the City Manager provide Council with more information for discussion later. CITY COUNCIL WORKSHOP MEETING - JUNE 8, 1992 Page 10 City Manager Orr stated he would recommend that the Police Department be first responder. Councilman Aldred agreed and stated he would be very uncomfortable having Fire Department personnel at the scene. He stated there were some employees he feels were psychologically immature; and based on the scheduling of the workload, he had no doubt they would be on duty when the call came in. He further stated he believed some employees were incapable of performing satisfactorily. Councilwoman Monroe stated if there is a problem with an employee then it should be handled. Councilman Aldred stated, "If the people who work with the employee Councilwoman Monroe was referring to do not deem it appropriate to clean up the department because of that individual, then I deem them to be just as guilty and immature." Councilman Russo stated it is very rare that Fire Departments are not the first responders. Mr. Orr stated that in some of those cities their Fire Rescue service is part of the Fire Department; however, Palm Beach Gardens does not have a fire rescue service. Ms. Rasmussen stated if Fire Department personnel have EMT training and are EMT licensed, it might be a good idea to look into what Palm Beach Community College teaches as first responder standards. She also suggested setting guidelines for what the Palm Beach Gardens Fire Department does on all medical calls. Mayor Martino stated it would be appropriate to discuss this another time after having the administration refresh the City CITY COUNCIL WORKSHOP MEETING - JUNE 8, 1992 Page 11 Council as to why it chose the direction it is going. He said the administration should suggest any improvements needed in the operation of the Fire Department and be recognized by the union before taking any drastic measures or before Council discusses this further. Mayor Martino further stated the City is not sacrificing any levels of service and perhaps is even giving a better level of service than some of the public agencies. Ms. Edwards stated in previous years Inter -City has had good rapport with the Fire Department, has given lectures, worked with them on in -house training, and encouraged them to accompany them on calls. Mayor Martino asked the City Manager if the City's Newsletter could be used to educate the public in a positive way about the role of Emergency Medical Services in the monitoring of private and public emergency agencies and show how the rules and regulations are enforced the same for both. Mr. Orr responded if the human nature aspects can be resolved, he has no problem with how the City responds. He stated patients will not be sacrificed because of internal problems, and this is why they have taken this particular course of action. Mayor Martino stated he hears nothing but endorsements for the emergency services given to the City. He also stated the City, in general, provides the very best in a creative and conservative way and needs to continue to do this. He stated that some of the suggestions received from persons attending recent Council CITY COUNCIL WORKSHOP MEETING - JUNE 8, 1992 Page 12 meetings perhaps are not valid and should be answered that way. Ms. Edwards suggested Council also look at the legal aspects and ramifications of being the first responder. ADJOURNMENT: There being no further business, the meeting was adjourned at 9:20 p.m. APPROVAL: Mayor Martino, Councilman Aldred 1 l LIs 1i0€ a 96sso Councilwoman Monroe Councilman Kiselewski J c ie Holloman Ad'imfnistrative Secretary