The URL can be used to link to this page

Home My WebLink AboutMINUTES - 09232014 - D.12RECOMMENDATION(S): 1. ACCEPT an update on the Emergency Medical Services Agency Request for Proposals process, and 2. RECEIVE a presentation from the Contra Costa County Executive Fire Chief's Association on Advanced and Basic Life Support services. FISCAL IMPACT: No fiscal impact. This is an informational item only. BACKGROUND: On August 5, 2014, the Board of Supervisors directed County staff to coordinate a presentation by the Contra Costa County Executive Fire Chief's Association to the Board for a future meeting date regarding the provision Emergency Medical Services (EMS). This request was made following a presentation regarding the timeline and content of the upcoming EMS ambulance transport request for proposals (RFP) process, which is scheduled to begin in early 2015. Fire Chief Paige Meyer, San Ramon Valley Fire Protection District and Dr. Peter Benson, an Emergency Medicine APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 09/23/2014 APPROVED AS RECOMMENDED OTHER Clerks Notes:See Addendum VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Candace Andersen, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor ABSENT:Federal D. Glover, District V Supervisor Contact: Timothy Ewell, 925-335-1036 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: September 23, 2014 David Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: D.12 To:Board of Supervisors From:David Twa, County Administrator Date:September 23, 2014 Contra Costa County Subject:EMS AGENCY AMBULANCE REQUEST FOR PROPOSALS UPDATE - FIRE EXECUTIVES PRESENTATION BACKGROUND: (CONT'D) Physician at the John Muir Medical Center - Walnut Creek campus will provide the Board with a presentation on Basic Life Support (BLS) and Advanced Life Support (ALS) operations as it relates to first responders and patient outcomes. In addition, the County Administrator has requested former EMS Agency Director Art Lathrop to assist with the development and coordination of the EMS Agency ambulance transport RFP effective August 21, 2014. This is primarily in response to the significant impacts on current EMS Agency staff from the potential closure of Doctors Hospital in West Contra Costa County. On August 7, 2014, Doctors Hospital discontinued accepting patients via ambulance transport, requiring immediate and ongoing coordination efforts with other local area hospitals by EMS Agency staff. The addition of Mr. Lathrop to the EMS ambulance transport RFP coordination team will provide continued stability to that process and allow current agency staff the needed flexibility to respond to the developing situation with Doctors Hospital. Mr. Lathrop will be in attendance at todays meeting for an introduction to the Board. CONSEQUENCE OF NEGATIVE ACTION: This agenda item is informational only. CHILDREN'S IMPACT STATEMENT: No impact. CLERK'S ADDENDUM Speakers: Dr. Joseph Barger, Contra Costa Emergency Medical Services. ACCEPTED report and presentation; and REQUESTED County Administrator to engage with the Fire Executives, EMS and appropriate parties to seek better communication between all involved parties on delivery of services. ATTACHMENTS CCC Executive Fire Chiefs Association - PowerPoint Presentation Optimizing EMS in Contra Optimizing EMS in Contra Costa CountyCosta County Fire Chief Paige Fire Chief Paige Meyer Meyer Contra Contra Costa Costa County Executive County Executive Fire Fire Chiefs Association, Chiefs Association, PresidentPresident and and Doctor Peter BensonDoctor Peter Benson Medical Doctor, Masters of Public Health, American Board of Medical Doctor, Masters of Public Health, American Board of Emergency Medicine/Emergency Medical ServiceEmergency Medicine/Emergency Medical Service A Fire-based approach 1 The Reasons Behind Early Advanced Life The Reasons Behind Early Advanced Life Support (ALS) vs. Basic Life Support (BLS)Support (ALS) vs. Basic Life Support (BLS) ••Saving Saving LivesLives ••Relieving Pain & SufferingRelieving Pain & Suffering ••Emotional Impact to Family MembersEmotional Impact to Family Members ••Science supports Science supports EARLYEARLY ALSALS ••Industry Standard National Fire Protection Association Industry Standard National Fire Protection Association (NFPA) (NFPA) 1710: Early 1710: Early ALSALS The Fire-based approach 2 Fire Based first response times standards:Fire Based first response times standards: ••National Fire Protection Association (NFPA) 1710 (National Fire Protection Association (NFPA) 1710 (2010 32010 3rdrd EdEd)) ••1 minute turnout and 4 minutes travel 1 minute turnout and 4 minutes travel (on scene in 5 minutes)(on scene in 5 minutes) ••1 minute turnout and 7 minutes travel for ALS 1 minute turnout and 7 minutes travel for ALS ((onlyonly if first unit is if first unit is already on scene)already on scene) Fire Based EMS supports rapid response to time Fire Based EMS supports rapid response to time sensitive ALS Emergenciessensitive ALS Emergencies Actual severity of patient’s condition possible only Actual severity of patient’s condition possible only when ALS on scenewhen ALS on scene Early Advanced Life Support 3 ••Chest Pain/Heart Attack Chest Pain/Heart Attack (7%) (7%) ••Cardiac Cardiac Arrest Arrest (2%) (2%) ••Stroke Symptoms Stroke Symptoms (10%)(10%) ••Severe Allergic Reaction (Anaphylaxis) Severe Allergic Reaction (Anaphylaxis) (0.8%)(0.8%) ••Respiratory Respiratory Distress Distress (10%)(10%) ••Diabetic Diabetic Emergency Emergency (2%)(2%) ••Seizure Seizure (2.5%)(2.5%) ••Combative/violent patient Combative/violent patient (0.5%)(0.5%) ••Severe Pain/Vomiting Severe Pain/Vomiting (10(10--15%)15%) The above calls total The above calls total at least at least 40% 40% of all EMS responsesof all EMS responses Must have systemMust have system--wide availability to provide wide availability to provide earlyearly ALS to all of ALS to all of thesethese calls when they occur, calls when they occur, whereverwherever they occurthey occur Early Advanced Life Support 4 Effects of an EARLY Advanced Life Support System How could patients and their How could patients and their families be affected by proposed families be affected by proposed changes changes from an early ALS from an early ALS system system to a delayed ALS system?to a delayed ALS system? 5 Effects of Proposed Changes How could fire agency providers be affected by How could fire agency providers be affected by proposed changes to ALS system?proposed changes to ALS system? ••Engine companies out of service for extended Engine companies out of service for extended time period time period ••Strips ALS personnel from fire first responder Strips ALS personnel from fire first responder ••Reduces firefighting capabilityReduces firefighting capability ••Delays readiness for next EMS responseDelays readiness for next EMS response Ultimately reduces fire first responder resourcesUltimately reduces fire first responder resources 6 FireFire--based EMS approach:based EMS approach: The standard is to get the patient The standard is to get the patient the the right right treatment and to the right treatment and to the right destination, in time for the best patient destination, in time for the best patient outcome outcome County fire agencies have historically been the County fire agencies have historically been the catalyst for innovation and positive changecatalyst for innovation and positive change Solutions 7 County EMS County EMS andand Fire Agencies Support Fire Agencies Support PatientPatient--Centric EMSCentric EMS ••Respect community choice for Respect community choice for level of EMS level of EMS serviceservice ••Never sacrifice patient Never sacrifice patient safetysafety ••Rigorous Rigorous multidisciplinary performance/QI multidisciplinary performance/QI monitoringmonitoring ••Reinvest in dispatch, data systems, Reinvest in dispatch, data systems, technology, and EMS Health Care technology, and EMS Health Care PartnershipsPartnerships ••Public education/prevention Public education/prevention Solutions 8 ••ALS first response (early ALS) is the foundation ALS first response (early ALS) is the foundation of a high performance 911 EMS systemof a high performance 911 EMS system ••The reduced morbidity and mortality resulting The reduced morbidity and mortality resulting from early ALS is supported by the current from early ALS is supported by the current medical literaturemedical literature ••All citizens of the county, rural or urban deserve All citizens of the county, rural or urban deserve access to early ALSaccess to early ALS ••22--4% of calls involve critical time sensitive ALS 4% of calls involve critical time sensitive ALS interventions with 3,400 potential lives saved interventions with 3,400 potential lives saved annually annually SummarySummary 9 QUESTIONSQUESTIONS?? Advanced EMS Advanced EMS vs.vs. Basic EMSBasic EMS 10