Notes – NYS DOH BEMS&TS 7/14/22 Briefing for EMS Agency Leadership and Providers

   
  Feel free to print and post these notes at your agency or pass them on to others you think would be interested.
Jim Downey
Editor, PULSE Newsletter
Coeditor, BLANKET newsletter
NYS Volunteer Ambulance & Rescue Association
www.nysvara.org______theblanket@nysvara.org
NYS DOH Bureau of EMS & Trauma Services
Briefing for EMS Agency Leadership and Providers
Thursday 7/14/22, 4:00 PM to 4:47 PM
Unofficial Notes
This is not an official verbatim transcript of the call. There was no prepared agenda distributed before the call. During the call outline notes of what was said were taken by a NYS Volunteer Ambulance & Rescue Association (NYSVARA) representative and the outline notes were filled in after the call trying to reflect what the presenters actually said and/or make reading easier. Links to forms or documents mentioned were added and are highlighted.
Questions can be submitted before the next call at: https://apps.health.ny.gov/pubpal/builder/survey/nys-covid-19-response-ems-agency or during the call through the chat box.
Notes from prior briefing calls plus other information is on the NYSVARA website under the Library tab and then select News Archives.
BEMS&TS Panelists
Peter Brodie, Deputy Chief, Informatics Branch (Host)
peter.brodie@health.ny.gov
Ryan Greenberg, Director, Bureau of EMS and Trauma Systems
ryan.greenberg@health.ny.gov
Steven Dziura, Deputy Director, Bureau of EMS and Trauma Services
steven.dziura@health.ny.gov
Jean Taylor, Deputy Chief, Education Branch
jean.taylor@health.ny.gov
Matthew Wiley, Manager, Emergency Preparedness and Response
matthew.wiley@health.ny.gov
Richard Robinson, Deputy Chief, Metropolitan Region, New Rochelle
richard.robinson@health.ny.gov
Brian Wiedman, District Chief/Investigator, Western Region, Buffalo
brian.wiedman@health.ny.gov
Jacob DeMay, Clinical Support Specialist, Informatics Branch
jacob.demay@health.ny.gov
Mark Philippy, Chairperson, State Emergency Medical Services Council (SEMSCO)
mark.philippy@mlrems.org


BRIAN WIEDMAN
• Edward Mager, Deputy Chief will be back from vacation after 7/21/22.
• Working on investigations, catching up from the last 12 to 18 months.
• Working on renewals that we are getting monthly.
• Starting to schedule some full agency inspections.
• Out doing some Part 18 inspections and some spot inspections of hospitals.
• We are trying to get back out there and be a little more visible.


JEAN TAYLOR
• Not much new in Education.
• We are working on updating some of the regulations pertaining to Education. There are no major changes, don’t anybody panic.
• QUESTION: Does a CLI need to be affiliated with a transporting agency or can the CLI be part of any agency that is a basic non-transporting agency to stay on-line as a CLI? ANSWER: Any agency.
• QUESTION: Do EMT students still have 1 year to retake the written exam if they failed on their 1st attempt? ANSWER: It is not from their 1st attempt. They are allowed 3 attempts within 1 year from the original end date of their class. Its not when they 1st took the exam. If their class ended on 6/20/22 they have until 6/20/23 to take all 3 attempts. After that they are no longer eligible and would have to take a refresher course.
• QUESTION: Have the new basic EMT practical exams been approved and has a course start date been set to start using this new exam. ANSWER: No and no. Ryan Greenberg added that it will be talked about at the Training and Education meeting. The program has been developed and we’re bringing it to Training and Education to get their feedback and discussion.


MATTHEW WILEY
• Lots of stuff going on with us.
• Still working on demobilizing some of the equipment we had from COVID.
• Conducted some after action items with the Department.
• Still working on plans and things like that for the next time we need to pull them out.
• Getting ready for some bigger events throughout the summer – State Fair – and a couple big events next year as well. Just working on planning and preparedness but nothing specific to report.
RICHARD ROBINSON (report was e-mailed to Peter Brodie to read)
• MARO (Metropolitan Area Regional Office) staff is out doing full service inspections.
• Brian Sherwood, District Chief/Investigator is retiring. Any Long Island EMS agencies can reach out to richard.robinson@health.ny.gov or (212) 417-5960.


PETER BRODIE
• Alex Mold(?) from the CDC Foundation will be working with Data & Informatics Branch on the Overdose Data to Action grant and doing some outreach to local health departments and working with BIOSPATIAL. He is currently receiving training and orientation in the Data & Informatics team and how everything flows and works.
• Partnering with 2 paramedic programs (SUNY Cobleskill and Dutchess Community College) and 2 basic EMT course sponsors (Dutchess Community College and Mid-State EMS). Preparing an ePCR training module as part of their education component so you learn how to document and understand more about NEMSIS as a student before you come out in the field so it is not an entirely new concept. Some other course sponsors are interested. All the work will be done on the ImageTrend platform as provided on the state Elite site.
• Working on some other projects that were put aside for 12 to 18 months while we were in the response mode for the pandemic.
• QUESTION: Does PCR need to be completed if there is no response from your agency? Call is handled by mutual aid agency or call is cancelled and no trucks from our agency responded. ANSWER: A cancelled call where personnel responded is helpful to your agency but its not required. For further clarification look at Policy Statement 12-02 Prehospital Care Reports (PCRs) on the BEMS&TS web site.


MARK PHILIPPY
• State EMS Council meetings will be held next week in person, Tuesday and Wednesday, 7/19/22 and 7/20/22, at the Hilton Garden Inn, Troy, NY.
• There have been issues with scheduling the meetings next week.
• Agenda will be out shortly if not already.
• There is a lot of committee work going on.
• Sustainability TAG is chaired by Michael Benenati, LaGrange Fire District. White Paper from group is expected next week.
• Training & Education Committee is chaired by Michael McEvoy.
• Systems Committee chaired by Mark Deavers and is looking at Article 30 and the Governor’s Part F recommendations and how to operationalize those. Also, looking at physician fly cars and how that is going to be operationalized through the state and regions.
• Legislative Committee is chaired by Al Lewis.
• Finance Committee chaired Steven Kroll has some initial results from the new Workforce Survey that went out.
• Safety Committee is chaired by Steven Cady has been working on some programs for some time.
• Will be reporting on Part 800 regulatory changes.


RYAN GREENBERG
• There are over 100 participants on this call.
• Feedback and the Q&As are important in giving us insights.
• State EMS Council (SEMSCO) and committee meetings will be held next week. All the committees will meet on Tuesday and SEMSCO on Wednesday. State Emergency Medical Advisory Committee (SEMAC) and its Medical Standards Subcommittee will not hold meetings.
• There are a number of different projects going on in BEMS&TS.
• Mental Health Project has hired a person. First class was taught this week in NYC. It’s an 8 hour continuing ed class and will also be held on-line. It is a free class and will be held around the state.
• On paramedic side there have been conversations about National Registry (NREMT) issuance on accreditation standards and what that means. In NYS almost all paramedic programs are accredited and the last 1 or 2 are working towards it. It is an important progression in EMS, the profession and education standards and we are looking at different aspects, what it means for NYS and have gotten a number of questions. It does not change anything. NREMT has not changed requirements for accreditation yet. We are working with SEMSCO and other state EMS directors to evaluate what that would mean and provide our feedback. Accreditation, education and degrees play a role in this. There are benefits that accreditation offers. This will be talked about at next week’s Training & Education Committee meeting.
• Sustainability TAG is working on wrapping up and write their document. Many angles are being looked at. Trying to put what the future of EMS will look like into a single document and see what the feedback will be from around the state.
• QUESTION: The state legislature just passed and the Governor signed into law legislation that prohibits purchase and possession of body armor by persons other than law enforcement officers. Although there is some provision for the Department of State to delineate other permitted possessors neither EMS nor fire service personnel are specified in the new law. What is the BEMS&TS doing to ensure EMS providers do not lose access to this important protection? ANSWER: It is something we have been keeping our eye on. There is a provision in there to determine what other areas would be permitted to buy protective gear such as body armor. We have made that point across on our channels and will be watching to make sure EMS is able to purchase those things. They are aware of it and I don’t believe that will be an issue. We will continue to monitor it. Mark Philippy advised that he was informed yesterday there was a change made to specify EMS providers and the mechanism requires that the provider have a letter from their agency and the purchase must be made in-person. [ED NOTE: Eligible professions was updated 7/6/22 to include: 29-2042 EMTs and Paramedics, 53-3011 Ambulance Drivers and Attendants and 33-2011 Firefighters. Go to https://dos.ny.gov/body-armor]
• There is a Project Specialist fellowship position open that closes tomorrow (7/15/22). This fellowship position with BEMS&TS will assist in reviewing, drafting and tracking proposed policy and regulation to improve and innovate New York State EMS in the future. The position is with Health Research Incorporated and will last for year to year and a half. Other openings will be coming.
• QUESTION: Is there an update on the pilot project on the supraglottic airway? ANSWER: We will have an update at the State EMS Council.
• QUESTION: Are AHA CPR cards extended past their expiration dates due to COVID? Does an EMT card trump a CPR card in cases of members who received both extensions but do not have a current CPR card? Have received conflicting information from other agency leaders. ANSWER: I do not believe AHA extended any of their cards and no, a state EMT card is separate from a CPR card, one does not apply to the other. John MacMillan confirmed the answer.
• QUESTION: When may we expect to see prior Vital Signs Academy CME courses on the website that may be taken for credit by those who missed the original presentation? ANSWER: It is a matter of trying to get additional support in order to convert those classes. I don’t have an answer at this time.
• QUESTION: Will SEMSCO and the committee meetings be webcast. Will the link be sent out or found on the DOH meetings page? ANSWER: We are working on that now. We plan on having it out there but now we are trying to see if we can get that. They will be broadcast but will not be 2 way. The committees will be broadcast and the Council will be broadcast as it normally is. [NOTE: This information was changed later in the evening advising only the Council meeting will be broadcast.]
• QUESTION: Status of Executive Orders – what mandates are still in effect and what has lapsed and is no longer in effect or permitted? ANSWER: Currently all of the Executive Orders related to staffing and everything else under Executive Order #4 is still in place. Steven Dziura added that the 2 Executive Orders in play that effect EMS are Executive Order #4 and Executive Order #11. #11 expires either today or tomorrow – keep an eye open on whether it is continued. Normally it is decided by Governor several hours ahead. All provisions that were in place last August remain in place as of this month. Ryan Greenberg added that all the Executive Orders expire every 30 days and get renewed.
• QUESTION: Any specifics on what Part 30 changes you are trying to implement? ANSWER: On Article 30 there is not much right now in discussion. Working on Part 800 2 different components that SEMSCO has asked for and working with Division of Legal Affairs (DLA) by the end of the summer for regulatory updates for education and equipment.
• QUESTION: Any update with a Policy Statement developed in addressing training timeframe for the last certification extension? ANSWER: That has actually just cleared the approval process. It will be up most likely in the early part of next week. There are actually several Policy

Statement that will be going up that went through:
CME Recertification policy
Extension of Certifications for Military Personnel policy
Paramedic Practical Skills Exam policy
Required CPR Education for EMS Providers policy
• QUESTION: It was mentioned in the past that providers would be able to create their own Health Commerce System (HCS) accounts, agencies and Course Sponsors would approve them and then providers would download their own certifications. Do you know when that will begin to be implemented? ANSWER: Yes. Instructions got one built upon another – how an agency can get on HCS, how to assign the HCS Coordinator and how to assign personnel to it and the 3rd step on how a provider can sign up for the HCS. Those instructions are completed and will be sent to a select few agencies to make sure those instructions are easy to understand and there is no other feedback before we put them up on our website. Program Agencies will also get the instructions for feedback. If no problems in next 2 weeks we will work on getting them up on our website. It is live and functional right now but each step needed another layer of instructions. Digital cards are in the very near future. Agencies that would like to try it and provide feedback through their Regional Program Agencies can e-mail Ryan Greenberg.
• QUESTION: Can you confirm that EMTs and paramedics working in hospitals will expire at same time as they are linked to expanded Scope/Executive Orders? ANSWER: Correct. When Executive Order(s) expire those EMS providers would return to their original Scope of Practice. This includes those in non-traditional work settings who would turn around and go back.
STEVEN DZIURA
• QUESTION: In the wake of the latest mass shootings in Buffalo and Uvalde, Texas is BEMS&TS imposing any new or expanded requirements for Part 18 permit applications. If so, could there be a general publication of exactly what those would be? With the summer event season upon us there will be many of these applications being filed and it would be important to know now about those changes. ANSWER: In June 2021 when all the restrictions were finally lifted we had during spare time developed our evaluation of Part 18 plans and permit applications to include a review of special event emergency operations plans, security plans, crowd management plans, sufficient resources and an assessment of the local health care capacity in the area. The question of having additional requirements in light of the events going on – having active shooter plans and IED and those type of plans have always been required and are definitely being more scrutinized now over the past year and a half. BEMS&TS has done several hundred Part 18s early this year. Each takes staff about 4 hours to complete from start to finish on average so it’s a pretty in-depth review and a lot of back and forth with the promoters. We have also been making visits at many events making sure that the plans and procedures that were submitted to us are being followed. There is a lot more now being looked at now than was previously
• COVID is still around. The 5 variant is making a presence throughout the United States. We are starting to see an increase in bed cases and hospital capacity throughout NYS. During this downtime we are reviewing plans for the fall assuming that at some point this fall we will have another surge either over the fall or winter. Departments are encouraged to do the same and take a look at their current policies and procedures and see what worked and what didn’t. Check PPE inventories. Make sure you have enough staff.
• Emergence of Monkeypox has definitely made itself known in NYS. As of today NYS has 414 confirmed cases of Monkeypox, 389 of those are in the NYC area with 25 in the rest of the state. Nationwide we have just hit 1,000 cases which is up from 50 about a month ago. There is a need to be aware of Monkeypox, its presentations, symptoms and how it is treated. We are working with the Bureau of Communicable Diseases on guidance that should be out early next week once it is formalized. In the meantime, go to the CDC website and visit the healthcare provider section on Monkeypox which includes pictures on what the rash looks like and some examples on how it has been presenting. The Department’s Bureau of Clinical Disease web page covers a Town Hall meeting with the Commissioner and local health departments a few days ago which provided a lot of information on Monkeypox, the state’s position, the federal position and what everybody should expect. More information will be out next week to clarify some additional issues. Ryan Greenberg added that on 7/1/22 there were 83 cases in NYC and today we have 389. Know how to transport a patient with Monkeypox so your providers stay safe.
• On 7/3/22 we launched the updated notification method for hospital diversions. The link is https://nydiverts.juvare.com and is open to the public. It covers hospital EDs that are reporting to BEMS&TS. If a dash (-) is shown under ED Status the hospital in not currently reporting to DOH. NYC hospitals are reporting their status to the FDNY EMS Diversion Desk. Eventually all hospitals across the state will be mandated to report their status to the DOH. There are filters built in such as county, ED Status, etc. and enhancements are expected.
• Over the next several weeks we will transition away from the generic listserve e-mails we have been sending out on diversion notifications to regions in a more targeted way such as only a specific region or a contiguous region.
• QUESTION: Can the Diversion website be sent to the Program Agencies to send out to agencies? ANSWER: All diversion notifications go out to every Program Agency. Ryan Greenberg added that not everybody is live on that Diversion site. Regions that are on it should know about it. We’re looking at what the next region is likely to go on to the board and move forward. We don’t want providers to default to that at the moment thinking all diversions are on it when they’re not. Steven Dziura emphasized that if a hospital status is showing Normal or On Divert the hospital is reporting to DOH. If status is showing a dash (-) it is not reporting to DOH. NYC hospitals report to the FDNY EMS Diversion Desk.
Next briefing call will be in August – date will be announced in the near future.
NYS Volunteer Ambulance & Rescue Association
214 Kent Avenue #278, Endwell, NY 13760
(877) NYS-VARA or (877) 697-8272
The mission of NYSVARA is to educate, represent, promote and advocate for Volunteer and Community Based Emergency Medical Agencies and Responders throughout New York State
To join NYSVARA click HERE. 
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NYS Volunteer Ambulance & Rescue Association 214 Kent Avenue #278, Endwell, NY 13760 (877) NYS-VARA or (877) 697-8272 The mission of NYSVARA is to educate, represent, promote and advocate for Volunteer and Community Based Emergency Medical Agencies and Responders throughout New York State   To join NYSVARA click HERE.