PSA Minutes 09/18/2013September 18, 2013
�W*ES OF THE MEETING OF T-IIF COLLIER COUNTY PUBLIC
'p,3\ ���5 SAFETY AUTHORITY MEETING
10 C`ER� Q� GO C Naples, Florida, September 18, 2013
LET IT BE REMEMBERED, the Public Safety Authority in and for the County of Collier,
having conducted business herein, met on this date at 10:00 A.M. in REGULAR SESSION
at Collier County Growth Management Division Building, Conference Room #609/610,
2800 N. Horseshoe Drive Naples, Florida with the following members present:
Vice Chairman: Janet H. Vasey, Citizen Representative
Joseph Bernard, Hospital Administrator
Chief Walter Koplca, Collier County EMS Chief
David Mennini, EMT, Collier County EMS
Mr. Justin Gibson, Paramedic, Outside Collier County EMS
Bobby Allen, Paramedic, Collier County EMS
Dr. Robert B. Tober, Collier County Medical Director
Dr. Matt Everett, Active ER Physician
Chief James S. Bloom, Collier County Sheriffs Office
Chief Michael D. Murphy, Collier County Fire Chief s Assoc.
Jose Santana, EMT, Outside Collier County EMS
(Vacancy)
Excused: Dr. Jeffrey A. Panozzo, Medical Director - COPCN Holder
Dr. Todd Bethel, Active ER Physician
Captain Robert Montagano, Naples Police Department
Reg A. Buxton, Citizen Representative
Phillip C. Dutcher, Hospital Administrator
ALSO PRESENT: Maria Franco, Administrative Assistant, EMS
Colleen Greene, Assistant County Attorney
COLLIER COUNTY
PUBLIC SAFETY AUTHORITY (PSA)
AGENDA
September 18, 2013 — Wednesday
10:00 am
Growth Management Division - Planning and Regulation
2800 North Horseshoe Drive
Conf Room 609/610
1. CALL TO ORDER AND PLEDGE OF ALLEGIANCE
2. AGENDA AND MINUTES
a. Approval of Today's Agenda
b. Approval of Minutes from the July 17th PSA Meetings
3. OLD BUSINESS
a.
4. NEW BUSINESS
a. PSA Injury Prevention
b. Office of the Medical Director: Develop a schedule for the review of an organizational
structure reflective of Item 10H (5/14/13 BCC Meeting).
c. Investigation regarding medical protocols: Review and gather information regarding the
following matters:
i. Whether the County's Medical Director in January 2013 released updated
protocols as final without allow for review and whether such protocols
contained life threatening standards;
ii. Whether EMS under the direction of the County's Medical Director is following
the adopted stroke protocols
1. the degree to which such protocols are being followed
2. the numbers of patients being transported to which hospitals and under
what circumstances
3. whether any protocols have been implements or decisions made
regarding stroke protocols based upon market share to any specific
hospital
5. STAFF REPORTS
6. PUBLIC COMMENT
a. NNFD short presentation
7. BOARD MEMBER DISCUSSION
8. ESTABLISH NEXT MEETING DATE
a. November 13, 2013
9. ADJOURNMENT
September 18, 2013
Any persons in need of the verbatim record of the meeting may request a copy of the video recording
from the Collier County Communications and Customer Relations Department or view online.
1. Call to Order and Pledge of Allegiance
Ms. Vasey called the meeting to order at 10:00am.
A quorum was established.
The Pledge of Allegiance was recited
Wayne Watson — CCEMS, Yaneisy Camps - CCEMS, Richard Juda - MD, Jorge Aguilera — NNFD,
Michael Marcus - Trauma Program Manager Lee Memorial Health System, Paula Dignopli - NCH
Safe and Healthy Children, Scott Wernert - CCEMS, Jim Burke - NNFD, Jeff Page — ENFD, Tony
Camps — CCEMS and Ron Myer — Citizen were also present.
2. Agenda and Minutes
a. Approval of Today's Agenda
Dr. Tober moved to approve the Agenda subject to the following additions:
Item 3.a — PSA Logo
Item 3b — PSA Ordinance Amendments and Member Composition.
Second by Mr. Mennini. Carried unanimously 10 — 0.
b. Approval of Minutes from the July 17, 2013 PSA Meetings
Chief Kopka moved to approve the minutes of the July 17, 2013 meeting subject to the following
change:
Page 1, Joseph Bernard from "Citizen Representative" to "Hospital Administrator"
Second by Dr. Tober. Carried unanimously 10 — 0.
3. Old Business
a. PSA Logo
Chief Kopka reported two draft logos have been developed for the PSA.
The Authority reviewed the proposed logos.
Chief Murphy moved to approve the "Circle Style" logo subject to revising Collier County
Sheriffs Department shield to "Law Enforcement" and incorporating the "Citizen
Representative shield." Second by Mr. Allen. Carried unanimously 10 — 0.
Chief Kopka reported he would make the necessary amendments and provide the proposed logo to
the Authority for review at the next meeting.
Dr. Everett arrived at 10: 07am
b. PSA Ordinance Amendments and Member Composition.
Ms. Vasey reported it has been previously brought to the attention of the Authority, certain
members of the Committee need to communicate during the course of daily business (i.e. the
Medical Director and the EMS Chief). Some of these matters may create an unintended violation
of the Sunshine Law.
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September 18, 2013
Discussion occurred on the feasibility of making the EMS Chief the Authority liaison, allowing the
Medical Director to sit on the Medical Director Subcommittee, but not on the PSA. Additionally, if
the EMS Chief s is removed from the Authority, should the similar position held by the Collier
County Fire Chief be removed to ensure the Authority is "balanced," etc?
Colleen Greene provided an update noting Staff is still reviewing the issues, however, a sitting
member on a Subcommittee must also be a member of the full committee.
It was noted the positions in question provide valuable input to the Authority and losing the
representation of those seats may be a disservice to the public.
Discussion occurred on the feasibility of having administrative personnel for these Agencies
assume the seat(s), however this may pose potential Sunshine Law violations as well.
The Authority requested the County Attorney's Office to prepare an amended Ordinance as
deemed necessary to address the concerns and incorporate the community education and
funding goals into it.
Dr. Tober moved to continue the item until the next meeting. Second by Chief Murphy. Carried
unanimously 11— 0.
4. New Business
a. PSA Injury Prevention
Ms. Vasey provided an update on the PSA intent to develop a public education program to address
injury prevention and other health/safety related issues. It was noted there are other organizations
in the community with similar programs such as the Injury Prevention Coalition (IPC).
Discussion occurred on the most effective means to achieve the goal including partnering with
existing groups, developing a Grant program, etc.
It was noted, for the first year, while the program's logistics are being developed, it may be prudent
to indentify existing opportunities available such as previously produced public service
announcements /publications. These items could be recycled for distribution and /or broadcast.
Sneaker
Jorge Aguilera, North Naples Fire Control and Rescue District reported he is the Chairman of
the IPC and would welcome partnership with the PSA. Their program currently is funded via "in
kind" donations.
Chief Murphy moved to remand the item to the Community Education and Awareness Working
Group including coordinating with the County Attorney's Office any changes necessary to the
PSA Ordinance to meet the goals of a program. Second by Chief Kopka. Carried unanimously
11-0.
The Authority appointed Chief Walter Kopka as Chairman of the Community Education and
Awareness Working Group.
September 18, 2013
b. Office of the Medical Director: Develop a schedule for the review of an organizational
structure reflective of Item 10H (5/14/13 BCC Meeting).
The Authority reported it would be beneficial to have a formal presentation on the item by Jorge
Aguilera of the North Naples Fire Control and Rescue District at the next meeting on the subject.
Chief Murphy moved to continue the item until the next meeting. Second by Dr. Tober. Carried
unanimously 11— 0.
c. Investigation regarding medical protocols: Review and gather information regarding the
following matters:
L Whether the County's Medical Director in January 2013 released updated protocols as
final without allow for review and whether such protocols contained life threatening
standards;
Protocol Changes
Chief Kopka reported:
1. The proposed changes in protocols were submitted to the Medical Director and PSA in
November of 2012.
2. All interested parties had ample time to review the proposed changes and provide
comments, with no comments being received.
3. The changes were disseminated to the necessary parties in January of 2013.
4. The protocol changes became effective on February 1, 2013.
Chief Kopka moved for the Authority to find the protocols were implemented based on the
facts identified above. Second by Dr. Tober. Carried unanimously 11— 0.
Pediatric Breathing Protocol
Dr. Tober provided an overview on the pediatric breathing protocol and the rationale for the
change to an age specific ventilation rate noting the previous protocol achieved the same goal of
treatment in a different manner. A peer review determined that protocols in place were not life
threatening.
Ms. Vasey moved for the Authority to find that changes to the protocols are provided on a
continual basis. The hospital community broughtforth the issue on pediatric ventilation
rates to the PSA Medical Directors Subcommittee meeting on 4117113 and changes were
implemented on 5120113. At no time did EMS have a protocol that would have resulted in
the death of a child. Second by Chief Kopka. Carried unanimously]] — 0.
ii. Whether EMS under the direction of the County's Medical Director is following the
adopted stroke protocols
• the degree to which such protocols are being followed
• the numbers of patients being transported to which hospitals and under what
circumstances
• whether any protocols have been implements or decisions made regarding stroke
protocols based upon market share to any specific hospital
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September 18, 2013
Ms. Vasey reported the item was brought forth to address previous allegations by Physicians
Regional Healthcare System regarding Collier County stroke protocols and their
implementation.
Chief Murphy moved to forward the letter to the Board of County Commissioners from C.
Scott Campbell, Market Chief Executive Officer for Physicians Regional Healthcare System
to Leo Ochs, County Manager dated September 17, 2013 — Re: EMS Stroke Protocols which
indicates representatives of PRHS and Collier County EMS met and have determined the
current system of protocols is functioning adequately. Second by Mr. Gibson.
Ms. Vasey expressed concern the motion does not reflect the system was functioning properly
at the time the issues were raised with proper protocols in place and implemented.
Committee discussion occurred on the confusion over the timing on the implementation of the
protocols.
Dr. Tober reported the protocols were implemented on February 1, 2013 and administered
appropriately. There was a logistics delay of 90 days (until April 1, 2013), for the medical
records software provider to integrate the information electronically into the system. "Paper"
versions of the protocol were made available to the necessary parties when the protocols
became effective.
Motion failed S "yes" and 6 "no." Chief Kopka, Ms. Vasey, Mr. Allen, Mr. Mennini, Dr.
Tober, Chief Bloom voted "no."
Dr. Tober moved for the following:
1. The EMS, to the best of their knowledge believes all protocols adopted were implemented
appropriately.
2. The number of patients transported to the respective hospital stroke systems was
consistent with the new protocols.
3. No protocols were implemented or decisions made to protect the market share of Naples
Community Hospital.
4. To forward the letter from Scott Campbell dated September 17, 2013 to the Board of
County Commissioners indicating all misunderstandings regarding the stroke protocol
initiation have been resolved.
S. To forward the statistical data on transports to the Board of County Commissioners.
6. That valid issues were raised and addressed by the necessary parties.
Second by Ms. Vasey. Motion carried 7 "yes" and 4 "no." Chief Murphy, Mr. Santana, Mr.
Bernard and Mr. Gibson voted "no."
5. Staff Reports
None
6. Public Comment
a. NNFD short presentation
Speaker
September 18, 2013
Jorge Aguilera, North Naples Fire Control and Rescue District provided an update on recent
North Naples EMS Council activities including review of protocols, addressing in field drug
shortage issues, reviewing communications systems, etc. He noted the Injury Prevention Coalition
will hold its first public event, a Free Health Fair, on September 21, 2013 at 9:00am at Physicians
Regional Hospital, Pine Ridge.
Sneaker
Ron Myer addressed the Authority noting he is a candidate to fill the Citizen Representative
vacancy. He provided a copy of his bio for information purposes and requested an update on when
the item may be considered by the Authority.
Ms. Vasey reported the Authority had previously determined, for logistics purposes, it would be
prudent to postpone any decision until any amendments to the Ordinance and membership are
completed.
Authority discussion occurred noting given the vacancy is for the Citizen Representative, any
amendments to the membership composition will most likely not affect these seats.
Chief Murphy moved to place an item on the next Agenda for recommendation of appointments
to fill the Citizen Representative vacancy on the Authority. Second by Chief Bloom. Carried
unanimously 11— 0.
Colleen Greene requested the Staff liaison contact the BCC Office to determine if all
requirements have been met for advertising the vacancy on the Authority before consideration of
the item.
7. Board Member Discussion
Medical Protocols Review
Chief Murphy moved to request the North Naples EMS Council conduct a review of all County
medical protocols and submit the results to the Medical Directors Subcommittee for review.
Colleen Greene reported she would have to research the concept of requesting an outside party to
complete a task that may be the responsibility of the Authority.
Without a second the motion was not considered.
7. Establish Next Meeting Date
a. October 30, 2013
There being no further business for the good of the County, the meeting was adjourned by
order of the chair at 11:45A.M.
September 18, 2013
Collier County Public Safety Authority
Vie e hairman, Janet Vasey
These minutes ap roved by the Board /Committee on
as presented or as amended
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