HomeMy WebLinkAbout1998-09-22 Municipal Operations Committee MinutesMunicipal Operations Committee
Meeting Miames
Septemba M, 1998
Councilors Attending: Jim Tyler, Michael Aube, Nchi Farnham
Staff Attending: Edward Barrett, Jeff Cammack, Erik Stmnpfel
Others Attending: Rick Petrie, Dr. Bob Anthony
I
Ed Barnett explained that the purpose of the policy is to provide some guidelines for the provision of
ambulance service "a Fire Department. The policy tries to place priority on emergency response
services. It amhodza charg isfor mvddamce services, peanuts inter -facility, transport to the extent that
the service can be provided with erJating equipment and men power and without jeopardizing the basic
response mission for emergencies. It also outlines the City's goals and interests in providing such a
service under section 3.0. The policy attempts to outline service parameters. First, three primary
service ambulances would be operated, one at each station, plus a backup unit Second, it would
provide paramedic level service and continue to upgrade to that leve. Emergency medical dispatch
would be provided to home that the dispatchers are trained and certified. The Department would also
maintain the appropriate certification to comply with all the laws, rules and regulations that govern the
service.
In section 42, it is recognised that individuals and institutions within the community would retain the
right to use their provider of choice for ether emergency or transport services. Section 5 deals
specificahywhhuma->holdytmnder services, and indicates Ne service will be provided upon request
or if men tramsfem originate within the area covered by our existing mutual aid egeemmts and to the
City Nursing facility. It is specifically indicated that we will not provide what's termed "critical care
transfer services'.
The last section authorizes negotiating nurtual aid agreements with public and private sector entities,
to negotiation of other agreements related to joint services or cooperative ventures in areas such as
dispatch and communication, purchasing, training, claims and billing medical direction and data
collection and reporting. It specifically indicates that the Department is authorized, upon request, to
provide stand-by ambulance service at Bangor School Department athletic events and other special
events wither the City and specifically points out that nothing in the policy would supersede or interfere
with our ability or requirements to respond under mutual aid agreements.
OVERSIGHT COMMITTEE: Ties Cormurtee would be set up under the Council's special
Committee provision for a We year term to we how it works. The purpose of this Committee would
be to oversee and evaluate the emergency medical system in the community, to review and comment
on protocols used by providers to coordiume the system, to undertake quality assurance reviews to
inmre that standards for responsas and quality of me are maintained, and to make recommendations
in providers on changes to improve timeliness and quality of the service or any other recommendations
that they feel might be appropriate. The composition of the group is two representatives of the City
Council, the Chief his designate from the Bangor Fee Department, the Emergency Service Directors
Of due two hospitals (INMC and St Joseph's) or their designee, a representative from Eastem Maine
HealthcmHMeridian, and up to three other members selected by the Committee represmbng
institutions or orgam'vations that regularly use ambulance services or who are trained in emergency
medical services.
Once these orders are passed, the Wert step would be to start working on the mutual aid agreement
with Capital Ambulance and Wen dealing with some of the other cooperative issues that have been
discussed previously.
COMMENTS
Rick Pelle (Dmmar Capital Ambulance): lick indicated that they have received a copy of the draft
and indicated wmems about the way the document is written in that it allows the Bangor Fre
Department not only to compete d'vudy agame Capital within the City, but also to go outside the City
ofBangor and compete with Capital in the areas of inter-facility and emergency transport. Ingestion
4.2, it states that "...mewga'vzs individuals and institutions in the community." wlOcis appears to
indicate the community ofBangor, but than goes on to state... `inter-fncility transports would only be
limited to those communities where the City has mutual aid agreements." Mr. Parma commemhd that
mwrgecyrmyomeappe wbeansidethefi n appticadmofd Bmgor Fhe Department They
are not licensed to respond outside ofthe City ofBaugor unless called by a mutual aid agency. The
statement in the policy that `.-the primary goal of the Fire Department is to merchant appropriate
response to the amergency response in the City of Bangor.."there have been instances where Bangor
Fire called Capital to ask them if they bad an ambulanceto respond to their fire call because all
Bangor s ambulances were out on transports.
Councilor Aube commented that his reading of the principals that were agreed upon by the Committee
ache Cound indicated that the principals need to be part of this record because at soothe meeting,
he specifically asked whether or not the draft of the policy would be a departure from what had been
previously agreed upon. The answer was no. fie asked that question because of the statement on page
62, which was agreed upon by both Committees. "...both parties would specifically mougoize and
ogee that individuals and institutions in the mmmnunity would retain the right to use their provider of
choice regardless of the service involved." Mr. Petrie answered that the key words are "in the
community. Then wmcen b that Bangor Firs could go to any surrounding wmamnities and would
be competing with Capital an musing home transports, do Coundor Aubeaskediftheissue isoce
of choice by the institution, not one of marketing by the Fire Department. Mike asked if this is a
departure from them principles. Mr.Panne noted that he deals there is a departure because of Bangor
Fite responding outside the City of Bangor. It was his understanding the community is described as
the boundaries of the City of Bargor. Councilor Aube didn't recall defining community in this manner,
but defined it in a broader comm of the community that the hospitals serve, the mnmunities than we
currently serve with respect to mutual aid agreements and institutions that utilize facilities within the
Cityboundaries. Comcdor Aube feels the departure is that individuals and institutions will have a
choice Individuals will have a choice if they five in Bangor and institutions will have a choice only if
they are in Bangor. No one else would have a choice, there would be no alternative. Mr. Petrie
answered yes.
Dr. Bob Anthony, (St. Joseph's Hospital): Commented that St. Joseph's has always stood for the
maximarm choice possible both for individuals and institutions both in emergency health services and
b caremgeneal. Tothegremenm=dWisposiblgtNsshouldbeput thepokg. Dr.Anthmry
comrmentedfist mMay orlum ofdus year, the Governor amomced the hmma system for the more
state and that it was based on input from a number of hospitals, and emergency medical providers
across the Haze. To Mve an individual, service activation or a municipality dividing up responsibilities
or contacts, is a detrimental step. Dr. Anthony feels there will be a lot of demand for critical care
in the future. To limit this demand to one service or another is a loss for We patient.
Rick Petrie: hick commented that they do not have a problem with individuals outside the City of
Bangor. Currently, Bangor Eve does not respond to emergencies outside the City of Bangor unless
theyarecalledbyamutualaidwrmact As fuss trayskvs go, ifan individual wants a transfer outside
the City of Burger, they believe in the individual's choice. The concern is Danger Fire marketing thew
sery ass to all the institutions in the mea.
Councilor Aube asked, as an example, if Brewer Rehab world be prohibited from using Bangor
Fire? Rick communed that they would hope that Bangor Fire wouldn't go notable the City.
Capital believes that ifthe institution is outside ofthe City ofEangm, they could not use Bangor
Fire.
Councilor Tyler asked who the City currently has mutual aid agreements with? Chief Cammack
answered Brewer, eddington, Holder, Hermon, Hampden, Glenburn, Carmel, Old Town, Orono,
and Veazie. Jim asked Swe wrrently have 3 working ambulances? EA answered yes and clarified
that ffwe are doing standby service, people will be brought in to staff that unit. Rick Petrie asked if
Bangor Fre were using the fourth ambulance during the day? Cluef answered that sometimes
during the day, if there us 4 or 5 transports scheduled, a am will be brought in to staff it. Rick
asked if this agreement would prohibit Nat? Chid answered nes as he can see it It will still be
provided to surrounding communities and institutions. Rick thought that this should be clm5ed m
the policy because the way he reads it is thin fourth ambulance world be put one service only due
to repair or vehicle maintenance.
Councilor Tyler asked ifthere is an analysis tool in EMs that would indicate how many calls will
likely come oten a cannot time? lie would like to be comfortable with the mother of ambulances
needed. Ed Barnett cormnemed that what should be considered is deal a certain percentage ofthe
time, you can get an ambulance to someone who has called for an atergmey within 4-5 mhmtea
There is also the capability with the First Responder program to get to people with an engine
company if the ambulance cant get to them within 4 or 5 rWrmar. Councilor Aube asked ffthere
was any indication from a national association or another source that Provides that there should be
x"rumba ofarnbWancex Chief Cammack explained that Nae is a system that private compances
use by trying to predict where, when and what time the calls are going to come in. NBke asked if
given the Citys mmmal aid agreemem, how comfortable are we with what we have in tams of
ambulances (3+ 1). Chid Cammack currently feels comfortable with this amber. It is difficult to
predict if in the fume more ambulances will be needed.
Councilor Tyler asked form explanation about the 9-1-laccess. Cldd Cammackerplained Natit
has happened where an individual calls on 9-1-1 and requests Capital Ambulance. At that time,
they are put on hold and Bangor Fire calls Capital and tells them where the call is and have them
respond. Chid would not Eke to open the 9-1-1 centerm Capital. Rick Pirie commended that
they put ther emergency number out primanly to outlying communities so that they can call
directly to Capital, however, they have always Pushed 9-1-1 as the number to call. If the issue of
choice comes up, tbey would need to look m all the calls then come or Councilor Aube asked how
a patient who calls considers a choice? what is the medical protocol associated with a person
having a heart anaW Dr. Anthony answered that the protocol is a need oftinnsity and this is
why there is 9-1-1.
Councilor Tyle asked with respect to the issues raised show the City's license are there any liability
sues then might be raised? Chid answered that they are usually firmly related. For example, a
brother of an employee ofBangor Fire would call Bangor Fire to respond. Mon of the cases
where Bangor Fire has gone on an emergency call outside of City Emits has been situations that
were either en error or a unique situation. Ed will an down with Mr. Petrie and go through these
instances. Erik Stumpfel congregated that Ice was unclear if the Chyli license is au lacrized for this or
mt. There is a liability issue if you are in violation.
Sithe Committee wishes, these items can be put forward for Council consideration As discussions
with Capital and EMII continue, the issues that have been brought up can be ironed out. If the
Committee does not want to continue ar this point, gaff can go back and look at the plan again.
Rick Petrie commented that they would like to move forward on this issue. Councilor Aube stated
that he did not feel that the Committee could recommend this policy for approval, but that It could
be tabled and the Council could discuss it at Monday rights meeting. He would like to achieve
fundamental policy and than look toward the other opporuuuties talked about (training, combining
dispatch, etc.) Recommendation is to put item 91 on the Council Agenda for Mondaps meeting
without mwmrvendation from the Committee.
2. proposed Amb .lanc+ mMrnent
Comments with respect to the Committee structure:
I)r. Anthorry pointed out that with a Committee such as this, it may be helpful to have an outside
agency on the Committee.
Outside Agencies will be contacted to see ifthey, are interested in participating in this policy.
3. MMA Mail Ballet for 1999 Slate ofofgcers
This is the annual ballot for the slate of officers for MMA Councilor Aube has been nominated
fora3-yearterm on the ememove committee ofthe Maine Mmucipal Association. Thiswouldtake
care ofthe slate of oficem. Recommendation to full Council to approve slate of offrcems and cast
the City's ballot.
Also, one individual as a voting delegate to the MMA conference and a second individual as an
alternate voting delegate needs to be decided upon. Recommendation is that Councilor Aube be
designated as the voting delegate and a Baarett be designated as the alternate. Approved.
4. Ordinance Arnending Section 134 27 I
ARsistance
This is the annual update required. The adjustmerrts are minor and primarily deal with food and
housing assistance. Approved.