State Board of Emergency Medical, Fire, and Transportation Services

State Board of Emergency Medical, Fire, and Transportation Services
Ohio Department of Public Safety, Division of Emergency Medical Services Ohio Association of Emergency Medical Services Beachwood Embassy Suites June 21, 2019

Twenty-one Member Board Representing:
State Board of Emergency Medical, Fire, & Transportation Services (EMFTS) Twenty-one Member Board Representing: American College of Emergency Physicians Ohio Chapter of American College of Surgeons Ohio Chapter of American Academy of Pediatrics Ohio Hospital Association Ohio Nurse’s Association Ohio Society of Trauma Nurse Leaders Ohio Fire Chiefs’ Association Ohio Instructor/Coordinators’ Society Ohio Association of Professional Firefighters Ohio State Firefighters Association Ohio Association of Emergency Medical Services Ohio Ambulance and Medical Transportation Assn. Ohio Association of Critical Care Transport Ohio EMS Chiefs’ Association Ohio Department of Public Safety *20 nominated by the above-listed organizations & appointed by the Governor; one appointed by the Director of Public Safety.

EMS Regulations Ohio Revised Code (ORC) Ohio Administrative Code (OAC)
– Ohio Administrative Code (OAC) through

ODPS Division of Emergency Medical Services
EMS/Medical Transportation/Trauma Division of EMS is “administrative arm” of the State Board of Emergency Medical, Fire, & Transportation Services EMS Ohio Administrative Codes EMS curriculum Accreditation of EMS training programs Approval of CE sites Scope of practice Provider certifications Medical transportation licensing EMS Executive Director serves as CEO of Board

EMFTS Committees

State Board of Emergency Medical, Fire, & Transportation Services
Committees - Statutory Firefighter & Fire Safety Inspector Training Committee & Subcommittee Trauma Committee Subcommittees/Workgroups Medical Transportation Committee Critical Care Subcommittee

State Board of Emergency Medical, Fire, & Transportation Services
Committees – Non-Statutory Medical Oversight Scope of Practice (Workgroup) Education EMS for Children EMS System Development Homeland Security (Subcommittee) Rural EMS Human Resources (Ad Hoc)

Fire Regulations Ohio Revised Code (ORC) 4765.55
Ohio Administrative Code (OAC) (Firefighter/Fire Safety Inspector) (Instructor) (Professional Standards) (Disciplinary Actions) (Chartered Fire Training Programs) (Definitions/References)

Fire Committees

Firefighter & Fire Safety Inspector Training Committee & Subcommittee
Six Member Committee and Subcommittee Representing: American College of Emergency Physicians Ohio Chapter of American College of Surgeons Ohio Chapter of American Academy of Pediatrics Ohio Hospital Association Ohio Nurse’s Association Ohio Society of Trauma Nurse Leaders Ohio Fire Chiefs’ Association Ohio Instructor/Coordinators’ Society Ohio Association of Professional Firefighters Ohio State Firefighters Association Ohio Association of Emergency Medical Services Ohio Ambulance and Medical Transportation Assn. Ohio Association of Critical Care Transport Ohio EMS Chiefs’ Association Ohio Department of Public Safety

ODPS Division of Emergency Medical Services
Fire Committee Case review/disciplinary recommendations Fire Subcommittee Fire training rules Curriculum Qualifications for certification Course hours Chartering of fire training programs Provider certifications

The Division

EMS Division of EMS is “administrative arm” of the State Board of Emergency Medical, Fire & Transportation Services Fire Executive Director, with Advice & Counsel by FFFSI Training Committee & Subcommittee is the authority

Division Work Distribution
Medical Transportation Licensing Services Ambulances MoICU Air Medical Ambulettes Investigations Compliance Enforcement Certifications Fire EMS RPAB Coordination Business Operations OAC Coordination Records Management Trauma & Research Trauma System Data Systems Education & Testing Education Fire Charters EMS Accredited Programs CE Approved Sites Examination Administration Grants EMS Grants (P1 – P5) Supplemental Grants Tablet Grants EMS-C Other SEOC Operations EMS Star of Life Awards Fire Service Hall of Fame Awards ODPS Training

DEMS Organizational Chart

Certifications

Certifications EMS Emergency Medical Responder (EMR)
Emergency Medical Technician (EMT) Advanced EMT (AEMT) Paramedic EMS Instructor Assistant EMS Instructor EMS Physician Instructor EMS Physician CE Instructor

Certifications FIRE Volunteer Firefighter Firefighter I
Firefighter I & II Hazard Recognition Officer (NEW 1/1/2018) Fire Safety Inspector Fire Instructor Assistant Fire Instructor Live Fire Instructor (NEW 1/1/2018) Fire Safety Inspector Instructor

Certifications & Re-certifications
Fire Firefighter = 39,035 (VFF, FFI, & FFII) Fire Safety Inspector = 9,948 Hazard Recognition Officer = 11 EMS EMR, EMT, Advanced EMT, Paramedic = 41,262 Instructor: EMS = 5310 (1976 EMS Instructor) Fire = 4744 (4456 Fire Instructor) Live Fire Instructor = 2122 Fire Safety Inspector = 138 Dual Certified = 26,960 Total Certifications = 102,570 Total Certificate Holders (Providers) = 53,337

ONLINE CERTIFICATION RENEWAL SYSTEM
May 24, 2016 All initial & renewal fire and EMS certifications Requires valid, distinct address Mobile device compliant Identity Manager Data collection Do not wait until last day to renew certification(s)

Keep contact information current… If any contact information changes such as your mailing address, telephone, or address, please access your record online and make the changes or submit a “Change of Address” form that is available on the EMS website to download, print and fax or mail to EMS. Renewal notices or new certification cards won’t get to you if we don’t have correct information. One Card… 3 Year Cycle…All certifications expire on Birthday…

41,325

EMS Certificates Summary
Includes statewide distributions by county and certificate holder county affiliations.

Highest Total Number of EMS Providers: Franklin, Cuyahoga and Hamilton counties.
Lowest Total Number of EMS Providers: Morgan, Noble and Vinton counties.

Counties with the highest number of primary affiliations: Cuyahoga, Franklin and Hamilton.
Counties with the lowest number of primary affiliations: Carroll (17), Noble (15) and Vinton (20).

Counties with the highest number of primary full-time affiliations: Cuyahoga, Franklin and Hamilton.
Counties with no primary full-time affiliations: Carroll, Noble and Paulding.

Counties with the highest number of primary part-time affiliations: Cuyahoga, Franklin and Montgomery. Counties with no primary part-time affiliations: Carroll, Noble.

Counties with the highest number of primary volunteer affiliations: Mahoning (174, Wayne (187) Wood (206). Counties with the lowest number of primary volunteer affiliations: Gallia (4), Morrow (2), Vinton (4).

Lowest (median) Provider Age: Mercer (38), Montgomery (38) and Wayne (38) counties.
Oldest (median) Provider Age: Belmont (47), Monroe (50), Morgan (49) and Noble (47) counties.

Attrition Survey

Most Common Reasons for Attrition…
Retired Relocated/Working out of State Did not Intend to let Certificate Expire Poor Management/Hostile Work Environment Low Salary/Poor Benefits Unable to Maintain Continuing Education Conflict with non-EMS Employment Working as Nurse/Doctor Family Obligations Disabled

Education

EMS Education 90 Accredited Institutions &
574 Approved CE Training Centers Courses Offered: Emergency Medical Responder Emergency Medical Technician (EMT) Advanced EMT Paramedic EMS Instructor 35 Accredited & 179 Approved CE on-site inspections conducted in 2018

CoAEMSP Accreditation of Paramedic Programs
The Division of EMS continues to assist Ohio paramedic training programs with obtaining national accreditation through the Committee of Accreditation of Education Programs (CoAEMSP) for the EMS Professions. 36 Ohio Accredited Paramedic Training Institutions have CAAHEP Accreditation 2 in process of being Nationally Accredited (Belmont & Univ. of Toledo) with a Letter of Review issued by CoAEMSP—CoAEMSP site visits completed; estimate accreditation in Spring 2019 One program surrendered accreditation effective 6/20/17. One program did not pursue accreditation. CoAEMSP Accreditation of Paramedic Programs

Fire Education 60 Chartered Institutions* Courses Offered: Firefighter (VFF, I, & II) Live Fire Instructor Fire Instructor Fire Safety Inspector Instructor 31 On-site Inspections conducted in 2018 *NEW – City of Cleveland Fire Training Academy - Clinton Twp. Fire Training Center Processed 1194 examination requests, testing 3883 candidates in 2018

Audits

EMS & Fire Certification CE Audits
All certificates are subject to audit at renewal or upon receipt of a complaint 15th of the month, month following renewal Audits are random (no extension) 10% of each certificate type (EMS provider, Firefighter, Fire Safety Inspector, Instructor, etc.) audited [Maximum one certificate per cycle] All certificates renewed while on an extension are audited

EMS & Fire Certification CE Audits
An individual who fails to demonstrate completion of the required continuing education during an audit of one certificate may be audited on all certificates (New – effective June 19, 2019) Certificate holders must maintain CE records for current AND previous certification cycle Keep contact information current Respond to CE audit requests…as failure to respond results in REVOCATION OF CERTIFICATE

Audits Completed—Fire & EMS FIRE AND FIRE INSTRUCTOR
Audits Completed—Fire & EMS 2013(1) 2014(1) 2015 2016 2017 2018 FIRE AND FIRE INSTRUCTOR 108 605 1481 1233 1519 1709 EMS AND EMS INSTRUCTOR 816 565 1171 1558 1610 1628 (1) 2013 and 2014 audit numbers reduced due audit process overhaul

Firefighter Continuing Education
54 hours (except shortened certification periods) Continuing education related to the fire service Approved by the applicant’s fire chief or program director of chartered program Out-of-state & unaffiliated applicant options Routine duties (emergency response, station duties, vehicle maintenance, civic events, etc. – NOT CE 12 hours CE per day maximum Same online course; not more than once per year

Fire Safety Inspector Continuing Education
24 hours (reduced from 30) [HRO = 6 Hours/Cycle] Continuing education related to FSI duties Approved by the applicant’s fire chief or program director of chartered program New fire code requirement (4 hour min. code update) Unaffiliated options Routine duties (emergency response, station duties, vehicle maintenance, fire safety inspections, etc. – NOT CE 12 hours CE per day maximum Same online course; not more than once per year

EMS Renewal Options Option 1:
Completion of continuing education requirements, including required specialty topics, for certificate level O.A.C (EMR), (EMT), (AEMT) or, (PARA) Option 2: Examination in lieu of Continuing Education within last 6 months of certification cycle or prior to expiration of approved extension period (National Registry Assessment Exam – must pass within 3 attempts)

EMS Renewal Options Option 3: Completion of Ohio Refresher at certificate level (+ 20 hrs CE for AEMT & 38 hrs CE for PARA) Option 4: Current NREMT certification at or above certification level + Ohio Trauma Triage*. (Trauma Triage not required for EMR. NR must be valid on expiration date of Ohio certificate.) *Ohio Trauma Triage determination (established in O.A.C ) must be completed during EACH certification cycle. Training is available on DPS Public Safety Training Campus or may be completed locally.

Acceptable EMS Continuing Education
Criteria for acceptable CE is established in O.A.C Must be related to EMS operations or patient care Session must be at least ½ contact hour Must have a certificate of successful completion from sponsoring agency

Acceptable EMS Continuing Education
Must be provided or approved from an acceptable source Ohio accredited or approved (CE) training program An EMS licensing agency in another state A branch of the armed forces A medical or nursing board CAPCE-approved courses Federal, national, or state entities EMA Homeland Security American Red Cross American Heart Association American Safety & Health Institute

EMS Certification Continuing Education Renewal Requirements
The following is a summary that will help answer questions about meeting the requirements for maintaining an EMT certification in Ohio. Reference Ohio Administrative Code shall apply. Emergency Medical Responder 15 hours to include 1 hour of each: Patient Assessment CPR Airway management and oxygen administration Automated defibrillation Illness and injury management Trauma issues Anaphylaxis Patient assisted epinephrine

The following is a summary that will help answer questions about meeting the requirements for maintaining an EMT certification in Ohio. Reference Ohio Administrative Code shall apply. Emergency Medical Technician 40 hours of CE to include: 6 hours Pediatric 2 hours Geriatric 8 hours trauma to include the Ohio Trauma Triage course Advanced Emergency Medical Technician 60 hours of CE to include: 8 hours pediatric 4 hours geriatric

The following is a summary that will help answer questions about meeting the requirements for maintaining an EMT certification in Ohio. Reference Ohio Administrative Code Paramedic 86 hours of CE to include: 12 hours pediatric 4 hours geriatric 6 hours cardiac* 8 hours trauma to include the Ohio Trauma Triage course * May be fulfilled by ACLS course

Ohio Department of Public Safety Division of EMS CY2018 Examination Update

Goals Enhance examination delivery system
Improve Fire Training Program performance Create more robust results Implement improved item metrics Implement data forensics capabilities

Delivery System Enhancements

Improve Fire Training Program Performance

State vs Program Comparison—FFI Content Reporting
Orientation and History Firefighter Health & Safety Fire Service Communications Building Construction Fire Behavior PPE/SCBA Portable Fire Extinguishers Ropes and Knots Search and Rescue Firefighter Survival Forcible Entry Vehicle Extrication Ladders Ventilation Water Supply Fire Hose and Streams Fire Suppression Salvage and Overhaul Fire Origin and Cause Determination

More Robust Results

Volunteer Firefighter Initial Courses 1/1/2018 – 10/22/2018

Firefighter I and II Initial Courses (Adult Only) 1/1/2018 – 10/22/2018

Examination Performance—CY2018
LEVEL 1st Attempt Pass Rate (Initial Testers) 3rd Cumulative Pass Rate ROOT (All Testers) Average Time/Item VFF N = 667 56.7% 80.2% 27.2 sec FFI N = 519 75.3% 91.9% 24 sec FFI & II N = 705 90.2% 96.2% 25 sec FSI N = 328 86.9% 96.3% 26 sec (Closed Book) 121 sec (Open Book) Instructor ---

Improved Item Metrics—CY2018

Data Forensics—CY2018

Volunteer Firefighter Course
2018 Courses Offered 79 # of Student Enrolled 746 # of Students Sitting for Exam 667 Attrition Rate (Students Lost--Course) 79(11%) Pass – 1st Attempt 378 (56%) Pass – 2nd Attempt 115 (74%) Pass – 3rd Attempt 41 (80%) Total Passed (State) 534 (80%) Attrition (Total Students Lost--Exam) 133(20%) Attrition % (Total) 28%

Firefighter I Courses Firefighter I (High School)
Firefighter I (High School) Firefighter I (Adult) Firefighter I (Total) Firefighter I Transition 2018 Courses Offered 5 39 44 # Students Enrolled 82 540 622 14 # of Students Sitting for Examination 69 450 519 Attrition (Students Lost--Course) 13(16%) 100(19%) 103(17%) 0(0%) Pass – 1st Attempt 46(67%) 345(77%) 391(75%) 13(93%) Pass – 2nd Attempt 6(75%) 57(89%) 63(87%) 1(100%) Pass – 3rd Attempt 6(84%) 19(91%) 0(N/A) Total Passed (State) 58 415 473 (Students Lost--Exam) 11(16%) 35(7%) 46(9%) Attrition % (Total) 29% 23% 24% 0%

Firefighter I & II Courses
Firefighter I & II (High School) Firefighter I & II (Adult) Firefighter I & II (Total) 2018 Courses Offered 9 43 52 # Students Enrolled 146 712 858 # of Students Sitting for Exam 77 628 705 Attrition (Students Lost--Course) 69(47%) 84(12%) 153(18%) Pass – 1st Attempt 52(68%) 584(93%) 636(90%) Pass – 2nd Attempt 13(84% 23(97%) 36(95%) Pass – 3rd Attempt 2(87%) 4(97%) 6(96%) Total Passed 67 611 678 Attrition (Students Lost--Exam) 10(13%) 101(3%) 180(4%) Attrition % (Total) 54% 14% 21%

Firefighter II Transition Courses
Firefighter II Transition (High School) Firefighter II Transition (Adult) Firefighter II Transition (Total) 2018 Courses Offered 3 35 38 # of Students 34 380 414 # of Students Sitting for Exam 369 403 Attrition (Students Lost--Course) 0(0%) 11(3%) 1st Attempt 33(97%) 353(96%) 386(96%) 2nd Attempt 1(100%) 14(99%) 15(99%) 3rd Attempt Total Passed 368 402 Attrition (Students Lost--Exam) 1(0%) Attrition % (Total) 0% 3%

2018 EMS Provider Examination Results
# Attempting Exam (Ohio) 1st Attempt (Ohio) 3rd Attempt National Average (1st/3rd) EMR 255 68% (174) 74% (189) 70%/74% EMT 2388 68% (1612) 77% (1846 71%/80% AEMT 87 53% (46) 63% (55) 61%/72% Paramedic 743 69% (512) 82% (612) 75%/86% OAC minimum pass rate = 65% 1st attempt & 80% third attempt

Investigations & Compliance
Conducts investigations into criminal convictions, misconduct, and patient care issues involving certificate holders Conducts investigations into training issues at CE sites, Fire charters, and EMS schools Ensures compliance with CE Audits Coordinates 119 Hearings for the Division

Investigations CASES 2015 2016 2017 2018 EMS Investigations 362 367
456 409 Fire Investigations 255 233 256 237 Dual Fire and EMS Cases 91 105 94 98 Totals 708 705 806 744 Medical Transportation Cases 22 18 24 39 2012 numbers reflect AI cleanup.

EMS Case Classifications
Investigations EMS Case Classifications 2015 2016 2017 2018 Criminal Convictions 132 117 125 109 Audit Issues/Application Issues 147 186 233 207 Protocol/Patient Care 21 15 45 30 EMS school violations (Approved & Accredited) 16 12 9

Fire Case Classifications
Investigations Fire Case Classifications 2015 2016 2017 2018 Criminal Convictions 83 75 73 40 Audit Issues/Application Issues 143 145 170 188 Fire Charter Violations 2 10 8 4

Dual Case Classifications
Investigations Dual Case Classifications 2015 2016 2017 2018 Criminal Convictions 90 97 83 87 Audit Issues/Application Issues 1 6 7 5

Investigations* EMFTS Board Actions 2015 2016 2017 2018
Notices of Opportunity for Hearings 64 96 133 67 Chapter 119 Hearings 7 9 13 8 Cases Closed 411 374 301 460 Consent Agreements Approved 90 89 75 100 Goldman Hearings Completed 38 22 28 39 Summary Suspensions 2 3 4 *EMS & Medical Transportation

FFFSI Training Committee/ Executive Director Actions*
Investigations* FFFSI Training Committee/ Executive Director Actions* 2015 2016 2017 2018 Notice of Opportunity for Hearing 65 71 70 63 Chapter 119 Hearings 2 10 7 Cases Closed 301 307 221 324 Consent Agreements Approved 81 62 42 50 Goldman Hearings Completed 20 21 19 24 *Fire Investigations – Executive Director with Advice & Counsel from Firefighter and Fire Safety Inspector Training Committee

OEMS Grant Program The purpose of the Ohio EMS grant program is to improve and enhance EMS and trauma patient care in the State of Ohio by providing grant funds to eligible applicants. Section of the Ohio Revised Code defines the priority distribution of available funds for Ohio’s EMS grant program.

OEMS Grant Program Training & Equipment (Priority 1)
Grant Priorities Training & Equipment (Priority 1) Research Grants (Priorities 2 – 5) Priorities 2-5 Adult & Pediatric Trauma Care Trauma Causes and Injury Prevention Trauma Rehabilitation EMS System Improvement Priority 2-5 Trauma Research RFP’s Electronic Tablet Grant

Priority 1 Grants 2013 $3.1 million approved applicants – 723 applications received Priority 1 - Grants $2,521,750 6 – denied for not reporting 1 – denied for not having a medical director 1 – denied for not being eligible (no runs, no transports) Priority 2 - Grants $55,691 Priority 3 - Grants $84,475 Priority 4 - Grants $144,369 Priority 5 - Grants $176,089 Priority 6 - Grants $42,919 2014 2.8 million approved applicants- 703 applications received Priority 1 - Grants $2,290,500 51 – denied for not reporting 2 – denied because they were deemed not eligible (no runs, no transports) 2- denied for not spending any money in the previous 2 grant period 1 – denied because the grant application was faxed 1 – application was postmarked after April 1st. Priority 2 - Grants $150,274 Priority 3 - Grants $167,220 Priority 4 - Grants $78,267 Priority 5 - Grants $0.00 Priority 6 - Grants $12,450 2015 $2.5 million approved applicants – 632 applications received Priority 1 - Grants $2,591,000 45 – denied for not reporting 8 – denied for other non-compliant Priority 2 - Grants $113,253 Priority 3 - Grants $69,999 Priority 4 - Grants $0.00 Priority 5 – Grants $75,790 Priority 6 – Grants $2,750

Priority 1 Supplemental Funding*
Economic Hardship 3 awards = $116, for the first grant cycle Average Award = $16,596.35 Board Priority 8 awards = $229,566 for the first grant cycle Average Award = $28,695.75 Total Supplemental Grant Disbursement $345, (13.4% of P1 Dollars; 9.6% in 2017) Second Round $20,000.00 *In addition to Priority 1 Training & Equipment Grant Awards

P1 Grants (Awards in $) 2,582,996 20,000 2013 $3.1 million approved applicants – 723 applications received Priority 1 - Grants $2,521,750 6 – denied for not reporting 1 – denied for not having a medical director 1 – denied for not being eligible (no runs, no transports) Priority 2 - Grants $55,691 Priority 3 - Grants $84,475 Priority 4 - Grants $144,369 Priority 5 - Grants $176,089 Priority 6 - Grants $42,919 2014 2.8 million approved applicants- 703 applications received Priority 1 - Grants $2,290,500 51 – denied for not reporting 2 – denied because they were deemed not eligible (no runs, no transports) 2- denied for not spending any money in the previous 2 grant period 1 – denied because the grant application was faxed 1 – application was postmarked after April 1st. Priority 2 - Grants $150,274 Priority 3 - Grants $167,220 Priority 4 - Grants $78,267 Priority 5 - Grants $0.00 Priority 6 - Grants $12,450 2015 $2.5 million approved applicants – 632 applications received Priority 1 - Grants $2,591,000 45 – denied for not reporting 8 – denied for other non-compliant Priority 2 - Grants $113,253 Priority 3 - Grants $69,999 Priority 4 - Grants $0.00 Priority 5 – Grants $75,790 Priority 6 – Grants $2,750 DISCUSS TURNBACK!

Electronic Tablet Data Reporting Grant
On July 18, 2017, The Traffic Records Coordinating Committee (TRCC) awarded up to $700,000 to the Division of Emergency Medical Services (EMS) for the purpose of purchasing tablet devices and cases for Ohio EMS Agencies. 391 Applications received. 388 Applicants Eligible May 2018 – 600 tablets distributed to 266 agencies November 2018 – 420 tablets available for distribution

Information Resources

OEMS website: www.ems.ohio.gov
AskEMS Division Sections—Directory available on OEMS website OEMS website: 107

Certification Cards 24/7 Verification on OEMS Website: OEMS Website

Disciplinary Actions Popular Links (DEMS Home Page)
The State Board of Emergency Medical, Fire, and Transportation Services (EMFTS) is responsible for investigations to ensure EMS providers and medical transportation organizations comply with the Ohio Revised and Administrative Codes. EMS Discipline The files below can be opened in your browser or downloaded to your computer. You can use the keyboard shortcut Control+F, or Command+F on a Mac, to open a search box. Type a surname or certification number in the search box to locate any matching text in the file. 2018 to date Popular Links (DEMS Home Page)

Disciplinary Actions Fire
The Executive Director for the Division of EMS, with advice and counsel of the Firefighter and Fire Safety Inspector Training Committee, is responsible for investigations to ensure fire service providers comply with the Ohio Revised and Administrative Codes. Fire Discipline The files below can be opened in your browser or downloaded to your computer. You can use the keyboard shortcut Control+F, or Command+F on a Mac, to open a search box. Type a surname or certification number in the search box to locate any matching text in the file. 2018 to date To inquire about disciplinary actions from previous years, please the Investigations, Hearings & Compliance Section.

Projects and Issues

The clock starts to save a life
The clock starts to save a life And it takes a coordinated team to efficiently and safely help the most people in the shortest amount of time. The Ohio Department of Public Safety thanks you for your service and invites you to learn about Ohio’s recommendation for all first responders with regards to a specific type of critical incident known as an active shooter incident. By establishing common language, expectations, and strategies between law enforcement, fire, and EMS personnel, we aim to increase lives saved and reduce risk to you as a first responder.

Does your agency have an Active Shooter Protocol?
Yes 59% No 40% Describe your agency’s Active Shooter Model: RTF where law enforcement and EMS enter “warm zones” to limit life loss 57% No Active Shooter Protocol/Model 35% Other 6%

EMFTS Strategic Plan

Improve Quality of Patient Care
EMFTS Strategic Plan 5 Pillars Improve Quality of Patient Care Improve Population Health Through Prevention & Wellness Enhance Human Resources Improve Access to Healthcare Improve System Sustainability

Human Resources Ad Hoc Committee
EMFTS Strategic Plan Human Resources Ad Hoc Committee Staffing Needs Safety/Health Vehicle Accidents Recruitment/Retention/Reciprocity Fatigue Workforce Resilience Quality CE Impaired Provider Scope of Practice Ad Hoc Committee Comprehensive Review of Scope of Practice for all Provider Levels

EMS Provider Scope of Practice
Scope of Practice Changes CO-oximetry (EMR+)* Add Ketamine to list of medications (AEMT+)* *Currently permitted; adding to OAC

Proposed Scope of Practice Change “Blood chemistry analysis”—revise to “Body fluid analysis, except amniotic fluid” (Paramedic)** **Will be permitted upon effective date of OAC changes; estimate February 15, 2020

Proposed Scope of Practice Change – Non-emergent ALS transport of patients with tracheostomy tubes Under current rules, transport of patients on a ventilator is limited to adult patients (16 or older) and only by a paramedic Proposed rule change will permit non-emergent transport of patients with tracheostomy tubes (adult & pediatric) provided the care-giver accompanies the patient during transport (Paramedic)*** ***Estimate effective date of February 15, 2020

Proposed Scope of Practice Change Add ultrasound-guided peripheral venous access to paramedic scope of practice**** ****Research underway to determine cost of implementation and global versus specialty requirement as it relates to basic training

Fire & EMS Instructor Certification Review
The Problem: Current Ohio Instructor Course Dated Reciprocity Complicated Fire, Fire Safety Inspector, and EMS Instructor Instructional Methodology Curriculum/Course Delivery Restrictions NFPA 1403, 2018 Edition Requirements – Fire Instructor II for Live Fire Lead Instructor

Fire & EMS Instructor Certification Review
NFPA 1041 Fire Instructor I and Fire Instructor II compliant courses? National Association of EMS Educators Instructor I and II courses? Development of a Fire Instructor II – Transition course? Hours adjustment to accommodate additional course material? e.g., = 60 (Determined by Objectives) Grandfathering of programs currently offering Fire Instructor course meeting NFPA 1041 Fire Instructor II requirements? Public Safety Instructor?

NFPA 1001, 2019 Transition Effective April 1, 2019

Course Packets Course Overview Course Objectives Course Requirements
Contact Hours Course Admission Requirements Qualification for Certification Requirements Standard and OAC References Hours Guide (Cognitive & Practical) Publisher/Textbook References

Live Fire Training Operations Course
Charter Requirements Instructor Requirements Student Requirements

Hazard Recognition Officer (HRO) Certification
Course Forty Hours NFPA 1031, Inspector 1 Hazard recognition Certification ORC 3737 permits FSI to write citations HRO not permitted to write citations Charter Requirements Student Requirements

Examination System Improvements
Improving Fire Training Program Performance Examination Update Delivery System Metrics Results

Delivery System Enhancements

Examination Metrics 1/1/2018 – 10/22/2018
LEVEL 1st Attempt Pass Rate 3rd Cumulative Pass Rate Unanswered Items (ROOT) Average Time/Item VFF 56% 79.4% 2 27 sec FFI 78.7% 91.6% 14 24 sec FFI & II 92.2% 96.6% 1 FSI 87.1% 92.7% 6 27 sec (Closed Book) 107 sec (Open Book)

Volunteer Firefighter Initial Courses 1/1/2018 – 10/22/2018

Firefighter I and II Initial Courses (Adult Only) 1/1/2018 – 10/22/2018

State vs Program Comparison

State vs Program Comparison Draft FFI Reporting Content Areas
Vehicle Extrication Ground Ladders Ventilation Water Supply Fire Hoses and Fire Streams Fire Suppression Controlling Building Utilities Salvage and Overhaul Fire Origin and Cause Orientation and History Firefighter Safety and Health Fire Service Communication Building Construction Fire Behavior PPE/SCBA Portable Fire Extinguishers Ropes and Knots Search and Rescue, Firefighter Survival Scene Lighting, Portable Power Forcible Entry

Database Rewrite Project
Fire Testing – Phases 1 & 2—COMPLETED Certifications – COMPLETED Education – Phases 1 & 2 – COMPLETED Grants – COMPLETED Medical Transportation – COMPLETED Investigations – COMPLETED EMS Management – Phase 1—COMPLETED Fire Testing—Phase 3—COMPLETED EMS Management—Phase 2—Due 3rd Quarter 2019 Applications (Instructor, Education Programs, Medical Transportation – Due June 2020

EMSIRS PROJECT Pilot in April 2019 Live January 1, 2020

2018—Completed/Initiated…
Medical Directors’ Conference – November 13, 2018* 2019 Conference – November 13, 2019 EMFTS Strategic Plan* Staff Reorganization/Workload Redistribution/Position Reclassification/Succession Planning EMSIRS Project Funding/Kickoff* Examination System Improvements (Fire & Instructor) New Fire Certifications (Live Fire Instructor, Hazard Recognition Officer) OAC updates (EMS, Trauma, Medical Transportation, Fire) Action Training System Access (VFF & FFI courses) Legislation—NEMSIS, et al Data Sharing* Rescue Task Force Awareness Training Program* EMS Internal Data System Improvements* EMS for Children (EMS-C) Webinar Series*

Working On… Comprehensive EMS rule review/update
EMS & Fire Legislative Needs Improving course pass rates (EMS & Fire)*** Examination System Improvements Course Packets Action Training System Implementation High School Program Improvements Volunteer Firefighter (VFF) Course FSI & HRO Courses (course objectives, hours guides, etc.) Modular FFI Course EMS & Trauma Data Collection & Analysis Improvements***

Working On… Rescue Task Force Conference CARES Implementation
Ohio Board of Pharmacy Requirements Special Pathogen/HID Transportation NETEC Training Just-in-Time PPE/Decon Training Decontamination Capabilities (Bioquell Purchase) PPE Caches

Guidance Document for the Management of Suspected and Confirmed Cases of Ebola in the State of Ohio
(Issued June 3, 2019) The purpose of this Guidance Document is to inform local, state, and federal partners; relevant agencies and organizations; and other stakeholders about response plans to a single case or an outbreak of Ebola Virus Disease (EVD) in the state of Ohio. This document is specific to the management of EVD; however, the concepts may be applied to other novel highly infectious disease. Protocols and references outlined in this document will be updated as national and state guidelines change.

Other Issues… Mobile Integrated Healthcare (CP) DEMS Funding
Drug Shortages Naloxone Administration

EMS Week May 17 – 23, 2020 (EMSC Day May 20, 2020)
Ohio Department of Public Safety Tentatively Scheduled…May 20, :00 PM EMS Week May 17 – 23, 2020 (EMSC Day May 20, 2020)

AND FINALLY, in CLOSING….

Your Input is Valued…. EMS FIRE Contact the Division of EMS
Input through State Board of Emergency Medical, Fire, & Transportation Services Attend bi-monthly meetings or reach out to members FIRE Input through the Firefighter and Fire Safety Inspector Training Subcommittee Contact the Division of EMS Education/Testing Chief James Burke EMS Coordinator Kris Miller EMS CE Coordinator Carol Savage Fire Coordinator Joe Posey Executive Director Mel House

Our focus is customer service….

Mel House, Executive Director 614-995-4752 mrhouse@dps.ohio.gov
Questions? Mel House, Executive Director

State Board of Emergency Medical, Fire, and Transportation Services

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