09-20-2011 REMAC Minutes.pdf - REMSCO

THE REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL OF NEW YORK CITY, INC.
Page 1 of 6
REMAC NYC Minutes
September 20, 2011
Regional Emergency Medical Advisory Committee
Minutes
September 20, 2011
The Regional Emergency Medical Advisory Committee (REMAC) of New York City
met on Tuesday, September 20, 2011 at the Offices of the Regional EMS Council of
NYC, 475 Riverside Drive, Lounge, New York City. This meeting can be viewed via
webcast at www.nycremsco.org.
Members Present Absent Excused
Burn Surgeon (1) Roger Yurt, MD �
EMS Community Emergency Department
Medical Directors (3)
Nurses (2)
Administrators (2)
Jeffrey Horwitz, DO �
Katherine Vlascia, MD �
Allen Cherson, DO �
Vacant
Vacant
Clifford Miller �
Vacant
Fire Department, City of New York
Commissioner or Non-
Physician Designee
Medical Director (3)
Jack Finkelstein, alt
Abdo Nahmod, EMTP �
Dario Gonzalez, MD �
Glenn Asaeda, MD �
Bradley Kaufman, MD �
Online Medical Control
John Freese, MD �
Physicians (2) Doug Isaacs, MD �
Michelle Robbins, EMTP �
Emergency Medical
Technicians
Joseph Pataky, EMTP, alt �
(Basic/Paramedic) (2) Christopher Swanson, EMTP �
Greater New York Hospital Association
President or Non-Physician
Alison Burke �
Designee (1) Deborah Brown, alt
Emergency Physician (1) Jeffrey Rabrich, MD �
Ambulance Service Medical
Heidi Cordi, MD, Second Vice Chair �
Director (1) Kevin Chason, DO, alt
On Line Medical Control
Lewis Marshall, JD, MD Chair �
Physicians (2) Josef Schenker, MD �
Emergency Department
Michael Guttenberg, DO �
Administrator (2) Darlene Mercieca �

THE REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL OF NEW YORK CITY, INC.
Members Present Absent Excused
Greater New York Hospital Association (continued)
Emergency Medical
Anthony Conrardy, EMTP �
Technicians
(Basic/Paramedic) (2)
Craig Biscuiti, EMTP �
Medical Standards Committee
ALS Physician (1) Jay Reich, MD �
BLS Physician (1) David Ben-Eli, MD �
Medical Society of New York
Physician (1)
New York City
Peter Wyer, MD �
Department of Health &
Mental Hygiene-
Emergency Preparedness
Program Physician (1)
Lewis Soloff, MD �
New York City Health &
Hospitals Corporation
Physician (1)
Lorraine M. Giordano, MD �
New York City Police Charles Martinez, MD �
Department Physician
(1) Victor Politi, MD, alt
NYS Volunteer Ambulance & Rescue Association/District 4 & 18
Ambulance Service Medical
Director (1)
Joseph Bove, MD, First Vice Chair �
Emergency Medical
Ralph Cefalo, EMT �
Technicians
(Basic/Paramedic) (2)
Martin Grillo, EMTP �
Pediatric Emergency
Medicine Physician (1)
George Foltin, MD �
Psychiatric Emergency
Medicine Physician (1)
Pablo Sadler, MD �
Regional EMS Council
NYC Physician (1)
Vacant
Trauma Surgeon (1) Arthur Cooper, MD �
Training & Education
Committee Physician (1)
Jessica van Voorhees, MD �
United New York Ambulance Network (UNYAN)
Ambulance Service Medical
Director (1)
Victor Politi, MD �
Emergency Medical
Michael Vatch, EMTP �
Technicians
(Basic/Paramedic) (2)
Non-Voting
Maryanne Sawyer, EMT �
At Large Yedidyah Langsam, PhD, EMTP �
At Large Donell Harvin, MPH, MPA �
Public Vacant
STAFF
GUESTS
Page 2 of 6
REMAC NYC Minutes
September 20, 2011
Marie Diglio, EMTP, Executive Director Operations
Joseph Raneri, Disaster Preparedness Coordinator
Robert Goldstein, NYPD ESU
Kevin Munjal, MD, Mt. Sinai

THE REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL OF NEW YORK CITY, INC.
Page 3 of 6
REMAC NYC Minutes
September 20, 2011
Christopher Graziano, SIUH
Frank Mineo, PhD
Jack Quigley, FDNY EMS
Michael Redlener, MD, FDNY
Pamela Lau, MD, FDNY
Stephen E. Davis, III, Northshore Ambulance
Dr. Lewis Marshall, Chair, called the meeting to order. For the purposes of web
casting, a roll call was performed. A quorum was present. Dr. Marshall asked if
there were any corrections to the June 21, 2011 Minutes. Hearing none, the
REMAC Meeting Minutes were accepted as written.
Dr. Marshall changed the Agenda’s order so that Dr. Kevin Munjal could present
information on “Community Paramedicine’. This alternative service is being utilized
and studied both nationally and internationally for the improvement of community
health. Dr. Munjal reported paramedics being used to provide community health
services is a very cost effective way to extend care for community members who
would otherwise be using emergency departments are their primary care providers.
Dr. Munjal asked anyone interested in joining a Task Force to investigate this issue
should contact him. REMAC members asked Dr. Marshall, NYC’s representative to
the SEMAC, to have Dr. Munjal’s presentation put on the SEMAC’s agenda at its
next meeting.
The Offices of the Council received the following correspondence:
Membership:
� The following members requested to be excused: Roger Yurt, MD, Jeffrey
Horwitz, DO, Abdo Nahmod, EMTP, John Freese, MD, Alison Burke, Lewis
Soloff, MD, Lorraine M. Giordano, MD, Joseph Bove, MD, Pablo Sadler,
MD, Arthur Cooper, MD, Jessica van Voorhees, MD
� The GNYHA recommends the following new appointments:
o Emergency Department Administrators
� Michael Guttenberg, DO (replacing Frank Mineo, PhD)
� Darlene Mercieca
o Emergency Medical Technicians (Basic/Paramedic)
� Richard Bowe, alternate for Anthony Conrady, EMTP
� Dominick Battinelli
The nominations were discussed and voted unanimously for approval.
These recommendations will be forwarded to REMSCO for final approval.

THE REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL OF NEW YORK CITY, INC.
From FDNY:
� PCR Monthly Inventory for June 2011
� Copies of memos sent to EMS agencies identifying non-compliant months
for PCR submissions
From NYS DOH:
� Copy of NYSDOH Policy 11-05: Medical Control and Oversight. This policy
allows NP and RN (as defined in 405.19) to be physician extenders for the
purposes of providing on line medical control.
� Public Notice from New York State Department of Health, Bureau of EMS,
Operations Unit, to be read into the REMAC Minutes of the following
enforcement actions:
Provider
Name
Page 4 of 6
REMAC NYC Minutes
September 20, 2011
EMT # Penalty Violation of County of
Residence
None received
Protocol Update Completion Forms from:
� Flatlands VAC
� Primary Care Ambulance
ALS Renewals/Applications:
� Hunter Ambulance
� Lifestar Response Corp
� Priority One Ambulance
Epi-Pen Auto Injector Applications received from:
� Grace Lutheran Summer camp
The Office of the Council sent the following correspondence:
� Agendas, Minutes and associated attachments for the meetings.

THE REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL OF NEW YORK CITY, INC.
SUBCOMMITTEE REPORTS
Medical Standards Committee (Bradley Kaufman, MD, Chair)
Dr. Kaufman reported the no seconded motions from the Medical Standards
Committee: The C&C Subcommittee met on June 27 th and September 16 th , 2011.
Upcoming REMAC Regional Oral Exams are scheduled for September 27 at 9 am, at
St. John’s University, and October 25 at 9 am at Fort Totten. Call or email
Christopher Swanson for more information at 718.999.2671 or
swansoc@fdny.nyc.gov. There was no Protocol Committee meeting held in
September; a meeting will be held in October. The NYC and NYS protocols will be
discussed. The C&C Subcommittee created a comparison document that will be
used to consider the concept of whether NYC BLS Protocols can be eliminated and
replaced by NYS BLS Protocols.
REGIONAL COUNCIL UPDATE
No report. The next meeting of the Regional Council Committee will be September
27, 2011.
JOINT REMSCO/REMAC QA COMMITTEE UPDATE (JOSEPH SCHENKER, MD, CHAIR)
Yedidyah Langsam, PhD, reported that the Joint Regional Emergency Medical
Services Council/Regional Emergency Medical Advisory Committee (REMAC) Quality
Improvement Committee met on Tuesday, September 13, 2011.
The Committee re-discussed the issue of pediatric and adolescent psychiatric
diversion in order to prevent the transport of adolescent and pediatric psychiatric
patients to facilities not equipped or staffed to provide appropriate treatment. A
letter was received (and discussed at the June meeting) asking that hospitals with
the staff and equipment for the proper care of adolescent and pediatric psychiatric
patients be categorized, much like STEMI (PCI) or Stroke Centers. It went on to
recommend that adolescent and pediatric psychiatric patients not be delivered to
hospitals not having those services. Committee members discussed this problem.
FDNY stated that currently, if a hospital has no psychiatric services it receives total
diversion for psychiatric patients. If a hospital has adult psychiatric services, it can
not receive diversion for adolescent or pediatric psychiatric patients. The
Committee will gather information on certified mental health services (within
hospitals) in this region.
Patient Care Restriction policy version #4 was again discussed and revised. It
was suggested that REMAC has authority to empower the QA Committee to hear
patient care restrictions. It was requested that a letter be sent to NYS DOH asking
if REMAC has authority to restrict an EMT from working in a region. An updated
version of the Patient care Restriction policy was emailed to Medical Standards and
REMAC members. Members were urged to read their emails and be prepared to
discuss and act on this draft policy.
Page 5 of 6
REMAC NYC Minutes
September 20, 2011

THE REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL OF NEW YORK CITY, INC.
Development of possible QA Studies will be discussed at the next meeting.
The next meeting of the QA Committee will be held on October 4, 2011.
STATE EMS COUNCIL/SEMAC UPDATE (Yedidyah Langsam, PhD)
The State EMS Council and SEMAC did not meet. Future meeting dates are
unknown.
UNFINISHED BUSINESS
No Unfinished Business.
NEW BUSINESS
Dr. Jay Reich asked if any EMS Agency had been granted a waiver to allow the use
of revised protocols for the purposes of studies. The answer was no. He
recommended that the QA Committee report on regional demonstration projects
and associated protocols. All EMS agencies will be asked to keep the REMAC
informed of any studies, and also asked if they would be willing to share
information.
Members asked that the C&C Subcommittee’s comparison of NYS vs. NYC protocols
be emailed to them again.
The meeting adjourned at 7:30 pm. The next meeting of the REMAC Committee
will be on September 20, 2011.
Page 6 of 6
REMAC NYC Minutes
September 20, 2011