Emergency Medical Services Council - July 21, 2025

Agenda

1. Introductions
2. Additions/Deletions/Acceptance of Agenda
3. Call to the Public
   • Those persons wishing to address an issue not on the agenda. Limited to three (3) minutes per person but may be extended at the discretion of the chairperson.
4. Approval of Minutes from April 2025 meeting
5. Recognitions
6. Staff Reports
   • County Staffing Update (Bill Conway / Bill Steward)
   • Public Health Update (Dr Present)
   • Finance (Sherry)
   • Behavioral Health Response Update (Conway)
7. Committee / Special Interest Reports
   • EMS Strategic Plan Taskforce – No report
   • QI Committee – Ritu Sahni, MD
   • Protocol Development Committee – Dr Bohrer-Clancy
   • Operations Subcommittee – Brad Kuhn
   • System Enhancement Subcommittee – Jason Mahle
   • ESO Committee -Scott Vachter
   • EMS Training Group/ MAT – Dr Sahni
   • PSAP –Tony Collins/Tina Burgess
   • Labor Committee -No Report
8. Old Business
   • ALS Provider Council position appointment
9. New Business
   • Transition Center update
10. General Announcements
11. Next Meeting – October 20, 2025 12. Adjourn

Minutes

Members Present: Matt Dale, Chair; Dr. Ritu Sahni, EMS Medical Director; Dr. Thomas Kofoed, CC Associate Medical Director; Vince Stafford, Molalla Fire; Dr. Sarah Present, CC Public Health Officer; Jason Mahle, Clackamas AMR Operations Manager; Glen Suchanek, Milwaukie PD Behavioral Health Specialist; Vince Stafford, Molalla Fire; Ben Sorenson, ALS Provider TVFR; Tony Collins, CCOM Operations Manager

Members Absent: Jeanie Wilcox, County Resident Representative; Dr. Sean Stone, FACEP Manager

Guests: Cheryl Bledsoe, CCOM Director; Justin Behrens, TVFR; Charles Miller, WC Program coordinator; Sid Humphries ODHS; Tim Case WC EMS

Staff: Kim LaCroix, Interim Public Health Director; Bill Conway, Office of Public Health Emergency Services, Emergency Services Manager; Bill Steward, Office of Public Health Emergency Medical Services, EMS Coordinator; Megan Cardoza, Office of Public Health Emergency Services, Administrative Specialist; Sherry Olson, Finance & Business Services Manager; Deidre Toczyski, Office of Public Health Emergency Services, Data Analyst

The meeting was called to order at approximately 9:00 am.

Introductions:

• Introductions were completed.

Additions/Deletions/Acceptance of Agenda:

• Agenda approved with no additions.

Call to the Public:

• Sid Humphries – Oregon Department of Human Services
  • Vacancy on ODHS EMS Advisory Council for Physician Supervisor that has emergency medical services background
  • Contact Sid for more information on that position:
    SIDNEY.L.HUMPHRIES@odhs.oregon.gov

Approval of Minutes:

• April 21st, 2025, Meeting Minutes approved.

Recognitions:

• Ben Sorenson has been appointed to the new ALS Provider Council position, vacated by the retirement of Chief Boughey
  • Online vote was conducted after the application process, of which the BCC approved the vote

Staff Reports:

• County Staffing Update (Bill Conway)
  • No staffing updates
    • State funding budget has been reduced for Public Health Emergency Preparedness and could affect staffing
      • Waiting to see what the state comes up with
    • 70% of Oregon Health Authority’s Emergency Preparedness funds have been received from the CDC for this fiscal year
    • Other 30% unknown until end of September
    • Will know more for future FY 2027 in October
• Public Health Update (Dr. Sarah Present)
  • 1 Measles exposure from international travel
    • No cases from that exposure and out of the timeframe
• MMR vaccine is the safest and best prevention against Measles
  • CIDRAP started the Vaccine Integrity Project, which will be doing science—based research on vaccines and ongoing recommendations
  • EMS Coordinators group working on reducing ambulance patient offload times in the region – APOT: Ambulance Patient Offload Time
    • Brought to the Health Officer group to brainstorm ways to elevate in the hospital systems
      • Discussed at CMO workgroup meeting
        • How do we look for individual solutions for unique circumstances?
    • Dr. Sahni:
      • Tim Case presented at the last Region 1 and 6 meeting (Tri-County data):
        • Since 1 January: 80,386 Total offloads
        • 8% Total offloads (offload times >20 minutes)
        • 1,164 Hours spent delayed at hospital
        • 1,164 hours spent delayed at hospitals equates to $267,720 of EMS subsidizing local Emergency Departments*
        • 97 twelve-hour ambulance shifts serving our communities
      • A lever that could be pulled is when a patient is boarded, they have an imminent bed
        • Imminent bed: Patient can go to their floor and wait for a bed instead of waiting in the Emergency Department
      • Takeaway:
        • Issue is with boarding and needs to be looked at at a hospital level
          • Not enough beds for patient load
        • Each CMO is going to go through their system to take the pulse of the issue
• Finance (Sherry Olson)
  • Currently in the 4th quarter
    • Have not seen the revenue from AMR Cost Savings Payments from May and June
      • 5% increase from previous payments of $33,333.33
      • Now $34,999, totaling approximately $70k for the missed 2 months
      • Late payment due to currently being in negotiations
    • Fire agencies have been paid out their 60%
  • Paid out more in Compassion care this year than previous years
    • Only pulls 20% of the total amount coming in for the year
      • Pulls from fund balance if short
    • Current fund balance is approximately $150k
      • This does not include the $70k that will come in from AMR
      • Fund balance to be around $220k once payment has been received.
• Behavioral Health Response Update (Glen Suchanek)
  • Community Response Advisory Group that meets monthly
    • Group of individuals that touch behavioral health response
      • Goal is to break down silos leading to better patient care
    • Working on Universal ROI (Release of Information) form for practitioners to communicate with each regarding patient care
    • Interested in Julota – charting platform Community Paramedics use that brings together all the charting platforms data into one location
      • Launching soon with hope to incorporate Behavioral Health system into the platform
  • 23 Hour Stabilization Center to be in Milwaukie
    • Next chief meeting will be held at the Stabilization Center to tour the facility
    • Drop off for Emergency Response, Police, and Behavioral Health
    • Front of the center will be ran by Clarvida
    • Father’s Heart will run the 13 bed shelter in the back of the facility
      • Goal is to open by December but hoping to open in September
  • Recovery Center will be in an old school building off 82nd Drive
• Goal is to have detox, outpatient, and residential all on one site as well as some housing
  • No projected timeline currently
  • Caring Place
    • New home to LoveOne and Fathers Heart
    • Homeless Solutions Coalition of Clackamas County purchased the Miles Fiberglass building in Oregon City
      • Construction to around the beginning of the year
      • Move in date to be around end of 2026, early 2027
  • LoveOne and Father’s Heart working with Acacia on opening a medical respite house
    • Clackamas County does not have a medical respite house
    • More cost effective to have people in a medical respite than the hospital
      • Reach out to Acacia for any solutions for people coming out of the hospital without a home or shelter to return to
    • Location is set that is all ADA accessible
      • Start out with 5-8 beds
      • Some funds are allocated but will need more revenue to keep the program running
  • Clackamas Village is very close to opening
    • It is a new tiny home village next to the Vets Village in the Industrial Area
      • 24 pods
    • Sunstone Way will be running the program
  • Go in front of council on the 5th of August for more coverage in Milwaukie

Committee / Special Interest Reports:

• EMS Strategic Plan Taskforce (Bill C.)
  • No new report
• QI Committee (Dr. Ritu Sahni)
  • Had a joint meeting last week with Washington County that covered cardiac arrest survival rates
    • Reviewed annual CARES data
      • Cardiac Arrest Registry to Enhance Survival
    • National database that all 3 counties participate in
      • Multnomah, Clackamas, Washington (and Clark)
    • Looking to improve:
• Bystander compression rates
• Equity data
• Protocol Development Committee (Dr Ritu Sahni)
  • Mid-Season changes – implemented a more aggressive cooling protocol
    • Information pushed out to fire screws
    • Protocols locked in by October
    • Start working on education and training material by November/December
• Operations Subcommittee (Bill Steward)
  • Met this month
  • Working towards a Video laryngoscope replacement
  • Meet again in August
• System Enhancement Subcommittee (Jason Mahle)
  • GlideScope and CMAC video Laryngoscopes identified as the top 2 scopes
    • CMAC is significantly more expensive
    • Working on moving to the GlideScope Go 2 VL
    • Working on the requirement list for an RFP process through Clackamas County Procurement
    • Lead time unknown
• ESO Committee (Scott Vachter/Ethan Hupp/Jason Mahle)
  • Charts transferring very well from fire agencies to AMR
    • Still 2 charts due to fire agencies being in contract with ESO
      • All the information from Fire before AMR is on scene goes in both charts
  • AMR meeting with ESO to start having CARES data automatically extracted
    • The State is not extracting CARES data currently
• Clackamas Fire switching to Apple iPads due to the App having technical issues.
  • Molalla FD having technical issues as well
  • Bring issues up at next ESO Committee meeting
• EMS Training Group/MAT (Dr. Sahni)
  • In the process of planning Fall training and looking at dates
    • Focus will be on the deployment of the new GlideScopes
      • Very different than previous video laryngoscopes due to having a high angulated blade
    • Possibly moving from 6 days to 3 days
      • At this time, Clackamas Fire will not be participating in MAT this year
• EPAB/Emergency Physician Advisory Board (Dr. Sahni)
  • Meets quarterly and includes all the Medical Directors involved in the County and now expanded to the ED Directors
  • Met in April
• Discussed the overview of the system
• Today’s discussion will be covering APOT and give the ED an opportunity to give an update
• PSAP (Tony Collins/Cheryl Bledsoe)
  • Nurse Navigation started almost a year ago, last September
    • Now sending around 100 calls a month to nurse navigation
    • BLS return calls do not get a fire response anymore
    • 2400 calls a month – 4% of calls being transferred to Nurse Navigation
  • New In-House Clinician started several months ago
    • Works graveyard shift, Sunday – Wednesday
    • Slowly increasing the number of calls he takes
      • Responds to in the field and phone calls
      • Takes Clackamas County Crisis Line phone calls
  • CCOM has all positions hired
    • Many employees still in training
    • 1 Supervisor retired
    • 2 employees promoted to fill the vacancies
• Labor Committee (Bill S/Mark O.)
  • No updates

Old Business:

• Welcome Ben Sorenson from TVFR, the new ALS Provider Council

New Business:

• Transition Center Update – Glen Suchanek covered in Behavior Health Response Update

General Announcements

• Bill Conway –
  • Clackamas County and AMR have reached a tentative agreement on an Ambulance Service Contract
    • Will be presented and put in Public Record to the Board of County Commissioners meeting tomorrow, July 22, at their policy session
      • Staff’s recommendation is the BCC to approve the contract
      • If approved, it will be moved forward for a vote on July 24th or the 31st
        • After the meeting, contract will be signed and put into effect immediately
      • Meeting is available to watch
      • Changes and implementations:
        • Clinical performance metrics with Incentives and liquidated damages
        • Revised response time requirements with Incentives and liquidated damages
        • Providing Nurse Navigation throughout the entirety of the

Next Meeting:.

contract

• Secure transport services
• New compliance review processes
• New performance improvement process requirements
• New technology and equipment
• Option to add BLS (Basic Life Support) Ambulances
• Next meeting will be October 20, 2025, at 9:00 am.

Adjourn: The meeting adjourned at approximately 10:07 am.