Emergency Medical Services Council - April 10, 2026

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 2026 meeting
5. Presentation
   • DA John Wentworth – Gold Standard Project
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 Ritu Sahni
   • Operations Subcommittee – Brad Kuhn
   • System Enhancement Subcommittee – Jason Mahle
   • ESO Committee – Nate Weikel
   • EMS Training Group/ MAT – Dr Sahni
   • PSAP –Tony Collins/Tina Burgess
   • Labor Committee -No Report
8. Old Business
9. New Business
   1. New Council Positions
   2. Bylaws Update
10. General Announcements
11. Next Meeting – July 20, 2026
12. Adjourn

Minutes

Members Present: Matt Dale, Chair; Dr. Thomas Kofoed, CC Associate Medical Director; Vince Stafford, Defense Board Representative, Molalla Fire; Jason Mahle, Clackamas AMR Operations Manager; Dr. John Turner, CC Associate Medical Director; Ben Postlewait, CCOM; Sahni, Clackamas County EMS Medical Director; Mike Bauer, Clackamas Fire EMS Division Chief; Justin Colvin, Clackamas Fire Training Officer; Tony Collins, PSAP Representative; Brad Kuhn EMS Coord. Colton Fire

Members Absent: Dr. Sean Stone, FACEP Manager

Guests: Justin Behrens, TVF&R; Ben Sorenson, TVF&R; Laurie Smallwood, Clackamas Fire, Theresa Muncy, Providence Safe Program; Glen Suchanek, Milwaukie PD Behavioral Health Specialist; Tony Hadeed, EMS Coord. Estacada Fire; Clackamas County DA John Wentworth

Staff: Kim LaCroix, 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; Ana Lua, Finance & Business Services Manager; Deidre Toczyski, Office of Public Health Emergency Services, Data Analyst; Dr. Sarah Present, Health Officer; Jamie Breunig, Office of Public Health Emergency Services, Community Paramedic

The meeting was called to order at approximately 9:01 am.

Introductions:

• Introductions were completed.

Additions/Deletions/Acceptance of Agenda:

• Agenda approved with no additions.

Call to the Public:

• None

Approval of Minutes:

• October 25th, 2025, Meeting Minutes approved.

Presentation:

DA John Wentworth – Gold Standard Project
Overview:
District Attorney Wentworth presented the "Gold Standard Project," an initiative aimed at making Clackamas County a national leader in the response to domestic violence and sexual assault, with a strong emphasis on trauma-informed, multidisciplinary care.

• Key Objectives:
  • Build a coordinated system across EMS, law enforcement, hospitals, and advocacy partners
  • Improve early identification and intervention in high-risk victims
  • Strengthen prosecution outcomes through better evidence and documentation
  • Provide consistent, survivor-centered care
• Focus Areas:
  • Prevention – community education and early warning indicators
  • Intervention – primary area for EMS engagement
  • Aftercare – long-term victim support and follow-up
• Strangulation Emphasis:
  • 700% increased likelihood of death in DV relationships involving strangulation
  • Identified as a high-lethality predictor in domestic violence
  • Victims may have minimal or no visible injury   
    • Physical signs often absent (visible marks only ~50% of cases)
  • Symptoms EMS should recognize:
    • Voice changes
    • Difficulty swallowing
    • Neurological symptoms (confusion, memory loss)
    • Breathing difficulty
  • Highlighted risk of delayed stroke or death
• EMS Role & Proposed Actions:
  • Train all EMS providers in strangulation recognition and assessment
  • Expand existing Lake Oswego model countywide
  • Encourage transport and evaluation even when injuries are not visible
  • Improve documentation practices to support legal cases
  • Integrate trauma-informed communication techniques into patient care
• Discussion:
  • Strong support from EMS Medical Director and council members
  • Recognized challenges:
    • Training time and system capacity
    • Workflow and documentation changes
    • Interagency coordination
    • Hospitals confirmed readiness to support evaluations, including forensic nursing services

Staff Reports:

• County Staffing Update (Bill Conway)
  • No updates
     
• Public Health Update (Dr. Sarah Present)
  • Measles Update:
    • Approximately 20 confirmed cases statewide, including local spread
    • Reached outbreak at 5 cases in our region
      • OHA will start a dashboard at 25 confirmed cases
      • Clackamas has seen many of them
    • EMS guidance includes:
      • Verification of vaccination/immunity status
      • Use of N95 or higher-level respiratory protection
      • Monitoring and managing exposed personnel
      • Ambulance downtime (~2 hours) after transport of suspected cases
        • Dr. Sahni would like a memo to be sent to all EMS agencies in Clackamas County
  • Congenital Syphilis has rose in cases
    • Increasing statewide incidence
    • Public Health coordinating with hospitals and EDs to improve screening and detection
      • OHA has partnered with Oregon Perinatal Program
    • Future workgroups planned
• Finance (Ana Lua)
  • Overview of current EMS system financial status
    • Received 1st and 2nd quarter
    • Waiting on January payment
  • Continued monitoring of funding streams and cost pressures
  • Discussion of sustainability for special programs and system enhancements
    • Video laryngoscope purchase has been executed and completed
  • No immediate budget concerns raised, but long-term planning emphasized
     
• Behavioral Health Response Update (Bill Conway)
  • Continued collaboration between EMS and behavioral health partners
  • Crisis Intervention Team (CIT) training ongoing and expanding
  • Moved meeting frequency to 5 times a year, avoiding months with big holidays
  • Focus on improving field response to behavioral health crises

Committee / Special Interest Reports:

• EMS Strategic Plan Taskforce (Bill Conway)
  • No new report
     
• QI Committee (Dr. Sahni)
  • April's meeting included a PSAP presentation from LOCOM and CCOM on their QI data
    • Strong system performance reported from dispatch centers (CCOM and LOCOM)
    • High standards and increasing call volume
  • Ongoing focus on data-driven system improvements 
     
• Protocol Development Committee (Dr. Ritu Sahni)
  • No major protocol revisions anticipated in the current cycle
  • Monitoring potential state-level updates, particularly in stroke triage and screening
  • Continued alignment with best practices and evidence-based care
  • September will be the last meeting
    • Training rollout (Nov–Dec)
    • Updates implemented annually on February 1.  
       
• Operations Subcommittee (Brad Kuhn)
  • Ongoing coordination of operational issues across agencies
  • Focus on system efficiency, response coordination, and resource deployment
    • Ongoing drug shortage discussion
  • Continued collaboration between fire agencies and EMS partners
  • Moved meeting frequency to bi-monthly
     
• System Enhancement Subcommittee (Jason Mahle)
  • Updates on system-wide improvement initiatives
    • Video Laryngoscope project completed and will take some time to build those funds back up
  • Continued refinement of response models and integration of new programs
  • Exploration of opportunities to enhance service delivery and patient outcomes
• ESO Committee (Scott Vachter/Bill Steward)
  • Extending renewal despite struggles with customer service
    • Continues to make steady progress
  • Update on ESO electronic health record (EHR) system
  • iOS platform not yet ready for full deployment
    • Clackamas Fire is beta testing the platform
  • Continued collaboration with ESO and Apple to improve functionality
  • Ongoing work on data integration, reporting, and usability improvements
• EMS Training Group/MAT (Justin Colvin/Dr. Sahni)
  • April 21 – 23 is the scheduled first week of Multi-agency Training (MAT)
    • Location: Carver Event Center in Damascus/Carver – first week
  • April 28 – 30 is the scheduled second week
    • Location: Clackamas Community College - Harmony Campus   
       
• EPAB/Emergency Physician Advisory Board (Dr. Sahni)
  • Nothing to report
     
• PSAP (Tina Burgess – LOCOM/Tony Collins – CCOM)
  • LOCOM: No update
  • CCOM:
    • Telecommunicators week was last week.
    • Approximately 100 calls get forwarded to nurse navigation program
    • Lost imbedded clinician recently
      • Took a position elsewhere
      • Planning to fill his role again, date to be determined
    • Filled Operations Manager position, Ben Postlewait, who was the interim Operations Manager
    • In-House Academy has 2 people currently
    • 5 trainees in dispatch training
    • Promotions coming to fill Supervisor and shift leader positions
    • New director in 2027 after Tony Collins' retirement
      • Congratulations to Tony for the Director position
• Labor Committee (Bill S/Mark O.)
  • No update

Old Business:

• None

New Business:

• New Council Position
  • Members with expiring terms reapplied and were reappointed to new three-year terms
  • EMS Medical Director is still vacant
    • Position to be reposted and begin the recruitment process in the near future
• Bylaw Update
  • Proposed updates to ensure compliance with:
    • Public meeting laws
    • Conflict of interest requirements
  • No significant functional changes
  • Draft to be circulated for review and vote via email
     

General Announcements

• Kim La Croix:
  • High Rocks River Rescue program continuing under revised structure
    • Will have a lifeguard on duty approximately 15 days
      • holidays + limited high-risk days
      • AMR to place lifejacket station in the two parks the days that a lifeguard will not be on duty
  • Reach and Treat program moving forward with adjusted funding and partnerships:
    • Scaled down ALS
    • Close to finalizing
    • Majority of the calls were for pain control, which ALS will fill
  • Public Health is applying for a Rural Transformation Grant
    • Some may receive a letter of commitment
       
• Glen Suchanek:
  • Ongoing development of a medical respite program to support patients experiencing homelessness or housing instability who require short-term medical recovery but do not meet hospital admission criteria.
  • Program goal is to provide a safe discharge alternative for EMS and hospitals, reducing unnecessary hospital stays and repeat EMS utilization.
    • Target open date is set for June 2026
    • Father's Heart nurses will employ the program
  • Program remains in planning and development phase, with further updates expected as partnerships and logistics are finalized.

Next Meeting:

• Next meeting will be July 20, 2026, at 9:00 am.

Adjourn: The meeting adjourned at approximately 10:16 am