Emergency Medical Services Council - July 20, 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. Staff Reports 
   • County Staffing Update (Bill Conway / Bill Steward) 
   • Public Health Update (Dr Present) 
   • Finance (Sherry) 
   • Behavioral Health Response Update (Conway) 
6. 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
7. Old Business 
   • Bylaws Update – Bill Conway
   • DA Gold Standard Project – Matt Dale
8. New Business 
   • AMR contract review panel -Matt Dale/Bill Conway/Bill Steward
9. General Announcements 
10. Next Meeting – October 19, 2026
11. Adjourn    

Minutes

Members Present: Matt Dale, Chair; Dr. Thomas Kofoed, CC Associate Medical Director; Justin Gold, Clackamas AMR Operations Manager; Dr. John Turner, CC Associate Medical Director; Dr. Ritu Sahni, Clackamas County EMS Medical Director; Mike Bauer, Clackamas Fire EMS Division Chief; Justin Colvin, Clackamas Fire Training Officer; Tony Collins, PSAP Representative; Rachelle Herr, LOCOM;

Members Absent: Dr. Sean Stone, FACEP Manager; Brad Kuhn EMS Coord. Colton Fire

Guests: Rob Sadowsky, Clackamas County DTD; Ben Sorenson, TVF&R; Laurie Smallwood, Clackamas Fire; Diane Johnson, AMR; Dustin Hamilton, Molalla Fire

Staff: Kim LaCroix, Public Health Director; Bill Conway, Office of Public Health Emergency Services, Emergency Services Manager; Megan Cardoza, Office of Public Health Emergency Services, Administrative Specialist; 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: 

• April 20th, 2026, Meeting Minutes approved.

Presentation:

Transportation Safe Systems Approach

Presenter: Rob Sadowsky, Traffic Safety Outreach Coordinator, Clackamas County
Rob Sadowsky presented an overview of the County's updated Transportation Safety Action Plan, which is being revised for the first time in approximately six years. The new plan aligns with the U.S. Department of Transportation's Safe Systems Approach, emphasizing that roadway fatalities are preventable through coordinated improvements across engineering, education, enforcement, emergency response, and public health.

Safe Systems Priorities

Five pillars of the Safe Systems Approach:

• Safe Road Users 
• Safe Roads 
• Safe Speeds 
• Safer Vehicles 
• Post-Crash Care  

The updated federal emphasis on post-crash care creates significant opportunities for grant funding and cross-agency collaboration. 

Post-Crash Care Initiatives
The presentation focused primarily on four proposed initiatives involving EMS and healthcare partners:

Post-Crash Clinical Research

• Explore best practices for trauma triage and post-crash treatment. 
• Evaluate implementation of prehospital whole blood and future blood products. 
• Review innovative trauma response models used in other states. 
• Develop collaborative regional projects eligible for federal funding.

Specialized Rescue Equipment

• Partner with Clackamas Fire and regional agencies to identify equipment needs for electric vehicles and larger commercial vehicles. 
• Improve rescue capabilities in rural portions of the county through grant funding opportunities. 

Fatal Crash Review Team

• Establish a multidisciplinary Fatal Crash Review Team to regularly review serious and fatal crashes. 
• Utilize findings to improve roadway design, emergency response, behavioral health interventions, and prevention efforts while maintaining confidentiality for participating agencies. 

Behavioral Health Response

• Explore expanding behavioral health services following fatal crashes for: 
  • Victims and families 
  • Schools and affected communities 
  • First responders 
  • County road crews and other personnel responding to traumatic incidents 

The Council discussed recognizing the emotional impact of fatal crashes on responders and the need for additional post-incident support resources.

Funding Opportunities

The County is preparing for potential 2027 USDOT Safe Streets for All grant opportunities, which could provide millions of dollars in funding for post-crash care initiatives, equipment purchases, training, staffing backfill, and collaborative regional projects. Volunteers will be sought for a triage task force, fatal crash review team, and grant writing group. 

Council Discussion

Dr. Ritu Sahni highlighted ongoing work evaluating implementation of prehospital whole blood in Clackamas County and discussed opportunities to partner regionally with Washington County and Multnomah County. Discussion included:

• Preliminary evaluation of anticipated whole blood utilization. 
• Regional trauma protocols. 
• Federal and state funding opportunities. 
• Potential incorporation of Stop the Bleed education. 
• Advantages of multi-jurisdictional grant applications. 

Collaborative rural proposals may receive favorable consideration under upcoming federal funding priorities.

Staff Reports:

• County Staffing Update (Bill Conway)

  • No Update

     

• Public Health Update (Dr. Sarah Present) 

Measles

• Continued measles activity throughout Oregon.:
  • Approximately 30 statewide cases reported in 2026. 
    • Five to seven new cases reported during the previous two weeks. 
    • Cases continue to occur primarily within under-vaccinated communities. 
    • Several recent emergency department and urgent care exposures. 
  • Public Health continues educating patients on notifying healthcare facilities before arrival to reduce exposures.
  • EMS agencies were reminded that Public Health will notify responders following confirmed EMS exposures and will conduct exposure investigations for ambulance transports occurring within two hours of transporting confirmed measles patients. 

Ebola / Special Pathogens Update

• Dr. Present provided an update regarding international Ebola activity.
  • Finalizing EMS transport algorithms. 
    • Developing coordinated workflows with Legacy's Special Pathogens Unit. 
    • Continued collaboration with Dr. Sahni and Public Health physicians. 
    • Clarifying destination decisions between specialty centers and standard hospitals. 
  • Current risk to Clackamas County EMS remains very low due to CDC and State Department travel restrictions and enhanced traveler screening. Patients identified through federal screening receive CAD alerts when appropriate.
  • Dr. Sahni noted EMS educational materials and countywide guidance will be distributed once hospital workflows are finalized and thanked Clackamas Fire for assisting with hazmat planning.
• Finance (Sherry Olson/Ana Lua)
  • No Update
• Behavioral Health Response Update (Bill Conway)
  • Community Response Framework is the county's multidisciplinary behavioral health response workgroup.
  • Membership includes representatives from:
    • Public Health 
    • Behavioral Health 
    • Fire agencies 
    • AMR 
    • Law Enforcement 
    • Behavioral Health Specialists 
    • Hospitals 
    • Coordinated Care Organizations 
    • Peers 
    • Jail 
    • District Attorney's Office
    • Public Safety Answering Points (911) 
  • Beginning this year, meetings will take place five times annually (January, April, June, August, and October). 
  • The next meeting is scheduled for August 26. Council members interested in participating were encouraged to contact Bill Conway.

Committee / Special Interest Reports:

• EMS Strategic Plan Taskforce (Bill Conway) 
  • No meeting has occurred since the previous EMS Council meeting. The committee will remain active for future work.
• QI Committee (Dr. Sahni)

Dr. Sahni summarized the annual CARES (Cardiac Arrest Registry to Enhance Survival) report presented during the June QI Committee meeting.

Highlights included:

• Cardiac Arrest Outcomes
  • Clackamas County continues to outperform national benchmarks.
  • Current survival to hospital discharge is approximately 24%, compared to the national average of approximately 10.5%.
  • Nearly 90% of survivors are neurologically intact at discharge.
  • Approximately one in four cardiac arrest patients now survives to hospital discharge in Clackamas County.

Areas for Continued Improvement

• Increased bystander CPR participation.
  • Expanded public AED availability and utilization.
  • Continued dispatcher-assisted CPR.
  • Strong collaboration among PSAPs, law enforcement, fire agencies, EMS providers, hospitals, and Public Health.

These outcomes represent a community-wide success resulting from coordinated efforts across the entire emergency response system.

• Protocol Development Committee (Dr. Ritu Sahni)
  • Dr. Sahni reported that the Protocol Development Committee (PDC) is approximately 80% complete with the 2026 protocol revision process.
  • Clackamas County is serving as the lead agency for this year's protocol development cycle, with Dr. Sahni serving as Chair and Scott Lind (Lake Oswego Fire) serving as Vice Chair.
  • The committee will continue protocol review during the September and October PDC meetings, which are expected to conclude the remaining protocol work.
    • Several protocol proposals presented throughout the year were ultimately not adopted after committee review.
    • The committee has evolved into a strong multidisciplinary group that carefully evaluates evidence and is comfortable deciding when proposed changes are not necessary, rather than implementing changes simply for the sake of change.
  • Following completion of protocol revisions, the committee will transition to provider education beginning in October and continuing through November. Educational materials will be developed to support implementation of the new protocols.
  • Beginning next year, the annual protocol rollout is expected to move from the traditional first Monday in January to early February (either February 1 or the first Monday in February).
    • The implementation date was adjusted to provide EMS agencies additional time during January to complete education and competency training. 
• Operations Subcommittee (Brad Kuhn) 
  • The Operations Subcommittee continues to review EMS operational issues affecting system performance and coordinate with agency partners on system improvements.
  • Meeting schedule has changed to bi-monthly.
• System Enhancement Subcommittee (Justin Gold) 
  • Leadership has transitioned within AMR from Jason Mahle to Justing Gold and continues coordination among system partners.
• ESO Committee (Scott Vachter/Bill Steward) 
  • No update
• EMS Training Group/MAT (Justin Colvin/Dr. Sahni)
  • Fall MAT dates have been determined:
    • October 27-29 and November 3-5.
• EPAB/Emergency Physician Advisory Board (Dr. Sahni)
  • Nothing to report
• PSAP (Tina Burgess/Rachelle Herr – LOCOM/Tony Collins – CCOM)

Tony Collins – Clackamas 911 (CCOM)

• CCOM currently has three vacant positions and anticipates opening recruitment for additional call takers later this summer. 
  • Dispatch call volume has increased significantly since the Fourth of July holiday, with emergency call activity returning to typical summer levels following a slower June. 
  • The Behavioral Health Clinician Program has advanced to the second round of interviews for an overnight clinician position. 
    • Three candidates were scheduled to interview later that week to replace the previous overnight clinician who transferred to Wilsonville. 
    • Filling the position would restore seven-day-per-week behavioral health clinician coverage within the dispatch center. 

Rachelle Herr – LOCOM

• Communications center remains fully staffed. 
  • One newly hired dispatcher is currently completing training. 
  • No significant operational issues or system concerns were reported. 
• Labor Committee (Bill S/Mark O.) 
  • No update

Old Business:

• The EMS Council bylaws were updated to meet the new public meeting law.
  • Will be presented to the Board of County Commissioners for final approval on July 28th.
• To better support DA Wentworth’s Gold Standard Project on strangulation in Clackamas County, Canby Fire has completed their training.
  • Starting with smaller agencies then move to countywide participation.

New Business: 

Council members discussed several organizational updates, including:

• Formation of the AMR Contract Review Panel.
• Recognition of Jason Mahle's departure from AMR and introduction of Justin Gold as Interim Operations Manager. 

General Announcements 

• Dr. Sahni reported the initiation the of Field Nurse Navigation process.
  • Rollout to be by September.
• Upcoming EMS Council membership vacancies.
  • Appointment of a new System Enhancement Committee Chair.
  • Plans to elect a new EMS Council Vice Chair during the October meeting
• Justin Gold to have AMR present a review on the last 12 months and the Field Referral Process at the October meeting. 

Next Meeting:

• Next meeting will be October 19, 2026, at 9:00 am.

Adjourn: The meeting adjourned at approximately 10:16 am