Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 The EMS Commission is definitely a worthwhile opportunity. Virtually every profession is granted the privilege of self-regulation by the government (i.e. State Bar, Texas Medical Board, Board of Professional Engineers, etc). However, in our rush to make this a reality, let's ensure that we don't inadvertently create something a lot worse than what we have. Here are several questions to ask about any potential legislation creating an EMS Commission: 1) What will be the composition of the Commission? 2) Will the legislation spell out qualifications for members of the Commission or of the executive director? 3) What powers/authority will the Commission have? (Statewide protocols, anyone?) 4) Will the Commission regulate individuals? EMS services? Both? 5) Perhaps most importantly, will the creation of an EMS Commission raise certification fees? (And will the volunteer exemption remain?) Just some points to ponder. Many other issues are out there as well. -Wes Ogilvie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 Okay....I got it now...I too had that fear but after the past 18 months...if there were to be any retribution for saying things (even some things really near inappropriate)...it would have happened....and my verbal issues were with Austin staff...not regional... Thanks for the clarification. Dudley Re: EMS Commission Is anyone confused out there but Dudley?? LOL I thought it was pretty clear what I said but maybe not. No, what I SAID was that folks come to people who they think will verbalize their complaints FOR them because they are afraid to say anything out loud themselves. They are afraid that they will be targeted if it gets back that THEY or THEIR company had issues about something that happened to them by or through DSHS representatives. Jane --------- EMS Commission Have we ever considered that the high burnout rate in our current EMS system might be linked to our current regulatory agency's inability to investigate complaints and enforce current regulations? Complaints are made to the DSHS and nothing is ever done about them. At what point do people just throw up their hands and say the hell with it. It is sad to see services that the administration could less about having units that are properly stocked. That have drug boxes/bags with unexpired medications. It is sad to hear that XYZ ambulance was shut down for fraud only to have the administrative folks open up a company under another name. It is sad to see individuals who were convicted of crimes while on duty and in a ambulance who are still in uniform. These people are representing themselves as EMS professionals. I have personally contacted the state several times about a administrator who refuses to keep medications current only to get a response of " Well I guess that we need to look into that " . Until we have a regulatory agency that is able to enforce the state regulation, we are not going to be seen as professionals. Folks it is time to contact your elected officials and let them know that Texas needs an EMS Commission. Call, write, email, send smoke signals, it does not matter how. Danny Denson, EMT-P Karnes County EMS Karnes City, Texas kcmedic904@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 OK folks, so the discussion Maxie pointed out needs to happen is now open. Folks, it is time to talk. It is time to step up to the plate. I opened the worm can - now, lets see what productive things we can come up with out of that can. Jane --------- EMS Commission Have we ever considered that the high burnout rate in our current EMS system might be linked to our current regulatory agency's inability to investigate complaints and enforce current regulations? Complaints are made to the DSHS and nothing is ever done about them. At what point do people just throw up their hands and say the hell with it. It is sad to see services that the administration could less about having units that are properly stocked. That have drug boxes/bags with unexpired medications. It is sad to hear that XYZ ambulance was shut down for fraud only to have the administrative folks open up a company under another name. It is sad to see individuals who were convicted of crimes while on duty and in a ambulance who are still in uniform. These people are representing themselves as EMS professionals. I have personally contacted the state several times about a administrator who refuses to keep medications current only to get a response of " Well I guess that we need to look into that " . Until we have a regulatory agency that is able to enforce the state regulation, we are not going to be seen as professionals. Folks it is time to contact your elected officials and let them know that Texas needs an EMS Commission. Call, write, email, send smoke signals, it does not matter how. Danny Denson, EMT-P Karnes County EMS Karnes City, Texas kcmedic904@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 Gene, I agree with you, but we have to place some blame on the individual. It time for us to stop making excuses and start becoming professional medics. We can began by treating our patients in a professional manner, and dressing accordingly. I know systems who furnish uniforms and these men and women are too lazy to wash and iron them and shine their shoes. A patient will usually see you before they talk to you, that first impression is your appearance. I'm sure there are medics who will say it they are really sick it doesn't matter what I look like, WRONG. The customer is not only your patient but there family members, neighbors and anyone else who see you riding and answering calls. I won't dwell on education, because some medics, not any of you reading this e-mail of course, still think education is getting your initial certification. If the state didn't mandate CE some of those medics would not take a course. I challenge each medic to become the best medic that he or she can be, take advantage of the classes being offered, read a book, or find and interesting topic on the internet. As I have said publicly I wish medics were required to have a degree in paramedicine, but I realize that is not possible at this time because of the reasons Gene has listed. Every medic can acquire knowledge and if you carry yourself as a profession and look like one, someone will recognize your talents and give you an opportunity to advance yourself. Education is not a four letter word, so stop acting like it's a curse to receive it. Maxie Bishop, LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 I'm not one to keep up with the threads on this list(too busy), however; this one is interesting since I, along with many others on the list were declared a EMS dinosaurs several years ago. I started in EMS in 1978. EMS in Texas has evolved over the last 30+ years into what we know as EMS today. We didn't get to today by ourselves, we as a trade (not profession, professionalism comes with education) had help from physicians, nurses, State and local civil defense, State health department, city and county governments, etc. Now we are wanting to emancipate ourselves from who and where we started and form a stand alone commission. I don't understand how EMS is that broken under the current DSHS organization. If you look at the updated (Feb 06.) org chart at http://www.dshs.state.tx.us/orgchart/default.shtm and click on the section discriptions you will find EMS under the Health Care Quality Section The four(4)HCQS sub-divisions all perform the same EMS duties that they did when they were under the former Bureau of Emergency Management and they still have the same Chief who is now the Director of the HCQS. Do they do everything right? Absolutely not! Who Does! I do know that both TECLOSE and the Fire Commission do not have the staff or the funding to do every single thing the Legislature mandates. This necessatates that some things are left undone. When I worked for DSHS we as staff felt the same way, not enough staff or funding, so things were put on the back burner. I personally will support an EMS Commission only if we don't forget to dance with the ones that got us to where are today. I just can't see that happening when I read the EMS Commission thread though. Solely my personal 0.2 cents worth. Shiplet > OK, not fair of me to ask such a non-answerable question. Let me pose it > this way.... > > What do you want a comission to do, that DSHS isn't doing or can't do? > Remember that funds are finite, and generally speaking no agency that can > fine for infractions gets to keep its fines. So, with user fees > (certifications and provider licenses) and funds dispersed by the > legislature being all you get, what do you want a commission to provide that > DSHS can't. > > Mike > > > EMS Commission > > > > > Have we ever considered that the high burnout rate in our current EMS > system might be linked to our current regulatory agency's inability to > investigate complaints and enforce current regulations? > > Complaints are made to the DSHS and nothing is ever done about them. > At > what point do people just throw up their hands and say the hell with it. > It > is sad to see services that the administration could less about having > units > that are properly stocked. That have drug boxes/bags with unexpired > medications. It is sad to hear that XYZ ambulance was shut down for fraud > only to have the administrative folks open up a company under another > name. > It is sad to see individuals who were convicted of crimes while on duty > and > in a ambulance who are still in uniform. These people are representing > themselves as EMS professionals. > > I have personally contacted the state several times about a > administrator who refuses to keep medications current only to get a > response > of " Well I guess that we need to look into that " . Until we have a > regulatory > agency that is able to enforce the state regulation, we are not going to > be > seen as professionals. > > Folks it is time to contact your elected officials and let them know > that Texas needs an EMS Commission. Call, write, email, send smoke > signals, > it does not matter how. > > > Danny Denson, EMT-P > Karnes County EMS > Karnes City, Texas > kcmedic904@... > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 Jane, I can understand some people not wanting to speak up, and I'm glad they have people like to representing and speaking on their behalf, God know if it wasn't for you speaking at many of the committee meetings there would not have been anything to discuss. Even though you and I may not have agreed on every issue, as i have told you in person I could always depend on you to have read the information before us and make comments. Thank you for you involvement I am attempting to work my way through these e-mails tonight as I work my second job and make some comments, something I feel free to do now that I'm not Chair of the Education Committee. I think the main point you make is that there are complaints being made and no one is following up from the state or at least they are not informing the person making the complaint what actions were taken, if any. As you know the EMS Magazine list many disciplinary actions so we know some things are being done. However, I think if a person takes the time to make a complaint they should receive a response for the state, particularly if they include their name, email or postal address. Lets address that at GETAC in May. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 Maxie, I couldn't agree more. I was trying to say, and may not have said it as well as you, that it is up to each individual medic to be a professional. I am not a professional because I am a lawyer; I am a lawyer because I am a professional. I hope I am also a medical professional, as I know you and many others are. When a person completes the initial training and education and becomes certified or licensed, that person is at the threshold of professionalism. It is what happens after that that determines whether one is a professional or a tradesman. Even a journeyman tradesman continues to grow and learn throughout his working life. In the medical professions it is even more important to continue to learn and grow for the obvious reason: we have the power to kill. A part of building a true profession is, in my mind, having a professional regulatory body dedicated solely to our profession, able to govern and support us in the most efficient way, and without competing interests both budgetary and in staffing. That's why I support the EMS Commission. Nursing has such an organization, as do the other major professions. We are not now a major profession, but we must begin at some point to build a professional structure. Why not now? Gene G. > Gene, > I agree with you, but we have to place some blame on the individual.  It > time for us to stop making excuses and start becoming professional medics. > We > can began by treating our patients in a professional manner, and dressing > accordingly. I know systems who furnish uniforms and these men and women > are too > lazy to wash and iron them and shine their shoes. A patient will usually > see you before they talk to you, that first impression is your appearance. > I'm > sure there are medics who will say it they are really sick it doesn't > matter > what I look like, WRONG. The customer is not only your patient but there > family members, neighbors and anyone else who see you riding and answering > calls. > > I won't dwell on education, because some medics, not any of you reading > this > e-mail of course, still think education is getting your initial > certification. If the state didn't mandate CE some of those medics would > not take a > course. I challenge each medic to become the best medic that he or she can > be, > take advantage of the classes being offered, read a book, or find and > interesting topic on the internet. As I have said publicly I wish medics > were > required to have a degree in paramedicine, but I realize that is not > possible at > this time because of the reasons Gene has listed. > > Every medic can acquire knowledge and if you carry yourself as a profession > and look like one, someone will recognize your talents and give you an > opportunity to advance yourself. Education is not a four letter word, so > stop > acting like it's a curse to receive it.     > > Maxie Bishop, LP > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 Well, I will come out of the shadows (OK, I'm never very far into the shadows), and voice some problems that in my estimation exist with DSHS. DSHS lacks sufficient staff to carry out its regulatory functions adequately. I am quite confident in making the statement that licensed providers are not being regulated adequately. There are simply not enough regulators to go around. The caseload is impossible for those tasked with this regulation to manage. There must be an agency with enough trained staff to do provider oversight correctly. Second, the disciplinary process used by DSHS is in shambles. There are not enough professional investigators. Investigations tend to be subjective rather than objective, and too often minor violations are treated as major while major violations receive little notice. Staff are not adequately familiar with administrative code procedures, so that sometimes the department is on the edge of violating the rights of alleged violators. There must be a professional investigative staff with adequate legal support to carry out disciplinary procedures in a timely and fair fashion. A regional peer review system similar to those in medicine and law would also help to cull out those violations that do not need heavy handed action. Third, education programs need more support. EMS education programs are, in my judgment, the poorest they have been overall in the last 15 years. After losing the opportunity to enact real professional education and training requirements, the department seems to have thrown up its hands in the area of support to EMS education. The result is that pass rates on the NREMT exams are lower than the national average and many students who have completed initial training programs simply do not have the minimum didactic knowledge, psychomotor and affective skills, and ability to think critically necessary to pass the MINIMUM requirements of NREMT. Why do I think a free standing EMS Commission would be able to carry out these duties better than DSHS? Because DSHS's structure is fragmented. What is needed is one cohesive commission, with commission members dedicated to EMS, a commissioner with extensive experience in delivery of EMS, and an adequate staff reporting to ONE boss. At DSHS there are too many lines of authority, and the ultimate seat of power is far too far removed from the troops. The process of regulation has too many layers, and the Board of Health is too many steps removed from GETAC. Ideally, GETAC would be melded together with the EMS Commission, and the buck would stop there. We must cut out the layers of bureaucracy between us and the decision maker, and we must distill the regulatory practices in to simple, clear lines of authority with adequate, trained staff, to carry them out. OK. Fire away. Gene Gandy > Well that is a start I guess. And, yes, there are lots of listings in the > back of the magazine - and that is yet another problem as I understand it. > However, I was really hoping some folks would stop lurking in the shadows and > lets start laying out the list of problems SOMEWHERE. If not here, then > somewhere. That is the only way we can see what is not being addressed or not > being addressed properly or JUST NEEDS TO GO AWAY! I have never minded speaking > out. But I really wish more folks would speak out and not be so afraid to do > that. I am still here - no one has buried me under TDH/DSHS yet - although > I suspect they would love to at times. LOL > > Folks, come on. What else is going on? Why do we need a Commission? What > do we need done with the current situation? Is it really all that bad? Is > it really all that good? Is it fixable as is? > > I am tired tonight so I better not ramble anymore right now. > > Jane Hill > > -------------- Original message from maxifire@...: -------------- > > Jane, > I can understand some people not wanting to speak up, and I'm glad they > have > people like to representing and speaking on their behalf, God know if it > wasn't for you speaking at many of the committee meetings there would not > have > been anything to discuss. Even though you and I may not have agreed on > every > issue, as i have told you in person I could always depend on you to have > read > the information before us and make comments. Thank you for you involvement > > I am attempting to work my way through these e-mails tonight as I work my > second job and make some comments, something I feel free to do now that I'm > not > Chair of the Education Committee. I think the main point you make is that > there are complaints being made and no one is following up from the state > or > at least they are not informing the person making the complaint what > actions > were taken, if any. > > As you know the EMS Magazine list many disciplinary actions so we know some > things are being done. However, I think if a person takes the time to make > a > complaint they should receive a response for the state, particularly if > they > include their name, email or postal address. Lets address that at GETAC in > May.  > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 Gene, What is the guarantee that the staffing of an EMS Commission will be any better, we know the staffing of DSHS is what it is because of budget cuts. As for as regulation, the laws are there and we must do our best as a provider to follow the law and when we don't, in the metroplex I can say, the Arlington office is there. It's like any other regulatory agency. Also since the 100% background checks it has been brought to our attention that we have some medics with legal issues in the past and we are addressing them with cooperation of the state, How many speeders, drunk drivers, nurse, doctors, etc break the law before they get caught. An EMS Commission will not catch every incident, therefore providers like anyone else are expected to follow the laws and when the get caught well the lawyers (not directed at you ) will do the re thing to get them off. It's up to the providers to make sure their medics are following the law. Medic should also report the provider who is cutting corners. They should call Jane, I know she will deliver the message. Yes some EMS Programs are performing poorly, however there are some in the state who are performing above the national average. Lets identify those successful programs to the ones who are performing poorly, maybe they can network and help the poorer programs improve. I guess what I'm saying is regardless of what the governing agency is called if the medics, providers, instructors, medical directors, etc don't work with the governing body there will always be problems. I'm working too many Hours. I'll see you guys in Austin in May. I would have a drink in the hotel with you but I'm afraid the state will have left Dallas and returned to Austin to rest us. Lastly, " cohesive commission " , well let me say I would define that as an oxymoron. (yes I'm Laughing) Love you Man. Maxie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 Maxie, While there might not be enough budget for an adequate staff, at least doing away with the fragmentation and simplifying the chain of command would be an improvement. Let's compare, for example the new FEMA with the old one. The new one is only a box in the organizational chart of Homeland Insecurity. That's roughly where the EMS Office is at DSHS. FEMA's effectiveness was decimated when it was placed under HSA. It needs to be an independent agency again. Same with the EMS Office. We a need a Commissioner who reports directly to the Governor, not to 5 levels of bureaucrats. Without breaking confidences, I think I can tell you that many staffers at DSHS go to work each day dreading it, whereas they used to love to go to work. The morale in the whole agency is in the ditch. At one time the Bureau of Emergency Management was an efficiently run machine, and it got the job done. Now it struggles to get the job done, not because the staffers have somehow gone bad, but because they are working under impossible circumstances. Let's give them a chance. Let's give them back their agency. It will take time to rebuild what the Governor and the Lege has destroyed, but if we can make the Legislature see that this is not working, we just might get an effective agency out of the process. There are many chasms to be breached before this will happen, the first and most important of which is funding. The EMS Commission must be able to keep the money it makes from fees. That idea is about as popular as a rattlesnake in the bed with legislators. But we have to try to make them understand. That will take all of us working in concert if it gets done. I'm not optimistic. But it IS possible. Isn't it? Now, I like your idea about identifying exemplary educational programs. That's a great idea. But who is going to make the determination of what an exemplary program is? If you look at NREMT results, you will get one view of what " success " means, but is that truly the best measure? When Harvard University Medical School and other prestigious medical schools switched to problem based learning (I hope you all know what that means) their graduates actually did poorer on national boards than the did before the change, but by all measures, those graduates were better practitioners because they had developed the critical thinking skills that PBL teaches and requires. So I would want to be very careful about the measurement to be used in identifying exemplary programs. Certainly national accreditation is not a meaningful indicator any more than regional accreditation of a college degree program is. Anybody can shuffle the papers and make themselves look good long enough for the site visitors to leave. So how would we go about identifying the exemplary program? I have some ideas, but they're too voluminous to list here. Best, Gene > Gene, > What is the guarantee that the staffing of an EMS Commission will be any > better, we know the staffing of DSHS is what it is because of budget cuts.  > > As for as regulation, the laws are there and we must do our best as a > provider to follow the law and when we don't, in the metroplex I can say, > the > Arlington office is there. It's like any other regulatory agency. Also > since > the 100% background checks it has been brought to our attention that we > have > some medics with legal issues in the past and we are addressing them with > cooperation of the state, How many speeders, drunk drivers, nurse, > doctors, etc > break the law before they get caught. An EMS Commission will not catch > every > incident, therefore providers like anyone else are expected to follow the > laws and when the get caught well the lawyers (not directed at you ) will > do the > re thing to get them off.  It's up to the providers to make sure their > medics are following the law. Medic should also report the provider who is > cutting corners. They should call Jane, I know she will deliver the > message. > > Yes some EMS Programs are performing poorly, however there are some in the > state who are performing above the national average. Lets identify those > successful programs to the ones who are performing poorly, maybe they can > network > and help the poorer programs improve.  > > I guess what I'm saying is regardless of what the governing agency is > called > if the medics, providers, instructors, medical directors, etc don't work > with the governing body there will always be problems. I'm working too many > Hours. I'll see you guys in Austin in May. I would have a drink in the > hotel > with you but I'm afraid the state will have left Dallas and returned to > Austin > to rest us. > > Lastly, " cohesive commission " , well let me say I would define that as an > oxymoron. (yes I'm Laughing) Love you Man. > Maxie > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 Well that is a start I guess. And, yes, there are lots of listings in the back of the magazine - and that is yet another problem as I understand it. However, I was really hoping some folks would stop lurking in the shadows and lets start laying out the list of problems SOMEWHERE. If not here, then somewhere. That is the only way we can see what is not being addressed or not being addressed properly or JUST NEEDS TO GO AWAY! I have never minded speaking out. But I really wish more folks would speak out and not be so afraid to do that. I am still here - no one has buried me under TDH/DSHS yet - although I suspect they would love to at times. LOL Folks, come on. What else is going on? Why do we need a Commission? What do we need done with the current situation? Is it really all that bad? Is it really all that good? Is it fixable as is? I am tired tonight so I better not ramble anymore right now. Jane Hill -------------- Original message from maxifire@...: -------------- Jane, I can understand some people not wanting to speak up, and I'm glad they have people like to representing and speaking on their behalf, God know if it wasn't for you speaking at many of the committee meetings there would not have been anything to discuss. Even though you and I may not have agreed on every issue, as i have told you in person I could always depend on you to have read the information before us and make comments. Thank you for you involvement I am attempting to work my way through these e-mails tonight as I work my second job and make some comments, something I feel free to do now that I'm not Chair of the Education Committee. I think the main point you make is that there are complaints being made and no one is following up from the state or at least they are not informing the person making the complaint what actions were taken, if any. As you know the EMS Magazine list many disciplinary actions so we know some things are being done. However, I think if a person takes the time to make a complaint they should receive a response for the state, particularly if they include their name, email or postal address. Lets address that at GETAC in May. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 Dudley, You make some good points. I'm not welded to any one model. There is more than one way to peel a banana. I mentioned National Registry results because that's something that is often mentioned as a benchmark. I don't believe that it's the best benchmark. It is only one. There is something to be said for using the existing structure of HHS as the framework. But I don't know how well it would work. I'm very suspicious of bureaucratic creep and that GETAC would still get lost in the spaghetti of DSHS. All these ideas can be discussed and debated. At least, we now seem to be of a mind to pursue this rather than simply arguing about status quo vs. a new commission. Gene > Gene, > > I don't want to put words in Maxie's mouth...but in your previous post you > used National Registry success as a measure of a successful training > program...that is, I believe, why his suggestion was to use that as a measuring stick > to identify the best programs...plus it is data we currently have. > > It would be great to use more appropriate measures to choose the best > programs...but like all things its time and money...both of which we have VERY > little of anymore...and the well is getting drier...not wetter... > > Sit down a minute Gene... > > I agree with you...a GREAT solution is to bring all the EMS pieces back > under one roof but I would leave it under DSHS and have GETAC still report to the > HHS Commission...but directly to it...not going through 2, 3, 12 > steps...this allows us to suck off the bearucratic teet and not have to re-create > support and M & O functions that DSHS has in abundance not only in Austin but in each > public health region (HR, legal, secretary pools, transportation, finance, > budgeting, purchasing, etc). > > I also agree that the money we spend on certifications and licensing should > ALL go back to DSHS - EMS and that money could go along way to restoring > staff that has been lost in the past...and providing more resources to step up > the regulation and enforcement pieces... > > NOW...all this being said, I would like to remind us all about some things > that have occurred in the last 4 years (besides the DSHS re-org) that have and > are currently taxing the staff and resources of the EMS function...and would > even if it was free-standing...remember 9/11? That changed the face of EMS > AND EMS regulation...and then, more recently...A couple of lovely ladies > known as Katrina and Rita...and the largest evacuation in the State's > history...plus the largest influx of refugees in our history...all of which are still > being dealt with even today at the regulatory and emergency management > levels...I truly don't think we could expect any regulatory body to staff at a level > to be able to handle these three life and society changing events adequately > when these events haven't happened....and since Texas is in a wicked 2-year > budgeting cycle...rapid changes and reappropriations are not in the > dictionary...it is tough with a one year budget to handle some of the things we have > been asked to handle (and front-finance for FEMA) in a small EMS agency...can't > imagine what it is like up the food-chain. > > BTW, having worked with FEMA in the 90's during my tenure in the Hurricane > Target known as Florida...I can tell you that effectiveness and FEMA were not > associated even back then... > > Dudley > > > Re: EMS Commission > > > Maxie, > > While there might not be enough budget for an adequate staff, at least doing > away with the fragmentation and simplifying the chain of command would be an > improvement.  > > Let's compare, for example the new FEMA with the old one.  The new one is > only a box in the organizational chart of Homeland Insecurity.  That's > roughly > where the EMS Office is at DSHS. > > FEMA's effectiveness was decimated when it was placed under HSA.  It needs > to be an independent agency again.  Same with the EMS Office.  We a need a > Commissioner who reports directly to the Governor, not to 5 levels of > bureaucrats.  > > Without breaking confidences, I think I can tell you that many staffers at > DSHS go to work each day dreading it, whereas they used to love to go to > work.  > > The morale in the whole agency is in the ditch. > > At one time the Bureau of Emergency Management was an efficiently run > machine, and it got the job done.  Now it struggles to get the job done, > not > because > the staffers have somehow gone bad, but because they are working under > impossible circumstances. > > Let's give them a chance.  Let's give them back their agency.  It will > take > time to rebuild what the Governor and the Lege has destroyed, but if we can > make the Legislature see that this is not working, we just might get an > effective agency out of the process. > > There are many chasms to be breached before this will happen, the first and > most important of which is funding.  The EMS Commission must be able to > keep > the money it makes from fees.  That idea is about as popular as a > rattlesnake > in the bed with legislators.  But we have to try to make them understand.  > That will take all of us working in concert if it gets done. > > I'm not optimistic.  But it IS possible.  Isn't it? > > Now, I like your idea about identifying exemplary educational programs.  > That's a great idea.  But who is going to make the determination of what an > exemplary program is?  If you look at NREMT results, you will get one view > of > what " success " means, but is that truly the best measure?  > > When Harvard University Medical School and other prestigious medical schools > switched to problem based learning (I hope you all know what that means) > their > graduates actually did poorer on national boards than the did before the > change, but by all measures, those graduates were better practitioners > because > they had developed the critical thinking skills that PBL teaches and > requires. > > So I would want to be very careful about the measurement to be used in > identifying exemplary programs.  Certainly national accreditation is not a > meaningful indicator any more than regional accreditation of a college > degree > program > is.  Anybody can shuffle the papers and make themselves look good long > enough > for the site visitors to leave.  So how would we go about identifying the > exemplary program?  I have some ideas, but they're too voluminous to list > here. > > Best, > Gene > > > > > Gene, > > What is the guarantee that the staffing of an EMS Commission will be any > > better, we know the staffing of DSHS is what it is because of budget > cuts. > > > > As for as regulation, the laws are there and we must do our best as a > > provider to follow the law and when we don't, in the metroplex I can > say, > > the > > Arlington office is there. It's like any other regulatory agency. Also > > since > > the 100% background checks it has been brought to our attention that we > > have > > some medics with legal issues in the past and we are addressing them with > > cooperation of the state, How many speeders, drunk drivers, nurse, > > doctors, etc > > break the law before they get caught. An EMS Commission will not catch > > every > > incident, therefore providers like anyone else are expected to follow the > > laws and when the get caught well the lawyers (not directed at you ) will > > do the > > re thing to get them off.  It's up to the providers to make sure their > > medics are following the law. Medic should also report the provider who > is > > cutting corners. They should call Jane, I know she will deliver the > > message. > > > > Yes some EMS Programs are performing poorly, however there are some in the > > state who are performing above the national average. Lets identify those > > successful programs to the ones who are performing poorly, maybe they can > > network > > and help the poorer programs improve. > > > > I guess what I'm saying is regardless of what the governing agency is > > called > > if the medics, providers, instructors, medical directors, etc don't work > > with the governing body there will always be problems. I'm working too > many > > Hours. I'll see you guys in Austin in May. I would have a drink in the > > hotel > > with you but I'm afraid the state will have left Dallas and returned to > > Austin > > to rest us. > > > > Lastly, " cohesive commission " , well let me say I would define that as an > > oxymoron. (yes I'm Laughing) Love you Man. > > Maxie > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 You are correct Dudley, I only used the NR because that is the reference Gene made in his post. We can identify these programs and you are correct Gene we must look at many areas of the successful programs. Maybe that program is successful because they have instructors who motivate their students to learn,or that program only accepts students who have had a college level English, Math, and Anatomy courses. Whatever makes them stand out we need to identify what it and see if it will work in other systems throughout the state, if not are there viable alternatives. It's time to raise the bar, not only for EMS but for education in Texas, I can tell you that one problem is some of these students can't read at a high school level. I'll get off that soap box Gene and I have talked enough for one night. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2006 Report Share Posted April 6, 2006 Gene, I don't want to put words in Maxie's mouth...but in your previous post you used National Registry success as a measure of a successful training program...that is, I believe, why his suggestion was to use that as a measuring stick to identify the best programs...plus it is data we currently have. It would be great to use more appropriate measures to choose the best programs...but like all things its time and money...both of which we have VERY little of anymore...and the well is getting drier...not wetter... Sit down a minute Gene... I agree with you...a GREAT solution is to bring all the EMS pieces back under one roof but I would leave it under DSHS and have GETAC still report to the HHS Commission...but directly to it...not going through 2, 3, 12 steps...this allows us to suck off the bearucratic teet and not have to re-create support and M & O functions that DSHS has in abundance not only in Austin but in each public health region (HR, legal, secretary pools, transportation, finance, budgeting, purchasing, etc). I also agree that the money we spend on certifications and licensing should ALL go back to DSHS - EMS and that money could go along way to restoring staff that has been lost in the past...and providing more resources to step up the regulation and enforcement pieces... NOW...all this being said, I would like to remind us all about some things that have occurred in the last 4 years (besides the DSHS re-org) that have and are currently taxing the staff and resources of the EMS function...and would even if it was free-standing...remember 9/11? That changed the face of EMS AND EMS regulation...and then, more recently...A couple of lovely ladies known as Katrina and Rita...and the largest evacuation in the State's history...plus the largest influx of refugees in our history...all of which are still being dealt with even today at the regulatory and emergency management levels...I truly don't think we could expect any regulatory body to staff at a level to be able to handle these three life and society changing events adequately when these events haven't happened....and since Texas is in a wicked 2-year budgeting cycle...rapid changes and reappropriations are not in the dictionary...it is tough with a one year budget to handle some of the things we have been asked to handle (and front-finance for FEMA) in a small EMS agency...can't imagine what it is like up the food-chain. BTW, having worked with FEMA in the 90's during my tenure in the Hurricane Target known as Florida...I can tell you that effectiveness and FEMA were not associated even back then... Dudley Re: EMS Commission Maxie, While there might not be enough budget for an adequate staff, at least doing away with the fragmentation and simplifying the chain of command would be an improvement. Let's compare, for example the new FEMA with the old one. The new one is only a box in the organizational chart of Homeland Insecurity. That's roughly where the EMS Office is at DSHS. FEMA's effectiveness was decimated when it was placed under HSA. It needs to be an independent agency again. Same with the EMS Office. We a need a Commissioner who reports directly to the Governor, not to 5 levels of bureaucrats. Without breaking confidences, I think I can tell you that many staffers at DSHS go to work each day dreading it, whereas they used to love to go to work. The morale in the whole agency is in the ditch. At one time the Bureau of Emergency Management was an efficiently run machine, and it got the job done. Now it struggles to get the job done, not because the staffers have somehow gone bad, but because they are working under impossible circumstances. Let's give them a chance. Let's give them back their agency. It will take time to rebuild what the Governor and the Lege has destroyed, but if we can make the Legislature see that this is not working, we just might get an effective agency out of the process. There are many chasms to be breached before this will happen, the first and most important of which is funding. The EMS Commission must be able to keep the money it makes from fees. That idea is about as popular as a rattlesnake in the bed with legislators. But we have to try to make them understand. That will take all of us working in concert if it gets done. I'm not optimistic. But it IS possible. Isn't it? Now, I like your idea about identifying exemplary educational programs. That's a great idea. But who is going to make the determination of what an exemplary program is? If you look at NREMT results, you will get one view of what " success " means, but is that truly the best measure? When Harvard University Medical School and other prestigious medical schools switched to problem based learning (I hope you all know what that means) their graduates actually did poorer on national boards than the did before the change, but by all measures, those graduates were better practitioners because they had developed the critical thinking skills that PBL teaches and requires. So I would want to be very careful about the measurement to be used in identifying exemplary programs. Certainly national accreditation is not a meaningful indicator any more than regional accreditation of a college degree program is. Anybody can shuffle the papers and make themselves look good long enough for the site visitors to leave. So how would we go about identifying the exemplary program? I have some ideas, but they're too voluminous to list here. Best, Gene > Gene, > What is the guarantee that the staffing of an EMS Commission will be any > better, we know the staffing of DSHS is what it is because of budget cuts. > > As for as regulation, the laws are there and we must do our best as a > provider to follow the law and when we don't, in the metroplex I can say, > the > Arlington office is there. It's like any other regulatory agency. Also > since > the 100% background checks it has been brought to our attention that we > have > some medics with legal issues in the past and we are addressing them with > cooperation of the state, How many speeders, drunk drivers, nurse, > doctors, etc > break the law before they get caught. An EMS Commission will not catch > every > incident, therefore providers like anyone else are expected to follow the > laws and when the get caught well the lawyers (not directed at you ) will > do the > re thing to get them off. It's up to the providers to make sure their > medics are following the law. Medic should also report the provider who is > cutting corners. They should call Jane, I know she will deliver the > message. > > Yes some EMS Programs are performing poorly, however there are some in the > state who are performing above the national average. Lets identify those > successful programs to the ones who are performing poorly, maybe they can > network > and help the poorer programs improve. > > I guess what I'm saying is regardless of what the governing agency is > called > if the medics, providers, instructors, medical directors, etc don't work > with the governing body there will always be problems. I'm working too many > Hours. I'll see you guys in Austin in May. I would have a drink in the > hotel > with you but I'm afraid the state will have left Dallas and returned to > Austin > to rest us. > > Lastly, " cohesive commission " , well let me say I would define that as an > oxymoron. (yes I'm Laughing) Love you Man. > Maxie > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 I have remained one of the silent ones as I have in the past banged my head upon the wall fighting an issue with the former TDH EMS department and found that the leadership along with certain recognized individuals throughout the state had already made the decision and the public forums were just a required formality. Therefore, it tends to lay waste to those that may bring something to the table. Thus, the silent majority. In this case, Mr. Shiplet brings the right idea to the table. If I may paraphrase, stop re-inventing the wheel. In this case, DSHS EMS is the inside tire on a dual tire axle. You never pay any attention to it unless it blows out or you think there is a problem because of noise or vibration. Forget a separate commission and bring the current DSHS EMS department out from among the DSHS bureaucracy and let it stand alone. It has one boss, not several sub bosses, funds and fees collected go to them expressly, they will have their own budget and not fighting multiple internal departments for their share. And then, we can stop this NR nonsense and administer and maintain our own examination system that is more appropriate to our state and helps realize properly, knowledge based trained medics, not book smart test takers without a lick of common sense. Not to mention the self policing capabilities that could be created without a lot of micro-managed approvals. Let's not make the same mistake that GDEM is making with this Regional Unified Command structure. It is creating what is already in place, namely the Disaster District Chairman, but due to what looks like an internal effort, GDEM wants to have all decision making in one office. Will a commission work? Just as Mr. Shiplet offered, the Texas Fire Commission and TECLOSE are examples. Maybe not perfect, but I feel a good starting template to draw from. (Joke: template, draw. Oh well, I thought it was good anyway.) And in the spirit of April 15th, this is my 2 cents before taxes. Chuck , EMT-P Alleyton, Texas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 First of all, you are not going to change DSHS. Not going to happen! Please somebody at least admit that point. What would lead anyone to believe that DSHS will do anything but continue to cut cost, raise fees and deliver less product. It not about the personnel at DSHS, its about the complete system. We can ride this horse until it drops dead under us or, or, or we can try and make a change now. A change that we will play a role in forming, good bad or whatever, we will have more input than we do now. Even at the beginning if the funding is not what it should be, we will not be any worse off than we are right now. We get absolutely nothing for the money we put in. You know, Gene puts into words a more reasoned reply. I believe in getting right to the point, were not getting nuthun now so lets change. Maxie, I respect your opinion, but you are where I was last year in regards to a commission. Things may be different in your perspective being that you are from a very large system that DSHS bends for somewhat. Last year before all the changes I too did not believe we needed a commission. I have since changed my mind. GETAC is made up of a great bunch of folks, but they can only suggest. We have all been to meetings where everyone wanted to do something different and TDH, DSHS stood up and said that we would not be able to do so because of staff this or staff that. That's because they are not our staff, they are DSHS staff that does what DSHS wants. Henry THEDUDMAN@... wrote: > Gene, > > I don't want to put words in Maxie's mouth...but in your previous post > you used National Registry success as a measure of a successful > training program...that is, I believe, why his suggestion was to use > that as a measuring stick to identify the best programs...plus it is > data we currently have. > > It would be great to use more appropriate measures to choose the best > programs...but like all things its time and money...both of which we > have VERY little of anymore...and the well is getting drier...not > wetter... > > Sit down a minute Gene... > > I agree with you...a GREAT solution is to bring all the EMS pieces > back under one roof but I would leave it under DSHS and have GETAC > still report to the HHS Commission...but directly to it...not going > through 2, 3, 12 steps...this allows us to suck off the bearucratic > teet and not have to re-create support and M & O functions that DSHS has > in abundance not only in Austin but in each public health region (HR, > legal, secretary pools, transportation, finance, budgeting, > purchasing, etc). > > I also agree that the money we spend on certifications and licensing > should ALL go back to DSHS - EMS and that money could go along way to > restoring staff that has been lost in the past...and providing more > resources to step up the regulation and enforcement pieces... > > NOW...all this being said, I would like to remind us all about some > things that have occurred in the last 4 years (besides the DSHS > re-org) that have and are currently taxing the staff and resources of > the EMS function...and would even if it was free-standing...remember > 9/11? That changed the face of EMS AND EMS regulation...and then, > more recently...A couple of lovely ladies known as Katrina and > Rita...and the largest evacuation in the State's history...plus the > largest influx of refugees in our history...all of which are still > being dealt with even today at the regulatory and emergency management > levels...I truly don't think we could expect any regulatory body to > staff at a level to be able to handle these three life and society > changing events adequately when these events haven't happened....and > since Texas is in a wicked 2-year budgeting cycle...rapid changes and > reappropriations are not in the dictionary...it is tough with a one > year budget to handle some of the things we have been asked to handle > (and front-finance for FEMA) in a small EMS agency...can't imagine > what it is like up the food-chain. > > BTW, having worked with FEMA in the 90's during my tenure in the > Hurricane Target known as Florida...I can tell you that effectiveness > and FEMA were not associated even back then... > > Dudley > > > Re: EMS Commission > > > Maxie, > > While there might not be enough budget for an adequate staff, at least > doing > away with the fragmentation and simplifying the chain of command would > be an > improvement. > > Let's compare, for example the new FEMA with the old one. The new > one is > only a box in the organizational chart of Homeland Insecurity. > That's roughly > where the EMS Office is at DSHS. > > FEMA's effectiveness was decimated when it was placed under HSA. It > needs > to be an independent agency again. Same with the EMS Office. We a > need a > Commissioner who reports directly to the Governor, not to 5 levels of > bureaucrats. > > Without breaking confidences, I think I can tell you that many > staffers at > DSHS go to work each day dreading it, whereas they used to love to go > to work. > > The morale in the whole agency is in the ditch. > > At one time the Bureau of Emergency Management was an efficiently run > machine, and it got the job done. Now it struggles to get the job > done, not > because > the staffers have somehow gone bad, but because they are working under > > impossible circumstances. > > Let's give them a chance. Let's give them back their agency. It > will take > time to rebuild what the Governor and the Lege has destroyed, but if > we can > make the Legislature see that this is not working, we just might get > an > effective agency out of the process. > > There are many chasms to be breached before this will happen, the > first and > most important of which is funding. The EMS Commission must be able > to keep > the money it makes from fees. That idea is about as popular as a > rattlesnake > in the bed with legislators. But we have to try to make them > understand. > That will take all of us working in concert if it gets done. > > I'm not optimistic. But it IS possible. Isn't it? > > Now, I like your idea about identifying exemplary educational > programs. > That's a great idea. But who is going to make the determination of > what an > exemplary program is? If you look at NREMT results, you will get one > view of > what " success " means, but is that truly the best measure? > > When Harvard University Medical School and other prestigious medical > schools > switched to problem based learning (I hope you all know what that > means) their > graduates actually did poorer on national boards than the did before > the > change, but by all measures, those graduates were better practitioners > because > they had developed the critical thinking skills that PBL teaches and > requires. > > So I would want to be very careful about the measurement to be used in > > identifying exemplary programs. Certainly national accreditation is > not a > meaningful indicator any more than regional accreditation of a college > degree > program > is. Anybody can shuffle the papers and make themselves look good > long enough > for the site visitors to leave. So how would we go about identifying > the > exemplary program? I have some ideas, but they're too voluminous to > list here. > > Best, > Gene > > > > > Gene, > > What is the guarantee that the staffing of an EMS Commission will be > any > > better, we know the staffing of DSHS is what it is because of budget > cuts. > > > > As for as regulation, the laws are there and we must do our best as > a > > provider to follow the law and when we don't, in the metroplex I > can say, > > the > > Arlington office is there. It's like any other regulatory agency. > Also > > since > > the 100% background checks it has been brought to our attention > that we > > have > > some medics with legal issues in the past and we are addressing > them with > > cooperation of the state, How many speeders, drunk drivers, nurse, > > > doctors, etc > > break the law before they get caught. An EMS Commission will not > catch > > every > > incident, therefore providers like anyone else are expected to > follow the > > laws and when the get caught well the lawyers (not directed at you > ) will > > do the > > re thing to get them off. It's up to the providers to make sure > their > > medics are following the law. Medic should also report the > provider who is > > cutting corners. They should call Jane, I know she will deliver > the > > message. > > > > Yes some EMS Programs are performing poorly, however there are some > in the > > state who are performing above the national average. Lets identify > those > > successful programs to the ones who are performing poorly, maybe > they can > > network > > and help the poorer programs improve. > > > > I guess what I'm saying is regardless of what the governing agency > is > > called > > if the medics, providers, instructors, medical directors, etc don't > work > > with the governing body there will always be problems. I'm working > too many > > Hours. I'll see you guys in Austin in May. I would have a drink > in the > > hotel > > with you but I'm afraid the state will have left Dallas and > returned to > > Austin > > to rest us. > > > > Lastly, " cohesive commission " , well let me say I would define that > as an > > oxymoron. (yes I'm Laughing) Love you Man. > > Maxie > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 Here's one question: The legislature often requires licensing commissions to be self-supporting from license fees and penalties. Does this mean our certifications would increase in price? -Wes Re: EMS Commission > > > Maxie, > > While there might not be enough budget for an adequate staff, at least > doing > away with the fragmentation and simplifying the chain of command would > be an > improvement. > > Let's compare, for example the new FEMA with the old one. The new > one is > only a box in the organizational chart of Homeland Insecurity. > That's roughly > where the EMS Office is at DSHS. > > FEMA's effectiveness was decimated when it was placed under HSA. It > needs > to be an independent agency again. Same with the EMS Office. We a > need a > Commissioner who reports directly to the Governor, not to 5 levels of > bureaucrats. > > Without breaking confidences, I think I can tell you that many > staffers at > DSHS go to work each day dreading it, whereas they used to love to go > to work. > > The morale in the whole agency is in the ditch. > > At one time the Bureau of Emergency Management was an efficiently run > machine, and it got the job done. Now it struggles to get the job > done, not > because > the staffers have somehow gone bad, but because they are working under > > impossible circumstances. > > Let's give them a chance. Let's give them back their agency. It > will take > time to rebuild what the Governor and the Lege has destroyed, but if > we can > make the Legislature see that this is not working, we just might get > an > effective agency out of the process. > > There are many chasms to be breached before this will happen, the > first and > most important of which is funding. The EMS Commission must be able > to keep > the money it makes from fees. That idea is about as popular as a > rattlesnake > in the bed with legislators. But we have to try to make them > understand. > That will take all of us working in concert if it gets done. > > I'm not optimistic. But it IS possible. Isn't it? > > Now, I like your idea about identifying exemplary educational > programs. > That's a great idea. But who is going to make the determination of > what an > exemplary program is? If you look at NREMT results, you will get one > view of > what " success " means, but is that truly the best measure? > > When Harvard University Medical School and other prestigious medical > schools > switched to problem based learning (I hope you all know what that > means) their > graduates actually did poorer on national boards than the did before > the > change, but by all measures, those graduates were better practitioners > because > they had developed the critical thinking skills that PBL teaches and > requires. > > So I would want to be very careful about the measurement to be used in > > identifying exemplary programs. Certainly national accreditation is > not a > meaningful indicator any more than regional accreditation of a college > degree > program > is. Anybody can shuffle the papers and make themselves look good > long enough > for the site visitors to leave. So how would we go about identifying > the > exemplary program? I have some ideas, but they're too voluminous to > list here. > > Best, > Gene > > > > > Gene, > > What is the guarantee that the staffing of an EMS Commission will be > any > > better, we know the staffing of DSHS is what it is because of budget > cuts. > > > > As for as regulation, the laws are there and we must do our best as > a > > provider to follow the law and when we don't, in the metroplex I > can say, > > the > > Arlington office is there. It's like any other regulatory agency. > Also > > since > > the 100% background checks it has been brought to our attention > that we > > have > > some medics with legal issues in the past and we are addressing > them with > > cooperation of the state, How many speeders, drunk drivers, nurse, > > > doctors, etc > > break the law before they get caught. An EMS Commission will not > catch > > every > > incident, therefore providers like anyone else are expected to > follow the > > laws and when the get caught well the lawyers (not directed at you > ) will > > do the > > re thing to get them off. It's up to the providers to make sure > their > > medics are following the law. Medic should also report the > provider who is > > cutting corners. They should call Jane, I know she will deliver > the > > message. > > > > Yes some EMS Programs are performing poorly, however there are some > in the > > state who are performing above the national average. Lets identify > those > > successful programs to the ones who are performing poorly, maybe > they can > > network > > and help the poorer programs improve. > > > > I guess what I'm saying is regardless of what the governing agency > is > > called > > if the medics, providers, instructors, medical directors, etc don't > work > > with the governing body there will always be problems. I'm working > too many > > Hours. I'll see you guys in Austin in May. I would have a drink > in the > > hotel > > with you but I'm afraid the state will have left Dallas and > returned to > > Austin > > to rest us. > > > > Lastly, " cohesive commission " , well let me say I would define that > as an > > oxymoron. (yes I'm Laughing) Love you Man. > > Maxie > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 This brings me back to the point of raising Provider fees. Why fund an organization on the backs of the Certificants, when you can do it on the employers. Re: EMS Commission > > > Maxie, > > While there might not be enough budget for an adequate staff, at least > doing > away with the fragmentation and simplifying the chain of command would > be an > improvement. > > Let's compare, for example the new FEMA with the old one. The new > one is > only a box in the organizational chart of Homeland Insecurity. > That's roughly > where the EMS Office is at DSHS. > > FEMA's effectiveness was decimated when it was placed under HSA. It > needs > to be an independent agency again. Same with the EMS Office. We a > need a > Commissioner who reports directly to the Governor, not to 5 levels of > bureaucrats. > > Without breaking confidences, I think I can tell you that many > staffers at > DSHS go to work each day dreading it, whereas they used to love to go > to work. > > The morale in the whole agency is in the ditch. > > At one time the Bureau of Emergency Management was an efficiently run > machine, and it got the job done. Now it struggles to get the job > done, not > because > the staffers have somehow gone bad, but because they are working under > > impossible circumstances. > > Let's give them a chance. Let's give them back their agency. It > will take > time to rebuild what the Governor and the Lege has destroyed, but if > we can > make the Legislature see that this is not working, we just might get > an > effective agency out of the process. > > There are many chasms to be breached before this will happen, the > first and > most important of which is funding. The EMS Commission must be able > to keep > the money it makes from fees. That idea is about as popular as a > rattlesnake > in the bed with legislators. But we have to try to make them > understand. > That will take all of us working in concert if it gets done. > > I'm not optimistic. But it IS possible. Isn't it? > > Now, I like your idea about identifying exemplary educational > programs. > That's a great idea. But who is going to make the determination of > what an > exemplary program is? If you look at NREMT results, you will get one > view of > what " success " means, but is that truly the best measure? > > When Harvard University Medical School and other prestigious medical > schools > switched to problem based learning (I hope you all know what that > means) their > graduates actually did poorer on national boards than the did before > the > change, but by all measures, those graduates were better practitioners > because > they had developed the critical thinking skills that PBL teaches and > requires. > > So I would want to be very careful about the measurement to be used in > > identifying exemplary programs. Certainly national accreditation is > not a > meaningful indicator any more than regional accreditation of a college > degree > program > is. Anybody can shuffle the papers and make themselves look good > long enough > for the site visitors to leave. So how would we go about identifying > the > exemplary program? I have some ideas, but they're too voluminous to > list here. > > Best, > Gene > > > > > Gene, > > What is the guarantee that the staffing of an EMS Commission will be > any > > better, we know the staffing of DSHS is what it is because of budget > cuts. > > > > As for as regulation, the laws are there and we must do our best as > a > > provider to follow the law and when we don't, in the metroplex I > can say, > > the > > Arlington office is there. It's like any other regulatory agency. > Also > > since > > the 100% background checks it has been brought to our attention > that we > > have > > some medics with legal issues in the past and we are addressing > them with > > cooperation of the state, How many speeders, drunk drivers, nurse, > > > doctors, etc > > break the law before they get caught. An EMS Commission will not > catch > > every > > incident, therefore providers like anyone else are expected to > follow the > > laws and when the get caught well the lawyers (not directed at you > ) will > > do the > > re thing to get them off. It's up to the providers to make sure > their > > medics are following the law. Medic should also report the > provider who is > > cutting corners. They should call Jane, I know she will deliver > the > > message. > > > > Yes some EMS Programs are performing poorly, however there are some > in the > > state who are performing above the national average. Lets identify > those > > successful programs to the ones who are performing poorly, maybe > they can > > network > > and help the poorer programs improve. > > > > I guess what I'm saying is regardless of what the governing agency > is > > called > > if the medics, providers, instructors, medical directors, etc don't > work > > with the governing body there will always be problems. I'm working > too many > > Hours. I'll see you guys in Austin in May. I would have a drink > in the > > hotel > > with you but I'm afraid the state will have left Dallas and > returned to > > Austin > > to rest us. > > > > Lastly, " cohesive commission " , well let me say I would define that > as an > > oxymoron. (yes I'm Laughing) Love you Man. > > Maxie > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 Henry, I'll bite here...what is it you would like DSHS to do for you? We don't get " nuthun " ...so what are some things you would like to see? Dudley Re: EMS Commission > > > Maxie, > > While there might not be enough budget for an adequate staff, at least > doing > away with the fragmentation and simplifying the chain of command would > be an > improvement. > > Let's compare, for example the new FEMA with the old one. The new > one is > only a box in the organizational chart of Homeland Insecurity. > That's roughly > where the EMS Office is at DSHS. > > FEMA's effectiveness was decimated when it was placed under HSA. It > needs > to be an independent agency again. Same with the EMS Office. We a > need a > Commissioner who reports directly to the Governor, not to 5 levels of > bureaucrats. > > Without breaking confidences, I think I can tell you that many > staffers at > DSHS go to work each day dreading it, whereas they used to love to go > to work. > > The morale in the whole agency is in the ditch. > > At one time the Bureau of Emergency Management was an efficiently run > machine, and it got the job done. Now it struggles to get the job > done, not > because > the staffers have somehow gone bad, but because they are working under > > impossible circumstances. > > Let's give them a chance. Let's give them back their agency. It > will take > time to rebuild what the Governor and the Lege has destroyed, but if > we can > make the Legislature see that this is not working, we just might get > an > effective agency out of the process. > > There are many chasms to be breached before this will happen, the > first and > most important of which is funding. The EMS Commission must be able > to keep > the money it makes from fees. That idea is about as popular as a > rattlesnake > in the bed with legislators. But we have to try to make them > understand. > That will take all of us working in concert if it gets done. > > I'm not optimistic. But it IS possible. Isn't it? > > Now, I like your idea about identifying exemplary educational > programs. > That's a great idea. But who is going to make the determination of > what an > exemplary program is? If you look at NREMT results, you will get one > view of > what " success " means, but is that truly the best measure? > > When Harvard University Medical School and other prestigious medical > schools > switched to problem based learning (I hope you all know what that > means) their > graduates actually did poorer on national boards than the did before > the > change, but by all measures, those graduates were better practitioners > because > they had developed the critical thinking skills that PBL teaches and > requires. > > So I would want to be very careful about the measurement to be used in > > identifying exemplary programs. Certainly national accreditation is > not a > meaningful indicator any more than regional accreditation of a college > degree > program > is. Anybody can shuffle the papers and make themselves look good > long enough > for the site visitors to leave. So how would we go about identifying > the > exemplary program? I have some ideas, but they're too voluminous to > list here. > > Best, > Gene > > > > > Gene, > > What is the guarantee that the staffing of an EMS Commission will be > any > > better, we know the staffing of DSHS is what it is because of budget > cuts. > > > > As for as regulation, the laws are there and we must do our best as > a > > provider to follow the law and when we don't, in the metroplex I > can say, > > the > > Arlington office is there. It's like any other regulatory agency. > Also > > since > > the 100% background checks it has been brought to our attention > that we > > have > > some medics with legal issues in the past and we are addressing > them with > > cooperation of the state, How many speeders, drunk drivers, nurse, > > > doctors, etc > > break the law before they get caught. An EMS Commission will not > catch > > every > > incident, therefore providers like anyone else are expected to > follow the > > laws and when the get caught well the lawyers (not directed at you > ) will > > do the > > re thing to get them off. It's up to the providers to make sure > their > > medics are following the law. Medic should also report the > provider who is > > cutting corners. They should call Jane, I know she will deliver > the > > message. > > > > Yes some EMS Programs are performing poorly, however there are some > in the > > state who are performing above the national average. Lets identify > those > > successful programs to the ones who are performing poorly, maybe > they can > > network > > and help the poorer programs improve. > > > > I guess what I'm saying is regardless of what the governing agency > is > > called > > if the medics, providers, instructors, medical directors, etc don't > work > > with the governing body there will always be problems. I'm working > too many > > Hours. I'll see you guys in Austin in May. I would have a drink > in the > > hotel > > with you but I'm afraid the state will have left Dallas and > returned to > > Austin > > to rest us. > > > > Lastly, " cohesive commission " , well let me say I would define that > as an > > oxymoron. (yes I'm Laughing) Love you Man. > > Maxie > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 It's about consistency and strong leadership. That's what has been missing a long time in Texas EMS. It's not that those in DSHS command/management positions are not good leaders, it's that the overall structure and bureaucracy will not allow them to lead as they should. Strong direction and leadership is what is needed over reorganizing a bureaucracy. -MH >>> ems@... 4/7/2006 8:41 am >>> I have remained one of the silent ones as I have in the past banged my head upon the wall fighting an issue with the former TDH EMS department and found that the leadership along with certain recognized individuals throughout the state had already made the decision and the public forums were just a required formality. Therefore, it tends to lay waste to those that may bring something to the table. Thus, the silent majority. In this case, Mr. Shiplet brings the right idea to the table. If I may paraphrase, stop re-inventing the wheel. In this case, DSHS EMS is the inside tire on a dual tire axle. You never pay any attention to it unless it blows out or you think there is a problem because of noise or vibration. Forget a separate commission and bring the current DSHS EMS department out from among the DSHS bureaucracy and let it stand alone. It has one boss, not several sub bosses, funds and fees collected go to them expressly, they will have their own budget and not fighting multiple internal departments for their share. And then, we can stop this NR nonsense and administer and maintain our own examination system that is more appropriate to our state and helps realize properly, knowledge based trained medics, not book smart test takers without a lick of common sense. Not to mention the self policing capabilities that could be created without a lot of micro-managed approvals. Let's not make the same mistake that GDEM is making with this Regional Unified Command structure. It is creating what is already in place, namely the Disaster District Chairman, but due to what looks like an internal effort, GDEM wants to have all decision making in one office. Will a commission work? Just as Mr. Shiplet offered, the Texas Fire Commission and TECLOSE are examples. Maybe not perfect, but I feel a good starting template to draw from. (Joke: template, draw. Oh well, I thought it was good anyway.) And in the spirit of April 15th, this is my 2 cents before taxes. Chuck , EMT-P Alleyton, Texas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 Dudley, I was not being specific. I stated that it was not an employee issue. Its really more of where we are going to be down the road. But here are a few examples. 1. I did not have a problem with certification fees when TDH was doing the testing and the certification. Now they get a fee for a service they really did not provide. I don't want to hear about over head. The cost for overhead if nothing else should have gone down. 2. Try and call your area rep and see if they can take care of a problem immediately that falls within someone elses job that is not really within EMS. 3. Long term employees don't seem to exist any longer. We are having to talk to folks that don't know much about EMS and when they finally learn that move in to some other state job. 4. I can remember the days when the state did much of the training all the testing and then to cut cost it became coordinators jobs and then that started to get away from them and some belt tightning was done with more regulation that they could not enforce. 5.then the meetings where Rules crippled the voices in the audience who were then allowed to speak after the vote. I hope I raised enough hell at those meeting to be able to take a little credit for that being changed. 6.Then came along concensus which is in many ways great but a few are allowed to drag that process down. My point is this: Over the years changes have been made with most in the Favor of TDH and not EMS. Our own commission will have only one agenda and that will be EMS. If you know a fella is getting ready to slap the crap out of you, you don't wait until he does to do something. If there were a way, which I know there isn't. you could actually talk to each and evey provider, ECA, EMT, Paramedic both paid and private I think you would find over the years that you would be able to write a book about TDH and things folks didn't like. I fear Dudley that you are convinced that you don't see the need for a commission and no matter what anyone says they don't like would be enough to convince you. That Ok because you like me each are entitled to our opinion. I just don't see the state being effective for ems over the years that I have been involved with them (1972-present). I have had some great friends that work for TDH , Gene Weatherall, Kathy Perkins, Jim Arnold, Jay Garner, Rothy Mosley, Steve Hanneman, Posada and others. I don't think they take my comments personally. The state has just not been effective and in our favor because their hands were tied. Henry THEDUDMAN@... wrote: > Henry, > > I'll bite here...what is it you would like DSHS to do for you? We > don't get " nuthun " ...so what are some things you would like to see? > > Dudley > > Re: EMS Commission > > > > > > Maxie, > > > > While there might not be enough budget for an adequate staff, at > least > > doing > > away with the fragmentation and simplifying the chain of command > would > > be an > > improvement. > > > > Let's compare, for example the new FEMA with the old one. The new > > one is > > only a box in the organizational chart of Homeland Insecurity. > > That's roughly > > where the EMS Office is at DSHS. > > > > FEMA's effectiveness was decimated when it was placed under HSA. > It > > needs > > to be an independent agency again. Same with the EMS Office. We > a > > need a > > Commissioner who reports directly to the Governor, not to 5 levels > of > > bureaucrats. > > > > Without breaking confidences, I think I can tell you that many > > staffers at > > DSHS go to work each day dreading it, whereas they used to love to > go > > to work. > > > > The morale in the whole agency is in the ditch. > > > > At one time the Bureau of Emergency Management was an efficiently > run > > machine, and it got the job done. Now it struggles to get the job > > done, not > > because > > the staffers have somehow gone bad, but because they are working > under > > > > impossible circumstances. > > > > Let's give them a chance. Let's give them back their agency. It > > will take > > time to rebuild what the Governor and the Lege has destroyed, but if > > > we can > > make the Legislature see that this is not working, we just might get > > > an > > effective agency out of the process. > > > > There are many chasms to be breached before this will happen, the > > first and > > most important of which is funding. The EMS Commission must be > able > > to keep > > the money it makes from fees. That idea is about as popular as a > > rattlesnake > > in the bed with legislators. But we have to try to make them > > understand. > > That will take all of us working in concert if it gets done. > > > > I'm not optimistic. But it IS possible. Isn't it? > > > > Now, I like your idea about identifying exemplary educational > > programs. > > That's a great idea. But who is going to make the determination of > > > what an > > exemplary program is? If you look at NREMT results, you will get > one > > view of > > what " success " means, but is that truly the best measure? > > > > When Harvard University Medical School and other prestigious medical > > > schools > > switched to problem based learning (I hope you all know what that > > means) their > > graduates actually did poorer on national boards than the did before > > > the > > change, but by all measures, those graduates were better > practitioners > > because > > they had developed the critical thinking skills that PBL teaches and > > > requires. > > > > So I would want to be very careful about the measurement to be used > in > > > > identifying exemplary programs. Certainly national accreditation > is > > not a > > meaningful indicator any more than regional accreditation of a > college > > degree > > program > > is. Anybody can shuffle the papers and make themselves look good > > long enough > > for the site visitors to leave. So how would we go about > identifying > > the > > exemplary program? I have some ideas, but they're too voluminous > to > > list here. > > > > Best, > > Gene > > > > > > > > > Gene, > > > What is the guarantee that the staffing of an EMS Commission will > be > > any > > > better, we know the staffing of DSHS is what it is because of > budget > > cuts. > > > > > > As for as regulation, the laws are there and we must do our best > as > > a > > > provider to follow the law and when we don't, in the metroplex I > > can say, > > > the > > > Arlington office is there. It's like any other regulatory > agency. > > Also > > > since > > > the 100% background checks it has been brought to our attention > > that we > > > have > > > some medics with legal issues in the past and we are addressing > > them with > > > cooperation of the state, How many speeders, drunk drivers, > nurse, > > > > > doctors, etc > > > break the law before they get caught. An EMS Commission will not > > > catch > > > every > > > incident, therefore providers like anyone else are expected to > > follow the > > > laws and when the get caught well the lawyers (not directed at > you > > ) will > > > do the > > > re thing to get them off. It's up to the providers to make > sure > > their > > > medics are following the law. Medic should also report the > > provider who is > > > cutting corners. They should call Jane, I know she will deliver > > the > > > message. > > > > > > Yes some EMS Programs are performing poorly, however there are > some > > in the > > > state who are performing above the national average. Lets identify > > > those > > > successful programs to the ones who are performing poorly, maybe > > they can > > > network > > > and help the poorer programs improve. > > > > > > I guess what I'm saying is regardless of what the governing agency > > > is > > > called > > > if the medics, providers, instructors, medical directors, etc > don't > > work > > > with the governing body there will always be problems. I'm working > > > too many > > > Hours. I'll see you guys in Austin in May. I would have a drink > > in the > > > hotel > > > with you but I'm afraid the state will have left Dallas and > > returned to > > > Austin > > > to rest us. > > > > > > Lastly, " cohesive commission " , well let me say I would define > that > > as an > > > oxymoron. (yes I'm Laughing) Love you Man. > > > Maxie > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 Thanks Henry, This is good information and pretty specific...I like that. I will take exception to your comments...I have not made up my mind as to a Commission or not a Commission...I was and am against the concept that was forwarded to the legislature last session as it was not well thought out or written... I see a need to change and improve what we have now...of course there is always need for improvement...my concern is this phantom " EMS Commission " is seen as panacea for the future of EMS...and the things that alot of people are upset about with DSHS are the result of state bureaucracy...and that will still exist with an EMS Commission, EMS Overlord, or EMS Office within the DSHS structure.... My desire, like those of others on here, is to start hearing what the specific issues are (like the ones you shared below) so that when the folks who start crafting an improvement get busy...they don't just repackage the same problems into a new box. Who else? Henry has stepped up....what else does an EMS regulatory group/agency need to do or be set up for? What problems would you not want to see re-created in the future? Dudley Re: EMS Commission > > > > > > Maxie, > > > > While there might not be enough budget for an adequate staff, at > least > > doing > > away with the fragmentation and simplifying the chain of command > would > > be an > > improvement. > > > > Let's compare, for example the new FEMA with the old one. The new > > one is > > only a box in the organizational chart of Homeland Insecurity. > > That's roughly > > where the EMS Office is at DSHS. > > > > FEMA's effectiveness was decimated when it was placed under HSA. > It > > needs > > to be an independent agency again. Same with the EMS Office. We > a > > need a > > Commissioner who reports directly to the Governor, not to 5 levels > of > > bureaucrats. > > > > Without breaking confidences, I think I can tell you that many > > staffers at > > DSHS go to work each day dreading it, whereas they used to love to > go > > to work. > > > > The morale in the whole agency is in the ditch. > > > > At one time the Bureau of Emergency Management was an efficiently > run > > machine, and it got the job done. Now it struggles to get the job > > done, not > > because > > the staffers have somehow gone bad, but because they are working > under > > > > impossible circumstances. > > > > Let's give them a chance. Let's give them back their agency. It > > will take > > time to rebuild what the Governor and the Lege has destroyed, but if > > > we can > > make the Legislature see that this is not working, we just might get > > > an > > effective agency out of the process. > > > > There are many chasms to be breached before this will happen, the > > first and > > most important of which is funding. The EMS Commission must be > able > > to keep > > the money it makes from fees. That idea is about as popular as a > > rattlesnake > > in the bed with legislators. But we have to try to make them > > understand. > > That will take all of us working in concert if it gets done. > > > > I'm not optimistic. But it IS possible. Isn't it? > > > > Now, I like your idea about identifying exemplary educational > > programs. > > That's a great idea. But who is going to make the determination of > > > what an > > exemplary program is? If you look at NREMT results, you will get > one > > view of > > what " success " means, but is that truly the best measure? > > > > When Harvard University Medical School and other prestigious medical > > > schools > > switched to problem based learning (I hope you all know what that > > means) their > > graduates actually did poorer on national boards than the did before > > > the > > change, but by all measures, those graduates were better > practitioners > > because > > they had developed the critical thinking skills that PBL teaches and > > > requires. > > > > So I would want to be very careful about the measurement to be used > in > > > > identifying exemplary programs. Certainly national accreditation > is > > not a > > meaningful indicator any more than regional accreditation of a > college > > degree > > program > > is. Anybody can shuffle the papers and make themselves look good > > long enough > > for the site visitors to leave. So how would we go about > identifying > > the > > exemplary program? I have some ideas, but they're too voluminous > to > > list here. > > > > Best, > > Gene > > > > > > > > > Gene, > > > What is the guarantee that the staffing of an EMS Commission will > be > > any > > > better, we know the staffing of DSHS is what it is because of > budget > > cuts. > > > > > > As for as regulation, the laws are there and we must do our best > as > > a > > > provider to follow the law and when we don't, in the metroplex I > > can say, > > > the > > > Arlington office is there. It's like any other regulatory > agency. > > Also > > > since > > > the 100% background checks it has been brought to our attention > > that we > > > have > > > some medics with legal issues in the past and we are addressing > > them with > > > cooperation of the state, How many speeders, drunk drivers, > nurse, > > > > > doctors, etc > > > break the law before they get caught. An EMS Commission will not > > > catch > > > every > > > incident, therefore providers like anyone else are expected to > > follow the > > > laws and when the get caught well the lawyers (not directed at > you > > ) will > > > do the > > > re thing to get them off. It's up to the providers to make > sure > > their > > > medics are following the law. Medic should also report the > > provider who is > > > cutting corners. They should call Jane, I know she will deliver > > the > > > message. > > > > > > Yes some EMS Programs are performing poorly, however there are > some > > in the > > > state who are performing above the national average. Lets identify > > > those > > > successful programs to the ones who are performing poorly, maybe > > they can > > > network > > > and help the poorer programs improve. > > > > > > I guess what I'm saying is regardless of what the governing agency > > > is > > > called > > > if the medics, providers, instructors, medical directors, etc > don't > > work > > > with the governing body there will always be problems. I'm working > > > too many > > > Hours. I'll see you guys in Austin in May. I would have a drink > > in the > > > hotel > > > with you but I'm afraid the state will have left Dallas and > > returned to > > > Austin > > > to rest us. > > > > > > Lastly, " cohesive commission " , well let me say I would define > that > > as an > > > oxymoron. (yes I'm Laughing) Love you Man. > > > Maxie > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 Figuring 55,000 certificants at $100 each for a four year certification/license, that's $5.5 million for 4 years, or $1,370,000 per year. Bear in mind that while, from my perspective, $1.4 million samoleans seems like a big pile of money, it's only a drop in the bucket of what I think a state EMS commission would need. Also, let me point out that the $1.4 mil assumes EVERYBODY in Texas EMS is a Paramedic and NOBODY receives a volunteer exemption, neither of which is a valid assumption. Therefore, if we decide to support an EMS commission with license/cert fees, they would have to increase. Somebody with some knowledge in the area of provider license fees chime in here and let us know what those fees are (today's costs) and how many organizations pay those fees. phil --- ExLngHrn@... wrote: > Here's one question: > > The legislature often requires licensing > commissions to be self-supporting from license > fees and penalties. Does this mean our > certifications would increase in price? > > -Wes __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 Phil you are also assuming the agency would get ALL of the $100 per certificant...and not just part of it. Dudley Re: EMS Commission Figuring 55,000 certificants at $100 each for a four year certification/license, that's $5.5 million for 4 years, or $1,370,000 per year. Bear in mind that while, from my perspective, $1.4 million samoleans seems like a big pile of money, it's only a drop in the bucket of what I think a state EMS commission would need. Also, let me point out that the $1.4 mil assumes EVERYBODY in Texas EMS is a Paramedic and NOBODY receives a volunteer exemption, neither of which is a valid assumption. Therefore, if we decide to support an EMS commission with license/cert fees, they would have to increase. Somebody with some knowledge in the area of provider license fees chime in here and let us know what those fees are (today's costs) and how many organizations pay those fees. phil --- ExLngHrn@... wrote: > Here's one question: > > The legislature often requires licensing > commissions to be self-supporting from license > fees and penalties. Does this mean our > certifications would increase in price? > > -Wes __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 Your last statement regarding accreditation is very accurate. I have seen some very good accredited programs in various disciplines. And I have seen some very bad ones too - still accredited. Accreditation will do NOTHING to help improve the education of our EMS folks. Jane Hill -------------- Original message from wegandy1938@...: -------------- Maxie, While there might not be enough budget for an adequate staff, at least doing away with the fragmentation and simplifying the chain of command would be an improvement. Let's compare, for example the new FEMA with the old one. The new one is only a box in the organizational chart of Homeland Insecurity. That's roughly where the EMS Office is at DSHS. FEMA's effectiveness was decimated when it was placed under HSA. It needs to be an independent agency again. Same with the EMS Office. We a need a Commissioner who reports directly to the Governor, not to 5 levels of bureaucrats. Without breaking confidences, I think I can tell you that many staffers at DSHS go to work each day dreading it, whereas they used to love to go to work. The morale in the whole agency is in the ditch. At one time the Bureau of Emergency Management was an efficiently run machine, and it got the job done. Now it struggles to get the job done, not because the staffers have somehow gone bad, but because they are working under impossible circumstances. Let's give them a chance. Let's give them back their agency. It will take time to rebuild what the Governor and the Lege has destroyed, but if we can make the Legislature see that this is not working, we just might get an effective agency out of the process. There are many chasms to be breached before this will happen, the first and most important of which is funding. The EMS Commission must be able to keep the money it makes from fees. That idea is about as popular as a rattlesnake in the bed with legislators. But we have to try to make them understand. That will take all of us working in concert if it gets done. I'm not optimistic. But it IS possible. Isn't it? Now, I like your idea about identifying exemplary educational programs. That's a great idea. But who is going to make the determination of what an exemplary program is? If you look at NREMT results, you will get one view of what " success " means, but is that truly the best measure? When Harvard University Medical School and other prestigious medical schools switched to problem based learning (I hope you all know what that means) their graduates actually did poorer on national boards than the did before the change, but by all measures, those graduates were better practitioners because they had developed the critical thinking skills that PBL teaches and requires. So I would want to be very careful about the measurement to be used in identifying exemplary programs. Certainly national accreditation is not a meaningful indicator any more than regional accreditation of a college degree program is. Anybody can shuffle the papers and make themselves look good long enough for the site visitors to leave. So how would we go about identifying the exemplary program? I have some ideas, but they're too voluminous to list here. Best, Gene > Gene, > What is the guarantee that the staffing of an EMS Commission will be any > better, we know the staffing of DSHS is what it is because of budget cuts. > > As for as regulation, the laws are there and we must do our best as a > provider to follow the law and when we don't, in the metroplex I can say, > the > Arlington office is there. It's like any other regulatory agency. Also > since > the 100% background checks it has been brought to our attention that we > have > some medics with legal issues in the past and we are addressing them with > cooperation of the state, How many speeders, drunk drivers, nurse, > doctors, etc > break the law before they get caught. An EMS Commission will not catch > every > incident, therefore providers like anyone else are expected to follow the > laws and when the get caught well the lawyers (not directed at you ) will > do the > re thing to get them off. It's up to the providers to make sure their > medics are following the law. Medic should also report the provider who is > cutting corners. They should call Jane, I know she will deliver the > message. > > Yes some EMS Programs are performing poorly, however there are some in the > state who are performing above the national average. Lets identify those > successful programs to the ones who are performing poorly, maybe they can > network > and help the poorer programs improve. > > I guess what I'm saying is regardless of what the governing agency is > called > if the medics, providers, instructors, medical directors, etc don't work > with the governing body there will always be problems. I'm working too many > Hours. I'll see you guys in Austin in May. I would have a drink in the > hotel > with you but I'm afraid the state will have left Dallas and returned to > Austin > to rest us. > > Lastly, " cohesive commission " , well let me say I would define that as an > oxymoron. (yes I'm Laughing) Love you Man. > Maxie > > > Quote Link to comment Share on other sites More sharing options...
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