Guest guest Posted April 7, 2006 Report Share Posted April 7, 2006 IF things were significantly better and the organization that governed us got all the money we put in, then I would be willing to discuss an increase in fees - but ONLY in that event. Jane Hill --------- 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 agreed RE: EMS Commission IF things were significantly better and the organization that governed us got all the money we put in, then I would be willing to discuss an increase in fees - but ONLY in that event. Jane Hill --------- 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 And in response to other sections of this thread, one thing that would HAVE to happen to support a Commission or whatever - one agency that runs us and nothing else - would be that the legislature would have to give all the EMS fees to EMS. Otherwise, there wouldn't be enough money to run it, period. THAT, my friends, is the biggest challenge of all - funding. Jane --------- 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 What DOES make an outstanding EMS education program? Perhaps we might start by identifying what we mean by an exemplary program. Anybody care to begin? Gene > 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 7, 2006 Report Share Posted April 7, 2006 BINGO! Direct hit. GG > 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 Gene, It's been a while since I took an EMT class, but I have spent a few hours on both sides of a classroom, so I'll throw some things out there (even if they aren't EMS specific). As a student, I want a class that is challenging mentally, where the instructors force me to engage them in expanding my capabilities. Make me think through problem solving, application of theory, research and lectures that aren't canned regurgitations of the power point slides. Tell me what you, the instructor know, not just what's in the book. Help me to learn not only what I need to know, but why I should know it and how to apply that knowledge in different situatuions. Lessons should include didactic, hands-on practicums that are monitored, and out of the classroom where I have to learn on my own (and get feedback afterwards from the instructor). As a teacher, I want students who want to be there because they want to learn. Students who will participate and engage in the learning experience as an active participant. I don't want a biological piece of furniture. As an empolyer, I want employees who I don't have to teach how to do their jobs, just how we do things on our shop (policies and procedures). I want staff who can think logically on their feet, make a decision and take ownership of their job. What does this look like in the real world of EMS education? I don't know. I'm thinking an academic based program that's part traditional emt/paramedic program, part liberal arts and part leadership. Also, throw in a little graduate program research and applied problem solving for good measure. Okay, Gene, I've tossed the first horseshoe in the pit, who's next? Barry -------------------------- Sent from my Wireless Handheld Re: EMS Commission What DOES make an outstanding EMS education program? Perhaps we might start by identifying what we mean by an exemplary program. Anybody care to begin? Gene > 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 8, 2006 Report Share Posted April 8, 2006 In a message dated 07-Apr-06 13:03:25 Central Daylight Time, preyn2@... writes: 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. now add in a registration fee per ambulance, handivan, transport car, fly car etc... and another one for the certification of an organization or program... And those can be a bit larger, even if it is a volunteer or county run organization... Maybe a surcharge on large public events which have an internal EMS response program...(it was such a surcharge that forced the WWF to become the WWE when NJ levied said tax on 'sporting events' to help cover the strain on the state and local responses to the mass crowds.) ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2006 Report Share Posted April 8, 2006 I am not anywhere on the commission, I'm still on a fact finding mission as i said in the last meeting before i make up my mind. One of my biggest concerns is cost and i know if we go to a commission my provider and certification fees will increase and our EMS budget will take a hit. I also don't want to see us go back to the state(commission) administering the certification exam, again because of cost the exam would not change regularly and the medics will know what the questions are before they sit to take it. If you think the state bend the rules because we are a large organization, WRONG. Luckily I work for an organization who expect us to read the rules, follow them, and hold us accountable. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2006 Report Share Posted April 8, 2006 OK, here are some approximate figures of potential income IF you COULD count all the $ that currently are collected by DSHS for EMS licensure/certification/provider licensure fees etc. Currently, the state is bringing in approximately $1.25 a year from this. There is some more money that comes in in penalties and fines, but it probably doesn't really cover the cost of the investigations. There is some small money that comes in from EMS education programs in the form of course approvals, but not a whopping amount enough to make a difference. The EMS conference and magazine basically have to be self-supporting and contribute nothing to general revenue or EMS revenue. Some money comes in from grants, but as we all know, the majority of that money goes to the hospitals and trauma, not for general funding. Now if there was a way to increase our part of the HB 3588 monies from 2% up to say 10 or 15%, we might could talk closer to the money we would need to do EITHER plan - form a c ommission or move DSHS BEM out of DSHS proper and make it a stand alone department and add back in what got gutted by HB 2292. (Just FYI, per what I understand, there is not one SINGLE EMS experienced person left in certification or enforcement - scary, huh - and there is only one left in the Austin central compliance office. There is another one in there who is EMT certified but she has never actually worked in EMS in the field. The salaries were also gutted with that bill meaning that they are playing heck trying to find experienced EMS people to fill vacant positions cause those people can make more money working EMS or other jobs that working for DSHS - now that is TRULY scary.) Anyway, the point is that whichever plan we decide is best, we STILL have to figure out how to fund it so we can make it better than what we have now. I think that we have to figure out a way to start small and work into bigger. But I am not sure how to go about that or what we would do to accomplish that and still take care of building a better organization to govern us. It takes somebody smarter than me to use this information, listen to everyone here and at GETAC and everywhere else involved, and figure out how to build something we can live with to start, how to get the monies secured for that, and then how to get access to more funding to build it better and better. I don't think just increasing cert and licensure fees will achieve that. Sooo... folks who are much smarter than me, it is your turn. Jane Hill -------------- Original message from maxifire@...: -------------- I am not anywhere on the commission, I'm still on a fact finding mission as i said in the last meeting before i make up my mind. One of my biggest concerns is cost and i know if we go to a commission my provider and certification fees will increase and our EMS budget will take a hit. I also don't want to see us go back to the state(commission) administering the certification exam, again because of cost the exam would not change regularly and the medics will know what the questions are before they sit to take it. If you think the state bend the rules because we are a large organization, WRONG. Luckily I work for an organization who expect us to read the rules, follow them, and hold us accountable. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2006 Report Share Posted April 8, 2006 If we were able to bring everything back together under DSHS again, what would prevent our gracious elected officials from breaking it up again??????? If we were organized as a stand alone agency, named what ever we like, it would be a whole lot harder for the government to break it up. wegandy1938@... wrote: 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 8, 2006 Report Share Posted April 8, 2006 Not really...and a fear I had when this came up last year...the fire commission, I believe TCLEOSE, and others all face sunset provisions when they are created...this means every few years the legislature has to decide to continue to have and fund a commission for whatever reason... If this comes up when there is surplus cash then the issue is usually moot and we move forward...but if it comes up during times of projected shortfalls (say like what happened in 2003...)...and if we came up at the same time as say the Fire Commission...and the choice was either or....not both...where could we end up? Under the fire commission, under the BME? the BNE?....shoved BACK into DSHS with little or no funding? Like Jane said earlier...we have to look past the excitment and joy and think 2, 5, even 10 years down the road...and how do we guarantee funding and support....for the long term. 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 8, 2006 Report Share Posted April 8, 2006 Whose is to say that if things stay the way they are now, the legislature will not decide in 2, 5, 10 years down the road to split up the EMS division even further? Anything is possible. THEDUDMAN@... wrote: Not really...and a fear I had when this came up last year...the fire commission, I believe TCLEOSE, and others all face sunset provisions when they are created...this means every few years the legislature has to decide to continue to have and fund a commission for whatever reason... If this comes up when there is surplus cash then the issue is usually moot and we move forward...but if it comes up during times of projected shortfalls (say like what happened in 2003...)...and if we came up at the same time as say the Fire Commission...and the choice was either or....not both...where could we end up? Under the fire commission, under the BME? the BNE?....shoved BACK into DSHS with little or no funding? Like Jane said earlier...we have to look past the excitment and joy and think 2, 5, even 10 years down the road...and how do we guarantee funding and support....for the long term. 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 8, 2006 Report Share Posted April 8, 2006 I have to agree with Dudley here - we HAVE to look and plan long-term. So, I KNOW some of you out here know a lot about funding issues - a lot about grants and federal support - a lot about ways to make even a Commission viable. And that is probably the BIGGEST issue that the legislature is looking at - how would we fund it either way? So now you folks out there with plain business and money making savvy need to chime in and help us figure this out. Question, it appears EMSAT is planning a meeting on May 18th in Austin, I think. Do we want to have this discussion as an agenda item just to have a place to discuss it? Are you going to discuss it at GETAC? Do the folks on the list and other folks you know who want to be involved want to have a separate meeting to discuss this? We have tried this before and didn't really accomplish much. This discussion seems to be going better for whatever reason, and I would like to see it continue in a larger forum. Whatever is going to be done, we need to start getting some definite pros and cons listed for the GETAC committee as well as ideas for ways to fund this thing if the pros outweigh the cons. Just my thoughts only.... Jane Hill --------- 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...
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