November 4, 2009



x Mr. Bartlett x Mr. Quirk x Interim Chief Myers
x Mr. Britton x Mr. Takacs x Mr. Long
x Mr. Brotzman x Mr. Wayman x Mr. Murray

MINUTES of: 10/07/09 Regular Session
Motion by: Mr. Quirk, Seconded by: Mr. Britton to approve as presented.
ROLL CALL: All ayes

Bills and Payroll:
Bills ($72,073.12) and payroll (113,163.08) totaling $185,236.20 are motioned for acceptance and payment.
Motion by: Mr. Brotzman, Seconded by: Mr. Takacs

Opening Public Portion:
No public comment.

Committee Reports:

Station #1:
The bay heater is not working (30,000 btu heat exchanger is cracked) and needs to be replaced. Mr. Britton purposed a newer, more efficient heater, 225,000 btu at a cost of $2,900.
Motion by: Mr. Brotzman, Seconded by: Mr. Bartlett
ROLL CALL: All ayes

Station #2:
Heating tube is cracked on unit. Penguin will forward pricing and replace.

Station #3:
Mr. Britton reported that Penguin Heating winterized St. #3 ($200).

New Training/Storage Building @ Station #1:
Mr. Britton reported that the new plans for this building are completed. For clarification purposes, the building will be situated 10’ off the curb behind Studio 45 and 2’ north of generator behind Station #1. He also reported that the county wants 6” x 6” angle iron welded around the bay doors. County also wants commercial grade man-doors installed. Britton will check with Eric Haibach for an explanation as to why these two specifications are necessary. Work schedule is as follows:

Cutting footer trench Friday, November 6, 2009
Footer cutout/poured Monday, November 9, 2009
Block Friday, November 13, 2009
Building Monday, November 16, 2009

Mr. Britton reported that he will call John Hopkins to install posts around new generators (previously contracted company did not show).

Nothing to report.

The November 4th meeting was not needed and was cancelled.

The November 18th Part Time Labor Management meeting needs to be delayed because various committee members will be out of town or otherwise unavailable. Greg Henry agreed and the meeting was rescheduled for December 2, 2009, 6:00pm at Village Hall.

Nothing to report.

Nothing to report

New Business:
Mr. Long presented Resolution No. 09-030 for adoption establishing the rate of pay for the Part Time Officers ($15.00/hr-effective 7/1/09). This resolution covers all Part Time Officers who are not covered by the union (includes future increases).
Motion by: Mr. Bartlett, Seconded by: Mr. Quirk
ROLL CALL: All ayes

Per Mr. Britton, the November 18, 2009 Regular Fire Board meeting needs to be cancelled because various board members will be out of town or otherwise unavailable. Next meeting will be December 2, 2009, 7:30pm at Village Hall.
Motion by: Mr. Britton, Seconded by: Mr. Quirk
ROLL CALL: All ayes

1) Lantern of Madison – Hazardous Material Incident – Monday, November 2, 2009, 12:12 -
Odor reported was determined to be a mixture of a cleaning product and hydraulic fluid in an elevator shaft (1900+ gallons). Township Police Department, Township Administration, Lake County Health Department, Lake County HazMat, Lake County EMA, Lake Tran, Community Care and mutual aid from countless departments from 2 counties were on scene and 41 residents were evacuated in less than 1 hour with no complaints or injuries. Residents were ultimately returned within 24 hours.

Per Myers, the owner/administrator of the Lantern, Jean Makesh, had a good plan in place for housing and meeting the needs of the residents. Myers commended him for his extra efforts and reported that he was a “role model for other facilities”.

2) Automatic Mutual Aid – Interim Chief Myers reported that the Thompson Fire Department is on board as of 11/1/09. He handed out an Automatic Mutual Aid Overview for board review. Summary as follows:

*Initial response for structure fires north of Middle Ridge Road supplied by Madison Fire District, Perry Fire District, Geneva Fire Department, Harpersfield Fire Department and Leroy Fire Department total 21 personnel, 7 vehicles and 5,212 gallons of water.

*Initial response for structure fires for Middle Ridge Road and southern locations supplied by Madison Fire District, Perry Fire District, Geneva Fire Department, Harpersfield Fire Department, Leroy Fire Department and Thompson Fire Department total 25 personnel, 10 vehicles and 11,212 gallons of water.

*Initial response for “special” structure fires supplied by Madison Fire District, Perry Fire District, Geneva Fire Department and Leroy Fire Department total 18 personnel, 6 vehicles and 4,212 gallons of water.

Per Chief Myers, he is comfortable with established response plans for all fire related calls.

3a) Events Attended By Madison Fire District:
* Represented and escorted procession for Lance Corporal David Baker
* Attended memorial service for James A. Redecker (District employee 1961-1982)
* TriPoint relocation drill

3b) Upcoming Events:
* YMCA Training & Safety Day
* School Bus Drill
* Soccer Tournament (126 teams)-3,000 people at Madison HS, Park, Memorial Complex

4) Summary of Accomplishments – Chief Myers handed out a report of 71 projects and activities completed by him and the District Officers during his first 6 months tenure as Interim Chief (in addition to running over a thousand calls). Summary as follows:

a) Created and followed new Mission Statement, Core Values and Vision Statement
b) S.O.P. 303.0 – Manning/Staffing – Evaluated and adopted
c) S.O.P. Committee established
d) Hired 1 full time employee
e) Hired 4 part time employees
f) Implemented Broad Band High Speed connections
g) Implemented District Credit Cards
h) Evaluated and improved Recall procedure
i) Implemented District Cell Phone
j) Updated uniform design
k) Participated in fact finding for the Master Plan
l) Station Alerting research
m) Budget
n) FEMA Grant

a) Achieved over 90% attendance
b) Created probationary personnel training program
c) Four District personnel sent to FDIC Train the Trainer
d) Two District personnel completed Fire Instructors Class
e) To District personnel completed Inspectors Class
f) One District personnel completed Paramedic Class
g) Two District personnel enrolled in Paramedic Class
h) Four District personnel attended Leadership Conference
i) Three District personnel completed Leadership 1-2 class
j) Several District personnel completed ACLS class
k) Implementation of Saturday Drill

a) Implementation of new Automatic Mutual Aid Agreements
b) Re-programmed all radios/Geauga County added
c) Purchased Kenwood portable radios (Ashtabula Co., Coast Guard, Community Care Amb.)
d) Updating of MABAS Box Alarm System
e) Implemented Wireless Paging
f) Completed SCBA annual testing
g) Research Station Alerting project
h) Two new Hot Stick Alerting tools installed on front line engines

a) Medical Control re-evaluation on going
b) Purchased four new 12 lead ECG’s/training completed
c) Purchased four new EZIO sets/training completed
d) $4,ooo EMS grant awarded to District
e) Introduced new EMS program which better utilizes District resources

Program Involvement:
a) Implementation of District Web Site
b) Participation in POD program
c) Increased inspections
d) Expanded Seniors Program (installing smoke and CO detectors)
e) Fund Raisers for MDA and ACBC
f) Smoke Trailer for public education
g) Address Sign program
h) Promotional District Logo Shirts

Event Participation:
a) Representation at services for Andrew Masowits
b) Geneva-on-the-Lake Round Up Days
c) Fairport Harbor Marti-Gras Parade
d) Walter Green Commons Grand Opening
e) Walmart Kids Miracle Network
f) Two Madison Community Meetings (Madison Public Library)
g) Thompson Fourth of July Parade
h) Madison Memorial Day Parade
i) Madison Old Fashion Day Parade
j) Madison Recreation Board Parade
k) Lake County Firefighters Softball Tournament
l) Lake County Fair Parade
m) Escort for Lance Corporal David Baker
n) Geneva Grape Jamboree
o) Services for two fallen firefighters in Buffalo, New York
p) Perch Fest in Fairport Harbor
q) TriPoint drill/patient relocation
r) Madison YMCA Safety Day
s) Fire Prevention Week for Madison Elementary Schools (Smoke Trailer)
t) AMA Apparatus Day at Harpersfield Community Center

a) Purchase of two Elliptical exercise devises for St. #1 and #2
b) Sale of two out of service squads and one chase vehicle
c) Auction of out of service district equipment at Station #3
d) Purchase of a new Explorer chase vehicle
e) Many station renovation project and improvements

5) Healthcare Facilities – Interim Chief Myers handed out a draft of a proposed program entitled Solving The Growing Demands Of Healthcare Facilities On The Madison Fire District which deals with the 13 healthcare facilities located within the district (represents 18% of 2008 annual calls). This business plan (whitepaper/draft) outlines objectives, goals and resources for a legitimate program that thoroughly addresses the growing need for healthcare facilities in Madison. The idea behind this “forward thinking” plan is to gather information and data to be able to justify and execute a plan that will work for this community. The District has been overwhelmed with healthcare transports and we have attempted to educate facility personnel. He asked the board to review and evaluate the plan as a taxpayer not as a firefighter/EMT/Board Member/Politician. Key issues of the proposed program include:

A) Nursing Facilities – Cardinal Woods, Broadfield and Lantern of Madison are expanding (baby boomers are becoming “of age” for needing skilled assistance) and the percentage of calls to healthcare facilities has doubled in the last 6 years which forces us to consider other options like adding District personnel or utilizing private ambulance services for non-life threatening calls which will leave District Fire/EMS personnel available to respond to emergency calls. In addition to cost savings for the District, involving not-for-profit services will better serve the residents of the community by allowing non-emergency patients to be transported to a destination of their choice.

Special Concern: Last week Broadfield sold their ambulance service which will probably cause a yet unknown increase in District calls.

B) Outline of the Process:
1. 911 call received
2. If call is to a nursing facility, MFD and Community Care will both be dispatched
simultaneously. This is especially advantageous on calls with obese patients where a
couple extra personnel is helpful in addressing patient needs.
3. Upon arrival, MFD paramedic crew will provide initial care and triage.
4. Upon arrival of Community Care, MFD will determine if care and transport is to be
transferred to Community Care.
5. The transporting agency will complete transfer.

C) Proposed timeline for implementing proposed program depends on the following issues being reviewed and researched:
1. Identifying outside transport services
2. Communications
3. Dispatching
4. Audit committee to oversee patient transfers
5. Standard Operating Guidelines
6. Legal review
7. Healthcare Facility Meetings/Discussions

Interim Chief Myers requested that the Fire Board review the draft proposal and be open and proactive with the new plan. He stated it is not our intention to hand calls off. MFD will still respond to calls (along with a private service), and will transport adhering to protocols and using every means to preserve life. The proposed plan is to utilize private transports for non-life threatening runs as a proactive step to ensure the District is prepared and available to handle critical 911 calls.

He also reported that the District’s Medical Direction, Lake Health, has reviewed the proposal and is “in the loop” (they are opposed). Myers stated that this draft proposal is available to anyone who would like to review it.

Mr. Bartlett asked if Madison was unique with respect to the large number of nursing facilities that we serve. Myers agreed.

Mr. Bartlett asked where these patients are being transported. Lt. Baker explained that these are people with non-emergent/non-life threatening issues being transported from a nursing facility where healthcare is available to the emergency department (not to a Doctor’s appt).

Mr. Bartlett asked if other fire districts in this area are implementing anything like this plan. Myers answered, “not a joint venture like this”. Lt. Tod Baker commented, though, that it is not an uncommon venture. Other districts (Talmadge Fire Department, for example) are using private/public partnerships to manage the needs based on what the community has to offer.

Mr. Bartlett asked to see detailed data regarding paragraph C of report (community concerns and trends). Chief Myers supplied information requested and reported that he has been approached by private citizens who are concerned about facility transports.

Mr. Wayman commented that he felt the plan would probably move the District in the right direction.

Mr. Bartlett asked if Myers felt that the community might get the perception of a two tier level for senior citizens. Myers said that keying on the facilities is the answer and by dispatching Community Care or other private ambulance services to the 13 nursing facilities through Central Dispatch. Myers stated that it is important that the public understand that we are not trying to privatize our EMS service. We are talking about facility transports.

Lt. Baker stated that we are only looking at places where health care is available and who have technical personnel with higher degrees in medical licensure and have the ability to make the transfer with stable patients. Baker further explained that we are not talking about residents who don’t have medical educations or skilled personnel available to assist in the transport.

Myers introduced representatives from Community Care Ambulance to answer any questions the board may have. He reiterated that it is important that the Fire Board and the community comprehend the intent and have a clear understanding of how the plan will be executed.

Julie Rose – Executive Director/CEO
Roger Sisson – Board Member
John Washko – EMS Consultant

Mr. Bartlett asked for an overview of Community Care. Ms. Rose stated that Community Care is a not-for-profit organization (since 1994) who serves nursing facilities in Ashtabula, Lake and Geauga Counties with multiple crews in service at different times of day. They handle both emergency and non-emergency calls staffed by Paramedics (some Intensive Care/Cleveland Clinic trained) and EMTs with ALS & BLS ambulances positioned at Lake Madison Medical Campus, Geneva Memorial Hospital, Ashtabula County Medical Center, and at facilities in Mentor and Middlefield, and are opening another at Rt. 44 & Rt. 322. They handle their own billing in house and their communication system will allow them to give accurate response times, unlimited destination options and substantial backup/ coverage. They plan to become more involved in Madison and are currently working with Cardinal Woods regarding a possible night time facility on their campus. Ms. Rose explained that Community Care continues to help communities build cooperative effort to meet community needs.

Mr. Sisson further commented on their global positioning capability and their ability to know where their squads are located at any given time.

Lt. Baker stated, for the record, that Community Care had two squads at the Lantern HazMat call to assist on November 2, 2009.

Mr. Takacs rationalized that Community Care has contracts directly with nursing facilities and asked what would prevent these facilities from scheduling non-emergent transport situations directly with Community Care (rather than going through 911 and the District). Ms. Rose responded they are called for prescheduled trips all the time but sometimes facility personnel accidentally call them direct when they should be calling 911. In those cases, appropriate questions are asked by Community Care’s Emergency Medical Dispatch and all life threatening calls would immediately be directed back to the District.

In a follow-up question, Mr. Takacs stated that in an effort to evolve into an EMS service that has less abuse with respect to non-emergent transportation situations, and since the District is responding and making the medical decisions to assign transport responsibility, how is that different from his neighbor calling the fire department in a non-life threatening situation and having them transported when Community Care is not involved in the process?

Mr. Washko explained that it comes down to the healthcare facility and the demands being placed on the fire service by the healthcare facility. Personnel turnover is a problem and trying to keep staff educated on when to use 911 as opposed to a private ambulance service is challenging, however, the amount of time the District spends on non-life threatening calls that are ultimately assigned to a private ambulance service will be decreased by 50-70% allowing them to get back in service while the private service transports the patient to the hospital. This protects the availability of the 911 system to respond to the next true emergency.

Mr. Takacs asked, “Taking out of the realm of the facility’s response, why wouldn’t you do that for all non-emergent transports throughout the District not just through the facilities?”

Myers commented that we are not asking them to do that. Mr. Takacs acknowledged that the proposed plan does not request this, but asked Community Care’s perception of that kind of program.

Ms. Rose answered that they would respond to a non-emergency call to a resident if, for example, a resident is unable to sit in a car or a wheelchair van and needs to be transported on a cot to a Dr.’s appointment or dialysis.

Mr. Takacs stated that he clearly understands that we are trying to get a handle on the use of private services for the transportation of facility patients, however, his dilemma is that a person in the community with exactly the same non-threatening situation is going to be picked up by the district and be transported by the district, and, another person who just happens to be a resident in one of these facilities is going to have a different program. There seems to be a double standard of what the District is transporting and what we are partnering to have transported by Community Care or another private service.

Lt. Baker explained that according to our Fire SOP or our Fire AMA, a resident who lives south of Middle Ridge gets different treatment than one who lives north of Middle Ridge. It’s the same logic which is based on needs. The whole goal is that the folks in a facility have health care available. The resident doesn’t necessarily understand their emergency because they don’t have a medical component available. The healthcare facility is a place designed to take care of that need.

Per Lt. Baker, for example, we get called to nursing homes for DNR (do not resuscitate) where the patient does not want anything done but yet the facility dials 911. When we get called to a residence for someone with a DNR, typically we are called because the family is not prepared to deal with that emergency. The demand in these two situations is different just like “hydrants vs. non-hydrants”, so we’re trying to address that specific demand. Although the emergency is the same, the resources, the recognition of resources and the support are different.

Mr. Washko explained that when one is looking at the end product of what the patient receives, from a certifying body standpoint, there is no difference in service or level of medical care received whether they are transported by the 911/District or a private ambulance service.

Mr. Wayman asked the board to review the document and have questions or changes ready for the December 2, 2009 meeting. He thanked Community Care for their attendance.

6) FULL TIME PROMOTION: Interim Chief Dennis Myers asked the board to promote FF Brian Faulhammer from Part Time to Full Time – B shift – Effective November 15, 2009.
Motion by: Mr. Britton, Seconded by: Mr. Brotzman
ROLL CALL: All ayes

Mr. Murray and I.C. Myers agreed and suggested that the swearing-in ceremony be held on December 2, 2009 with refreshments to follow.

I. C. Myers and the Officers requested that the full time candidate list be terminated.

Discussion: Mr. Bartlett asked why the established list of full time candidates should be terminated. I.C. Myers explained that the list is of people who had their credentials at the time the promotion was posted. In the meantime, others have finished paramedic school and other credential necessary to be promoted. Conversely, candidates currently on the list have taken full time positions elsewhere, etc. and are no longer available.
Moved by: Mr. Brotzman, Seconded by: Mr. Quirk
ROLL CALL: 5 ayes, 1 nay

Mr. Britton reminded I.C. Myers that the District will be transporting Santa to Christmas In The Park on December 5, 2009 from 6 to 8 pm.

Mr. Bartlett reported that 22 items have been completed. He inquired whether item #32 – District Agreement for At Will Full Time Firefighters – is complete (regarding legal matters). Mr. Murray said to leave it at 95% in case the new chief wishes to revisit the issue.

Closing Public Portion:
Beth Teahan – 5800 Chapel Road – thanked the firefighters and paramedics who came to her house and took care of the situation that recently occurred. She commented that District staff was very professional, very kind and very much appreciated. Mr. Wayman stated that the board was very sorry for what transpired.

POD – Lt. Alan Van Kramer responded to a board request from the October 7th meeting and reported that there still has not been a date issued for the Madison POD to begin.

He reported that there were 97 health care workers vaccinated at the County Health Department, 75 at Concord Fire and 84 at Mentor Fire. The next two POD clinics will be open to the public on November 15th at Willoughby South and November 22nd at Mentor Performing Arts. The county has 5,100 nasal doses and 6,300 multi doses. 4,100 resident have already signed up for the vaccine. The schools will be vaccinated on Tuesdays, Wednesdays and Thursdays in November and December.

The next regular Fire Board meeting will be held December 2, 2009 at Village Hall, 7:30 pm.

Mr. Wayman asked for motion to adjourn to Executive Session to discuss a potential hire with possible regular session business to follow.
Motion by: Mr. Quirk, Seconded by: Mr. Brotzman
ROLL CALL: All ayes @ 8:40 pm

Executive Session adjourned at 10:05 with no action reported.