EMERGENCY SERVICES COMMITTEE MEETING MINUTES
7 OCTOBER 2024
Chair Commissioner Caleb Savage opened the meeting asking Commissioner Roger Reedy to offer a prayer and lead the pledge. The minutes of 6 May 2024 were moved for approval by Commissioner Gayle Jones, seconded by Commissioner James Lathrop, and were approved unanimously. The Chair asked for a motion to change the agenda allowing Stryker Account Manager Ms. Lacey Barr to go first on the agenda, stating her travel time being considered. A motion by Commissioner Annelle Guthrie, seconded by Commissioner David Wamble, to allow the agenda change was made and was approved unanimously. County Executive (CE) Graham Stowe mentioned that two years of OHM reports were on Google Drive for the Commissioners access and asked if anyone had looked at them. Several commissioners said they had tried but had trouble seeing them, including being asked for a passcode.
Ms. Barr provided a handout showing a current cost estimate of $428,989.50 for LIFEPAK cardiac monitors and an additional Service and support plan for $18,964.57 yearly. This estimate includes a reduction in the hardware cost with a $95,000 trade-in of 10 monitors. Commissioner Shelly Goolsby raised the question of the county’s ability to “trade-in” county owned property, referencing a previous direction from the Financial Manager Beth Moore-Sumners on another county asset. Ms. Barr said counties may do that differently, saying that some counties do the trade-in. The Chair said that this trade-in would have to be reviewed for Giles County. Ms. Barr then presented the functionality of the latest reiteration of the LIFEPAK monitor, focusing on the capability of escalating joules that per Ms. Barr allows you to detect heart attacks early on. Commissioner James Lathrop asked about the maintenance contract and did that include battery replacement with Ms. Barr answering yes. Ms. Willow Chavez caveated that answer with 3 batteries per device per year. Commissioner Lathrop asked the cost of a battery with a $800 price provided. Commissioner Annelle Guthrie asked if this device included a defibrillator with Ms. Barr answering yes. The Chair asked if the price would be locked in with Ms. Barr said the price would remain fixed over the period of the contract. She also said the Heart Association usually sees a five-year service life for cardiac monitors but the Stryker model usually has 5 – 8-year service life. Commissioner Tracy Wilburn asked about all monitors expiring at one time, with Willow Chavez saying they would need to plan for that when that expiration would happen. Commissioner Guthrie asked about the age of the monitors being replaced and Willow Chavez answer several are 2-4 years of age with the remaining are 6 years old. She also noted they had paid $4120 for five batteries recently, and she will have to buy 15 more before all is done. Ms. Barr discussed the USB ports for all updates, and said with that capability they can push out to all fleets at one time. EMS Director Bill Myers said the goal is for 10-year service plan and that the annual service plan will be funded from the EMS operational budget. Commissioner Adams asked why need 10 monitors with Mr. Myers saying they will be in all 8 ambulances and two of the trucks. A motion by James Lathrop, seconded by Commissioner Annelle Guthrie, was made to purchase the monitors with a five-year maintenance support contract funded in the EMS operational budget and the hardware purchased from Budget Line Item 171. The Chair said the trade-in question would have to be resolved.
Giles County Medical Director Dr. Joe Fite then spoke on purchasing new monitors and said “not best Idea.” He mentioned the current monitors are state of the art and are compatible with the monitors Vanderbilt uses as well as the local hospital. He could see no good reason to switch (from current models made by Zoll) and to spend around $1M not necessary. At this point based on the committee’s rules for speaking by other than committee members and commissioners, the Chair asked that the conversation be complete and that if he had known he would have put the Zoll representative, Senior Account Executive Adam Britt, on the agenda to speak. Commissioner Gayle Jones as did Commissioner Terry Jones said she would like to hear from both companies. Other Commissioners said they would like to hear from EMS employees who actually use the equipment. Every employee that spoke said they liked the LIFEPAK noting the screens are almost unbreakable with ordinary use, and one employee who works FT with Giles and PT with Maury spoke to the attraction to bring in new employees who know of the LIFEPAK and their desire to work in counties that use that model.
Commissioner Tracy Wilburn said the purchase of the cardiac monitors was first mentioned after the CE had asked the department heads for Needs Assessementw outside of their annual budget. He asked Willow Chavez if there might be a higher priority, i.e., a station located at Minor Hill since it takes approximately 35 minutes to get an ambulance there. Ms. Chavez said the monitors did come up in the PoP, but adding locations would require additional funding for staff and infrastructure.
At this time the Chair did allow Mr. Adam Britt to speak, where he addressed some of the comparable Zoll efforts compared to the LIFEPAK model. He did mention that he had been asked for a quote but no request had been made to negotiate that price. Commissioner Judy Pruett mentioned that the discussion reminded her of AT&T vs Horizon, older generation preferred what they knew and the younger generation wanted the next coming model. She did say she did not want to micromanage the departments. A motion by Commissioner Caleb Savage to approve the hardware and the annual service plan with Commissioner James Lathrop providing the second was made. A roll call vote resulted in a 6 – 1 vote with Commissioner Gayle Jones voting no to send to the budget committee before advancing to the full commission, noting more information required on the possibility of the trade-in resulting in a reduced hardware cost.
The Chair noted the remaining two items on the agenda were not actionable items. EMS Director Bill Myers discussed the OHM in the design phase is looking at two options, one all EMS under one roof and requiring Cat 4 hardening (most costly) and two showing administrative, storage, training areas under one roof and not hardened and the rest of EMS e.g., ambulances, living spaces being Cat 4 hardened (less costly in total since only a portion of EMS will be hardened). While option 2 cannot be attached it can have a covered walkway, per Mr. Myers. Commissioner David Adams said he called CTAS and they said the service did not have to be hardened. Dr. Fite wanted to know where the morgue would be placed, with the Chair saying they are waiting for the actual proposal. When Commissioner Shelley Goolsby asked about a safe room, the Chair answered that there will be some different requirements if the state changes their building codes.
Re the Resolution for educational reimbursement, the Chair said this has to be renewed every year and requires approval. A motion by Commissioner David Wamble, seconded by Commissioner Annelle Guthrie, was made to approve and was approved unanimously.
No old business. Under new business – Commissioner David Wamble said the county needs to provide better EMS service to Minor Hill. Questions on where the service could be located, could Minor Hill provide building or funding support. Director Myers said he would put together a proposal including staff and cost and provide within 60 days. Commissioner Wilburn mentioned a possible retrofit of a building with a potential one identified. The Chair after a motion by Commissioner Gayle Jones seconded by Commissioner Annelle Guthre called for an Ad Hoc committee to be established to include the three commissioners from the Minor Hill district to work with Willow Chavez and to address such issues as funding, recommended location and staffing.
A motion by Commissioner Annelle Guthrie, seconded by Commissioner David Wamble, was made to adjourn and was approved unanimously.
ATTENDEES: Members of the Committee Chair Commissioner Caleb Savage, Other Commissioners: Annelle Guthrie, Carman Brown, Rose Brown (for Joseph Savage absent), Gayle Jones (for Brad Butler – absent), David Wamble, James Lathrop Other Commissioners in attendance: Shelly Goolsby, Joyce Woodard, Terry Jones, David Adams, Judy Pruett, Tracy Wilburn, Tim Risner, Matthew Hopkins, Roger Reedy, Matt Rubelsky Other Attendees: County Executive Graham Stowe, EMS Director Bill Myers, Other EMS: Willow Chavez, Jeremy Mitchell, other EMS members, Stryker Account Manager Lacey Barr, Medical Examiner and Medical Director Dr. Joe Fite, Zoll Senior Account Executive Adam Britt,