Board of County Commissioners. I Escambia County, Florida MEMORANDUM TO: Matt Coughlin FROM: Janice Kilgw DATE: 5! 14/ 2019 RE: Public Safety Ombudsman Final Report Attached you will find the final written report of my assessment of the Department of Public Safety. The report includes attachments offering additional information on some of the stated issues. There are other issues that need further review and additional research. Due to the short time frame, my assessment primarily focused on the EMS Division. However, the Fire and Communications Divisions have issues that need to be reviewed and addressed. Also, I believe there are some currently in leadership and/or administrative positions that are not the best person for the position, and this should be addressed by senior leadership. I appreciate the opportunity to assist County Administration with this assessment. 1 hope the work I was able to complete will be beneficial as you make improvements and enhancements to the Department. Public Safety should be a priority Department with support from County Administration and County Commissioners. CC: John Dosh Deana Stallworth 6576 North Street - Pensacola, Florida 32505-1714 Telephone {850) 471-6400 - Fax (850) 471-6455 x211 Public Safety Ombudsman Final Report May 14, 2019 Overview Janice Kilgore began work as the Public Safety Ombudsman on Wednesday, April 17, 2019- Original discussions with County Administration indicated this project should take approximately 2 to 3 months to complete. However, the week after work began, the Interim County Administrator requested a preliminary report be provided at the Committee of the Whole meeting on May 9, 2019. During three weeks of this review, discussions were held with over 50 individuals which included employees from Public Safety, County Administration, and members of Volunteer Fire Departments. In addition to the meetings, a review of various procedures, statistics, staffing and other documents began. The primary focus was the EMS Division. This report is not all-inclusive as there was not ample time to complete interviews, conduct research or provide required follow-up. The power point presentation provided on May 9, 2019, is included as Attachment 1. There was no further assessment requested by the Board of County Commissioners; only a final written report. NOTE: The certification issue that has been widely publicized was not part of the scope of this assessment as it had previously been forwarded to the Florida Department of Health for investigation. Loss of EMS Reserve Funds In June 2018, the County Commissioners reviewed the LOST projects and zeroed out the EMS am bulances/staff vehicles and water safety vehicles for the years 2019, 2020, and 2021. in addition to the loss of LOST funds, six interfund transfers from EMS Reserves have occurred over the past two years totaling $5,390,004. These funds could have been used for additional staffing and/or pay increases that are needed as noted later in this report. See Attachment 2 Aging Fire Equipment During discussions, there were comments about the aging equipment in the fire departments, especially from some of the Volunteer Fire Chiefs. Specifically mentioned was bunker gear and other firefighter gear and equipment. Some felt the older equipment is given to the Volunteer Firefighters. This is one area that needs further review. Fleet Maintenance issues Both Fire and EMS Fleet Supervisors voiced concerns about the status of emergency vehicles. There are 9 ambulances with greater than 250,000 miles and 6 fire trucks with mileage over 100,000. More review is needed regarding the aging fleet as well as implementing a multivear plan for replacement. See Attachment 3 Maintenance needs at Stations Reports of maintenance needs at various Fire and EMS stations included concerns of air quality, mold, mildew, mushrooms growing in shower drains, need for painting, ceiling tiles falling, lawn maintenance, etc. This area needs further review and coordination with Facilities Management. Statistics As our county grows, so will the emergency calls for assistance from Fire and EMS. The information in Attachment 4 shows Public Safety Communications is handling over 510 calls to 9-1~1 each day. EMS is averaging 192 calls for service each day and Fire is at 37 calls per day. Note the chart below shows a decrease in fire dispatches, however, that trend is reversing. Based on the first 6 months of this fiscal year, fire responses are on track to exceed over 15,000 this year. See Attachment 4 FY16-17 Dispatch Staff 28 28 28 Adm Staff 1 1 2 9-1-1 Calls 205,500 192,080 186,485 EMS Staff 96 108 108 Admin Staff 10 11 12 EMS Dispatches 61,980 69,005 70,260 Fire Staff 154 154 154 Admin Staff 11 11 11 Fire Dispatches 14,317 13,318 13,355 Update EMS Policies The EMS Division Policies need review as many were put in place by a previous EMS Manager and date back to 2011. Leadership Public Safety leaders currently receive limited leadership training, if any at all. To be an effective leader, there should be training in the proper way to effectively communicate with peers and subordinates. Senior leaders must ensure pertinent information is routinely shared with all employees in Public Safety. The new Department Director should review those in leadership positions confirming peeple are in the correct roles. Effective Use of Work Force Some EMS employees are currently in positions other than their assigned positions. Examples include a Paramedic Supervisor that has been assigned to Billing from the Coordinator role. Now another paramedic is now assigned to the Coordinator role, causing a vacancy on the shift. Several EMS crew members are on 'light duty? working in admin positions but their shift positions are being filled with either relief employees or overtime. The Medical Director has assigned a road paramedic to her staff to assist in rewriting the protocols. This requires his shift to be covered by either part time employees or overtime. There are other admin positions available to assist the Medical Director EMS Education Coordinator and Section Chief Admin/Professional Standards. However, these two individuals filed harassment charges against the Medical Director, so there remains friction. An EMT has been tasked with oversight ofthe American Heart Association training center. This requires that he be pulled from his shift frequently to perform these duties. This requires his shift to be covered by relief personnei or overtime. If employees are not able to perform in the positions they hold, perhaps they should be permanently removed so double staffing is not happening as frequently as it is now. Improve Public Image The recent negative publicity is taking its toll on employees at Public Safety. These employees are dedicated, caring individuals properly trained and certified for the job. Every day they are helping people in emergency situations and it is unfortunate the good they are doing is seldom heard. Continued support and appreciation from County leaders as well as from the citizens they serve is needed. Coordination between Divisions In speaking with the Division Managers at Public Safety, the coordination/communication among Divisions is not what it needs to be. There should be periodic senior level leadership meetings with the Director to correct this lack of coordination. This will allow Division Managers to get apprOpriate information that can be passed to employees in a timely manner. Training Training is extremely important for ail Divisions of Public Safety, yet training dollars are some of the first cut from budgets. Training for Fire, EMS and Communications/Dispatch must be given the priority it deserves. The need for a training facility has been in the plans for well over 10 years and was an identified expenditure of LOST funds in the past. Even though funds were available and County property was identi?ed, approval was never granted for the project to proceed. Vote of No Confidence The Fire and EMS unions provided public statements regarding a vote of no confidence for Director Weaver. During discussions, some indicated the vote was due to the resignation of Chief Nail. Others mentioned they did not feel Director Weaver was properly presenting the needs of Public Safety to County Administration and the Commissioners. in a conversation with the President of the Volunteer Fire Association, he indicated they did not hold a vote of no confidence and did not agree with the one taken by the career fire?ghters. He said they supported Director Weaver in his position. Vehicle Replacement Program A multi~year vehicle replacement program is needed for both Fire and EMS. During previous cycles of the Local Option Sales Tax (LOST), funds were identified for the purchase of ambulances and fire apparatus. These vehicles were listed as expenditures in the brochures that were mailed to citizens asking for their continued support for the tax. Timely Completion of Protocols The Medical Director has been working to complete an update of the medical protocols for many months. Currently employees are using protocols written almost entirely by Dr. Neal when he was the Medical Director. Dr. Neal left EMS in 2014. See timeline in Attachment 5 North end EMS coverage Because of staffing issues at EMS, there are times when the north end of the county is left without a County ambulance in the area. The Century ambulance crew will transport a patient to a hospital in Pensacola. Once here, they are then dispatched to various emergencies calls in the south end since they may be the closest and/or only ambulance available at the time ofthe call. This causes a delay in the ambulance returning to the north end ofthe County. Recent requirements for additional service in the Walnut Hill area and for the new Emergency Room in Perdido Bay have caused coverage issues because no additional staf?ng has been added to provide this service. Pay and Retention You will notice in the below chart the beginning hourly rates have not increased much over the past 11 years. This has an impact on employee retention. For example, a new dispatcher at other area facilities like Pensacola Police, Escambia Sheriff and Walton County make from $1 to $2 more per hour. Same is true for new EMTs and Firefighters, where others in this area are paying $2 to $4 per hour more. Even the Lifeguards on Pensacola Beach begin at $2.08 more per hour than the Fire?ghters and EMTs. While starting pay for Paramedics was raised from $14.54 to $16.00 in 2016, they are still at least $2.00 per hour less than those in Okaloosa County. In the past, Escambia County had the better wages and could draw employees from other areas. This is no longer the case. in order to continue to provide the services expected, something must be done about retention and pay. Attachment 6 provides examples of the differences mentioned above. 2003 2011 2019 Dispatcher $12.11 $12.49 $12.49 $12.11 $12.49 $12.49 Paramedic $13.65 $14.54 $16.00 Inspections The Florida Department of Health conducted a routine inspection of EMS on July 31, 2018. Areas inspected included personnel records, service records and facilities inspection, ALS and BLS vehicle inspection and equipment test results. No deficiencies were found. Further, the inspector noted this was an outstanding inspection with excellent employee and service records as well as a good Quality Assurance Quality Improvement program. See Attachment 7 for the inspection report. Summam Due to the short time frame allowed for this assessment, the primary focus was on the EMS Division. The issues identified all play a part in the overall quality of the service currently provided. There are concerns of staf?ng and other needs in the Fire and Communication Divisions that should be reviewed to improve and enhance those Divisions. Having the right people in leadership positions is critical. County Administration and the Board of County Commissioners must make Public Safety a priority department. By providing adequate funding for staffing, equipment, training and other resources, it will help ensure the Department can provide the best services possible for the citizens and visitors in our County. Public Safety Assessment >Began work on Wednesday April 17 >Discussions with over 50 people >Public Safety employees >County Administration >Volunteer Fire Chiefs >Still receiving requests for meetings >Concerns of Retaliation >Many issues/ concerns identified Di a Findings Funds and EMS Reserve Funds >Fire Dept concerns with aging equipment >Fleet Maintenance issues EMS and Fire >Maintenance issues at the Fire Stations >Leadership >Limited or no training >Poor communication skills/procedur a? F: 5 Findings >Emergency calls continue to increase >Staffing concerns Dispatch/ Fire FY15-16 FY16-17 FY17-18 Dispatch Staff Adm Staff Calls EMS Staff Admin Staff Calls Fire Staff Admin Staff Calls 28 1 174, 378 96 10 61,980 154 11 14,317 69,005 154 11 13,318 28 2 197,935 108 12 70,260 154 11 13,355* a a a Findings coordination between Divisions bMore effective use of workforce >Training >No medical training since October 2018 >Prefer skills based/ hands on >Need for Public Safety Fire Training Facil' a I-i Findings Pay and Retention issues with Dispatch, EMS and Fire 2008 201 1 2019 Dispatcher $12.11 $12.49 $12.49 $12.11 $12.49 $12.49 Paramedic $13.65 $14.54 51 6110* a a Findings >Recent vote of no confidence >Update EMS Division Policies >Multi year vehicle replacement program coverage in the North end of County >Improve Department?s public image ATTACHMENT 2 REPORT OF THE COMMITTEE OF THE WHOLE WORKSHOP - June 14, 2018 AGENDA NUMBER Continued 5. A. (2) Reviewed the allocation for economic development LOST projects and made no change; (3) Reviewed the allocation for Sheriff?s Office LOST projects and added $250,000 as a placeholder in 2022 for design with the understanding that this will be readdressed at a later date; (4) Reviewed the allocation for judicial LOST projects and made the following changes: The primary entrance renovation was moved to 2021; and Jury and audience affixed seating was moved to 2022; (5) Reviewed the allocation for detention LOST projects and made no change; (6) Reviewed the allocation for Parks and Recreation LOST projects and made no change; (7) Reviewed the allocation for Natural Resources LOST projects and deleted the line item for ecotourism large ship acquisition, which had previously been zeroed out; (8) Reviewed the allocation for Public SafetyfFire LOST projects and zeroed out the EMS ambulanceslstaff vehicles and water safety vehicles for years 2019, 2020, and 2021; (9) Reviewed the allocation for Supervisor of Elections LOST projects and made no change; (10)Reviewed the allocation for Neighborhood and Human Services LOST projects and made no change; (1 1}Reviewed the allocation for Public Worksi?Drainage LOST projects and the Ferry Pass Drainage Zone 5 project was adjusted to $50,000 in 2022 and $900,000 in 2023: (12) Reviewed the allocation for Public Worksl?l'ransportation LOST projects and made no change; (Continued) Page 5 of?lB SUNGARD PENTAMATION DATE: 05f10f2019 TIME: 14:17:31 ESCAMBIA COUNTY BOCC SELECTION CRITERIA: and expledgr.accountu?59101' ACCOUNTING 9091005: 1110 THRU 13(10 SORTED BY: COST TOTALED ON: COST SUBTOTAL PAGE BREAKS 0N: COST CNTR FUND - 408 EMERGENCY MEDICAL SERVICE COST CENTER 330371 TRANSFERS ACCOUNT DATE TIC ENCUHBRANC REFERENCE VENDOR TRANSFERS 59101 TRANSFERS 09/29;17 11-1 11/22/17 19-2 02100f10 19?4 05/31f19 19-9 19-10 TOTAL TRANSFERS SJEUGOEA SJE0005C SJEOOUSI TOTAL SUBTOTAL - OTHER USES TOTAL TOTAL COST CNTR TRANSFERS TOTAL FUND EMERGENCY MEDICAL SERVICE TOTAL REPORT THERE IS A NOTE ASSOCIATED WITH THIS TRANSACTION BUDGET .00 3,595,251.00 3,595,251.00 3,595,251.00 3,596,251.00 3,595,251.00 3,596,251.00 EXPENDITURE AUDIT TRAIL EXPENDITURES .00 899,062.75 899,062.75 3,596,251.00 3,595,251.00 3,596,251.00 3,596,251.00 3,596,251.00 ENCUMBRANCES .00 .00 .00 .00 .00 .00 PAGE NUMBER: 1 CUMULATIVE DESCRIPTION BALANCE BEGINNING BALANCE POSTED FROM BUDGET SYSTEM IF QTR FY10 2ND QTR INTERFUND 3RD QTR INTERFD TRANSFER 4TH QTR INTERFUND .00 .00 .00 .00 .00 ATTACHMENT 2 SUNGARD PENTAMATION DATE: 05f10f2019 TIME: 14:10:55 SELECTION CRITERIA: ACCOUNTING PERIODS: 1/19 THRU 8/19 SORTED BY: COST TOTALED 0R: COST SUBTOTAL PAGE BREAKS ON: COST CNTR FUND - 403 - EMERGENCY MEDICAL SERVICE COST CENTER - 3303?1 TRANSFERS ACCOUNT DATE TIC ENCUMBRANC REFERENCE VENDOR - TRANSFERS 59101 TRANSFERS 11?1 10f01f13 19?1 01/04x19 19?4 TOTAL TRANSFERS SJEUOOSA SJEOGDSC TOTAL SUBTOTAL OTHER USES TOTAL TOTAL COST CNTR - TRANSFERS THERE IS A NOTE ASSOCIATED WITH THIS TRANSACTIDN ESCAHEIA COUNTY EDCC EXPENDITURE AUDIT BUDGET .00 3,557,506.00 3,533,506.00 3,507,506.00 3.537.505.00 TRAIL EXPENDITURES .00 396,076.50 896,876.50 1,793,753.00 1,793,753.00 ENCUMBRANCES .00 .00 .00 .00 PAGE NUMBER: 58 CUMULATIVE DESCRIPTION BALANCE BEGINNING BALANCE POSTED FROM BUDGET SYSTEM REC Q1 INTERFUND TRANEFER REC Q2 INTERFUND TRANSFER l.?93.753.00 ATTACHMENT 2 ATTACHMENT 3 58242 1 251 19271 9 rs 10 month 140 1 133 5 23 1 36803 19933 years 2 months 21 9 years 10 mo 1392 I3 ears ears 3 mo 0 months 9 3 month rs 2 mont rs 4 ears months 10 months 3 ears 4 mo 3 4 10 months rs 0 months rs 8 months rs 8 months years 5 months 51 ears 5 months 0 3 months 24?5 0 rs 9 months 25276 0 rs 4 months W344 604 months 8429 7 months a: $98,312.83 35 1.57 $24 41 5.32 $93 ?54.87 $27 $24 18.49 $23 .33 $33,007.54 $63,959.11 $91,248.? $99,966.50 $17 3.69 $5,990.78 $1 119.52 $22,193.96 $4,553.20 $13,394.16 $13 628.74 $11 049.95 $12 712.00 $6 051.61 $408.87 $585.36 ATTACHMENT 3 Escambia County Fire Rescue Unit Availability Log Unit Engines Engine 1 Engine 2 Engine 3 Engine 4 Engine 5 Engine 6 Engine 7 Engine 8 Engine 9 Engine 11 Engine 14 Engine 15 Engine 16 Engine 17 Engine 18 Engnezo Engine 21 Engine 22 Engine 23 Ladder Trucks Ladder 12 Ladder 13 Ladder 19 Ladder 5 Tower 7 Squads Squad 13 Squad 15 Squad 19 Squad 8 Squad 729 Tankers Tanker 2 Tanker 7 Tanker 9 Tanker 11 Tanker 15 Year 2007 2004 2006 2010 2003 2010 2010 2003 2004 2004 2002 2011 2010 2003 2003 2011 2011 2011 2006 2011 2010 2010 2011 2010 2015 2002 2105 2002 2003 2010 2007 1997 1992 2007 Mileage 27,589 40,123 132,271 111,280 44,147 127,434 101,146 94,881 80,233 131,556 114,836 13,285 75,282 84,312 98,495 15,254 7,250 15,182 25,526 87,113 59,922 80,902 16,102 22,546 5,772 35,202 5,047 63,707 89,235 6,873 26,504 21,354 24,942 9,898 6146 10776 7751 5338 9818 9510 3359 5937 11480 10294 1019 7457 7327 7179 1117 623 1075 1919 7785 6306 6260 2049 2361 177 2176 578 736 2255 130 2903 643 Property 55772 53026 55055 58731 52312 58730 58729 52677 53610 53027 51210 59224 58728 52713 52713 59172 59176 59253 55054 59221 58594 58695 501107 58693 61753 50850 61754 502223 52043 58749 55993 501916 501455 55771 Station Location Sunbe? Empire Tanker 18 Tanker 22 Tanker 23 Brush Trucks Brush 2 Brush 223 Brush 225 Brush 4 Brush 5 Brush 923 Brush 14 Brush 15 Brush 1824 Brush 20 Brush 22 Brush 23 Watercraft Boat 4 Waverunner 13A Waverunner Waverunner 13B Waverunner 16 Waverunner 19A Waverunner 8 A Waverunner 19 Zodiac 3 Zodiac 8 Specialty Vehicles Haz Mat 6 Rescue 3 Air 11 Reserve Apparatus Reserve Engine 1 Reserve Engine 3 Reserve Engine 4 Reserve Engine 6 Reserve Engine 911 Reserve Engine 13 Reserve Engine 16 Reserve Engine 17 Reserve Engine 19 Reserve Ladder 14 1997 1997 1997 2002 1969 1986 2002 2004 2002 2002 2006 2012 2002 2004 2004 2000 2017 2008 2017 2013 2017 2013 2009 2014 1987 2000 1996 1991 1997 2002 2005 2002 2011 2002 2002 2005 1997 2002 29,956 15,398 20,808 28,496 1 1 17,235 22,355 14,731 44,469 12,438 21,287 40,784 16,844 14,338 110 2001 2001 10,000 5 1 1 2 1,848 45,106 136,590 76,488 92,806 6,579 99,421 104,300 74,527 78,888 119,655 2137 954 221 1775 854 3403 7 12 2925 382 2011 483 7783 10924 6797 1173 434 8612 9678 7376 2391 10319 501921 501926 501915 51640 501428 55814 51442 53022 51537 51526 55140 59193 51441 53013 53023 53544 63477 58237 63475 60439 63476 60440 58603 61055 50401 63854 501913 501118 501934 51208 54082 51209 59177 51207 51211 54081 501947 51642 Knowles 18 22 23 LOW-EMN CENTRAL Fleet Leme 13 16 17 19 14 61? Call OCT NOV DEC JAN FEB FY1 5-15 MAR APR MAY JUN JUL AUG SEP Total Bails Fire Rescue Dispatches 591 492 579 539 515 524 520 557 558 551 468 6,440 Fire Rescue (Medical) Dispatches 634 623 642 615 655 731 663 ITotal Fire Rescue Dispatches 1,225 1.115 1,221 1,161 1,194 1,246 1,187 IEMSfEmergency DisPatches 4,927 4,806 4,996 4,946 4. 765 4,442 5,112 745 1 .265 5,478 765 824 473 507 7,877 1 .322 1,382 1,624 975 14,317 5,186 5,388 5,153 4,910 60,097 @SINon-Emergency Dispatches 172 191 188 169 182 150 152 146 98 160 113 160 1,883 [Total EMS Dispatches 5,699 4, 897 5,178 5,109 4,947 4,592 5,264 5.626 5,284 5,548 5.266 5,076 61,986 911 Calls 16.997 15,563 16,414 15.232 16.065 17,289 1 7.098 18,494 18,079 19,583 17.695 16,891 205,606 Ring Down 2.447 2,497 2.372 2, 339 2,648 2.613 3,034 2,712 3,690 2.691 2.980 29,623 eratcr Assist 147 154 158 145 243 238 243 392 348 2,382 Administrative Calls (non-911) 11.980 1 2, 965 12,429 12,183 13,962 12,272 13,735 13,331 14,231 13.432 12,?53 142,373 379,978 ATTACHMENT 4 I - Inn: 'l "'05 NOV DEC JAN FEB MAR APR JMAY JUN JUL AUG 5 Calla FIRE [Fire Dispatch es 570 525 603 650 505 5?1 552 566 574 602 567 55? 6,962 Medical Dispatches 450 478 507 550 4?4 559 537? 582 540 656 556 465 5.356 Total Fire-Rescue Diapatches 1,020 1,103 1,110 1,200 91"9 1,130 1,089 1,168 1,114 1,258 1,125 1,022 13,310 EMS Emergency Dispatches 5.101 5.216 5.265 5.6?6 5.065 5.746 5,723 5.?49 5.618 6.344 6,035 5.640 6?.432 Non-Emergen cy Dispatches 160 137 125 128 114 133 103 151 123 118 133 143 1.5?3 Total EMS Dispatches 5,201 5,355 5,390 6,004 5,179 5,086 5, 826 5,900 5, 741 5,462 6,213 5,733 69,005 3-1-1 . 1111 Calls 13,315 15.325 15.433 15.735 14.705 13.171 13,359 15.373 15.391 17.531 15,154 15.433 152.323 Text 2 9-1Ring Down 2.868 2,617 3.052 3,299 2,957 3.239 3.416 3,505 3.406 3,770 3.51 1 3.534 36, 716 Operator Assist 329 400 569 670 540 594 560 51?}r 536 578 61 7 6.328 Administrative Calls (non-911) 12,680 11.345 11.922 13.226 11.537 12.482 12.972 13.456 13.044 13.945 13.572 13.19? 141,200 376,324 ATTACHMENT 4 of Gall OCT NOV DEC JAN FEB FY1748 MAR APR MAY JUN JUL AUG SEP Total Calla FIRE [Ere Dispatches 572 556 553 713 501 673 616 697 636 635 623 672 7,447 [Fire Medical Dispatches 495 470 479 531 392 460 480 ITotal Fire-Rescue Dispatches 1,067 1,026 1,032 1,244 393 1,133 '1 .096 I EMS Emeiyency Dispatches 5, 396 5.302 5,550 5.932 4,924 5.512 5,556 508 1 ,205 5.908 516 551 491 535 5?908 1,152 1,135 1,114 1 '201" 13,355 5,826 6,252 5,652 5,912 67,722 INen?Emergency Dispatches 140 137 136 65 112 115 159 323 313 411 312 295 2,536 Total EMS Dispatches 5, 536 5,439 5,586 6,017 5,036 5,627 5,71 5 6,231 8,133 6,663 5,954 6,207 70,260 9-1 -1 911 Calls 15,416 14,516 14,607 14,339 1 3,492 15,260 15,256 16,673 16,834 17,566 16,311 15,660 1 36,407 Ten 2 9-1Ring Down 3,183 2, 679 2,887 3,030 2,560 3,011 3,163 3,426 3.320 3,659 3.164 3.184 37,456 [Operator Assist 644 539 657 729 572 608 650 659 667 655 724 7,750 [Administrative Calls (new?! 1) 12,301 11,692 12,120 11,987 10,665 12,359 12,362 14,296 13,671 14, 344 13,259 12,961 1 52,719 384,420 ATTACHMENT 4 ITyponf?Call FY 13-19 DEC JAN MAR APR MAY JUN Total Calls 1 FIRE NOV [Fire Dispatches 657 640 665 635 561 6733 3,841 Fire Medical Dispatches 458 455 7'88 398 786 353 4,223 Total Fire-Rescue Dispatches 1,125 1 ,095 1,433 1 ,533 1 ,34? 1,531 0,064 EH8 Emergency Dispatches 5.678 5.25? 5,742 5,801 5,291 5.764 33,543 Non-Emergency Dispatches 270 242 221 252 311 293 1,594 Total EMS Dispatches 5,948 5,559 5,028 5,053 5,602 6,062 35,252 5-1-1 911 Calls 15.398 13,?91 14,38? 14,023 13.846 15,280 Text 2 9-1-1 15 15 54 Ring Down 3.194 2, 905 3,014 2.948 2,822 3,095 1 T378 erator Assist 1,542 714 737 760 624 7?04 5,081 Administrative Calls (non-911) 13,583 12,097 12,514 12,1?6 11,716 13,036 ?5 127 185,265 ATTACHMENT 4 ATTACHMENTS Protocol Timeline June 1, 2018 Updated Protocols issued to employees July 8th Email from Medical Director to IRE advising new protocols should be used for guidance and reviews. Discrepancies have been found that need to be addressed and corrected. She requested emails for input and errors. June 26, 2018 Medical Director provides concerns to Co Administration Email to Jack Brown, Matt Coughlin and Mike Weaver re concerns about the EMS Of?ce of Administration, Professional Standards June 29, 2018 Division Manager, EMS resigns Leon Salter acting EMS Chief July 31, 2018 Florida Department of Health completes Inspection of EMS No de?ciencies found Noted as Outstanding Inspection Reviewed 22 of 150 employee ?les noted Excellent employee and service records. Good QAJQI August 13, 2018 Chief Nail designated Deputy Public Safety Director September 4, 2018 - Requested Visio installation (for Protocol Revisions) Visio installed on October 25. Requested installation of Visio on laptop on November 5, 2018?Installed on February 8, 2019 October 18, 2018 Chief Nail designated Chief, October 27, 2018 Request for EMS reorganization Email from Rusty Nail to Matt Coughlin with Draft one?page memo regarding a request for EMS Reorganization Weaver not on email ATTACHMENT 5 October 31, 2018 - Last scheduled mandatory medical training for EMS Held two events in 2019 but not medical training - 1) review the new EMS units; 2) review strapping of large oxygen bottle February 4, 2019 Protocols recalled and reverted back to Dr. ea 1 5 Email from Medical Director to EMS personnel, Chief Nail and Captain Ammons (Fire) to have protocols distributed in June 2018 turned into supervisors ASAP and considered VOID due to discrepancies and drug dosage errors. Employees are to revert back to protocols found on the County website and signed by either Dr Neal or Dr. Edler. Further included was a list of 5 medications that will require medical control (a doctor?s order) prior to administering medication. February 12, 2019 email send to EMS personnel and Capt. Ammons (P ire) to clarify the Pain Management Protocol Paramedic sends email to Chief Nail, Chief Salter and Dr Edler on February 15, 2019 regarding current issues with protocols. Chief Nail responded requested concerns/questions up the chain and advise him of any issues. March 12, 2019 Medical Director signs new Clinical Policy This policy was provided to media on April 26, 2019 however, I discovered this policy was never issued to employees. I discussed with Bill Hopkins, the Paramedic assigned to Dr. Edler after she declined to meet with me. He accepted the blame for the policy not being issued to the EMS employees and I suggested he contact Chief Salter and get this policy out to the employees. Policy issued to employees on May 7, 2019. June 1, 2019 Target Date for Updated Protocols Bill Hopkins advised adult protocols should be out by mid-May. During meeting with Chief Nail on April 24, 2019, he said the target date is June I, 2019. Dr Edler advised in email dated April 30th that the date for protocol issuance may be delayed due to ?recent events and continuous distractions along with her job responsibilities that include the correctional center?. ESCAMBIA COUNTY OFFICE - "err-Homes Resources 1700 Leonard St. Pensacola, FL 32501 11__t;p: mbiaso.com INVITES APPLICATIONS roe THE POSITION or: Dispatcher An Equal Opportunity Employer $14.54 Hourly $1,163.20 Biweekly $2,520.27 $30,243.20 Annually NING A 09/24;13 QLOSING DATE: Continuous EHE EOSITEQE We invite and encourage all of our wpegtive applicants to view the YouTube video listed below prior to submitting an application. This video dives a general idea of what an emmgyee hired into this position can expect hisgher day-to-day tasks to be. This video is not intended to discourage?Qualified pr_o?pective Dispatcher applicants from applying, but to give a quick insight as to what this position entails at our .communications center, as communication centers var'ilr in volume from center to center, keeping in mind that this is a roughly 4 minute video 12 hour shift a communications center similar to the one at the Escambia County Sheriff?s Of?ce. This class receives, records, and routes emergency communications; dispatches appropriate personnel. OF QUTIES We ingite and encourage all of our prospective applicants to view the YouTube video listed below prior to submiging an application. This video gives a general idea of what an employee hired intg this position can exoect his?her day-to-day tasks to be. This video is not intended to discograguuali?ed Dispatcher applicants applying, but to Give a agick insight as to what this position entails at our communications center, as communication centers vary in volume from center to center, keeping in mind that this is a rougl_1_l_y 4 minute video of a 12 hour shift of a communications center similar to the one at the Escamgia County Sheriff's Office. Dispatches appropriate units to speci?c calls utilizing a radio console; tracks calls and notifies appropriate individual(s) of situations requiring their attention. Receives telephone calls reporting situations, incidences of an emergency nature, or life- threatening nature and directs emergency services, questions caller and solicits information, and receives and routes emergency and non-emergency telephone calls. Maintains and retrieves information from radio logs, flies, and computer programs; disseminates . information to appropriate individuals. I. Enters information into a computer-aided dispatch system (CAD). 6 . .. i. i 5 OKALOOSA COUNTY Department of Human Resources 547?9-8 Old Bethel Road, Crestview, FL 32536 http: ww. . INVITES APPLICATIONS FOR THE POSITION OF: Paramedic (Fulintime) 12 Hour Shift PUBLIC SAFETY EMS (4500) (NICEVILLE) do Equal Opportunity Employer .-.- NGE GRADE: N16 $18.13 $18.13 Hourly $42,351.68 - $42,351.68 Annuaiiy SSQE DA I E: 03/07/19 FINAL FILING DATE: Continuous Ems Provides basic and advanced life support assistance on an emergency basis for the care and . treatment of sick and injured personis). ESSENTIAL JOB Fuucnons Trains new employees and students. Drives an ambulance in a variety of conditions in response to emergency calls. .- Provides basic and advanced life support. Participates in the care and upkeep of equipment ambulance, life support equipment). Performs both medical and non-medical transfers. 'Makes presentations at schools, cardiopulmonary resuscitation classes, civic groups and public safety agencies. Maintains adequate stock of consumable supplies; restocks as needed. 5 Completes reports, forms associated with patient care. Testifies in court murder trial, DUI, chain of custody) and gives depositions. Attends training sessions; maintains all required certifications and forwards copies to the Shift Training Officer. Assists with control of scene and non-injured parties. . Must be able to meet work scheduie and attendance standards. Performs related duties as required. MINIMUM TRAINING AND EXPERIENCE High school dipioma, GED, or equivalent; certification in CPR, and must be a Florida ,certified Paramedic and at least 18 years of age. EVOC certification required within 30 days of hire. Must possess a valid driver license and a good driving record. . --.. - 2* ?vnl -. 6 OKALOOSA COUNTY Department of Human Resources 5479-3 Old Bethe! Road, Crestview, FL 32536 h_ttp: ww . . . INVITES APPLICATIONS FOR THE POSITION OF: EMT (ALS) 12 Hour Shift PUBLIC SAFETY EMS {4500) (COUNTY WIDE) An Equal Opportunity Employer . HG GRADE: 14 $14.57 $14.57 Hourly $34,035.52 $34,035.52 Annually DA I E: 02/21/19 FINAL FILING DATE: Continuous THE POSITION Provides basic life support assistance on an emergency basis for the care and treatment of sick i and injured personfs). SSENTIAL JOB FUNCTIONS Drives an ambulance in a variety of conditions in response to emergency calls. Provides basic life support. Performs both medical and nonsmedical transfers. Participates in the care and upkeep of assigned equipment: ambulance, life support equipment. 'Makes presentations as requested and scheduled at schools, cardiopulmonary resuscitation classes, civic groups and other public safety agencies. :Assists with control of scene and non?injured parties. Maintains adequate supplies of consumable supplies; restocks as needed. . Testifies in court murder trial, DUI, chain of custody), and gives depositions. Attends training sessions; maintains all required certifications and forwards copies to the Shift Training Officer. Must be able to meet work schedule and attendance standards. Performs related duties as required. . MINIMUM TRAINING AND EXPERIENCE High school diploma, GED, or equivalent; certification in must be a Florida registered EMT and at least 18 years of age. EVOC certification required within 30 days of hire. Must be computer literate and possess a valid driver license and a good driving record. MINIMUM OR STANDARDS BEQUIRED TO PEBEOEM ESSENTIAL JQE FUNCTIONS Physical Requirements: Must be able to exert in excess of 100 pounds of force occasionally, or in excess of 50 pounds of force frequently, or in excess of 20 pounds of force fconstantlv to move objects. Must be able to ascend or descend ladders, stairs, scaffolding, 5E3: mean? 201% lu- Omamma ?cmaoam Dwain: UmucEng. 41 If] . . mm: raw 3333; Tum: 2mg .32, - wamwm?mau?m?mo? - . vcmagm 00.1 3:23:03 Q?nwa ATTACHMENT 6 Escambia County - Class Speci?cation Bulletin Page 1 of 2 ATTACHMENT 6 Lifeg ua I?d Class Code: Bargaining Unit: No Union Affiliation (NU) ESCAMBIA COUNTY Established Date: Sep 26, 2015 Revision Date: Dec 22, 2015 SALARY RANGE $14.57 - $16.89 Hourly $1,165.60 - $1,351.20 Biweekly $30,305.60 $35,131.20 Annually DESCRIPTION: Mandatory Testing Position: Requires Drug Testing Monitors the activities at pubiic beaches to prevent accidents and provide assistance. Work is performed under the direction of a Senior Lifeguard. EXAMPLES OF DUTIES: Rescues swimmers in danger of drowning and administers first aid. Maintains order and discipline. Patrols beaches to protect property. Cautions swimmers regarding unsafe areas or conditions. Operate light truck or other motor vehicle. Performs other duties of a similar nature or level. TYPICAL QUALIFICATIONS: Training and Experience: Must successfully complete in-house training course as open water lifeguard. Any combination of education, training, and experience which provides the required knowledge, skills, and abilities to perform the essential functions of the job. Licensing Requirements: A valid Driver?s license Possession of an Amarican Red Cross Lifeguard Training Certificate is preferred 40290 1 9 STATE OF FLORIDA DEPARTMENT OF HEALTH - EMERGENCY MEDICAL SERVICES Personnel Records {Section 401.31, Service Name: Escambia County Inspector Name: Shelly Lewis Inspection Date: U7l31i'18 Total Number of Personnel: 150 Number of Files Reviewed: 22 ATTACHMENT 7 Name of Personnel Date of Employment Record of Training EMTiPara. Cert. Type and Exp. Date Cert. Type and Exp Date {Drivers Only) Driving Record Ve rif. YesiNo Date Valid ELL. YesiNo Exp. Date EVOG Training Yesiilio Dale Statement for Driver Only Alcohol Dr Drug Yesi'No Phys. Dr ?18 First Aid 0: Mental YOA Personal Safety Yeei?No Yeemo Card Yesme Exp. Date Ard. Kimberly 1 YES ACLS-12I1S 103311111 9 1 YES YES YES WA Alverson, Aimee OSHEHB YES 15-352 02720 CPR-USED NM 03? 4E0 05i14i13 YES YES YES NIA Kaliyn 1 6 YES CPR-USN 9 WA 07"1?051?26 051'231'15 YES YES YES MIA Bryars, Jason 02.106.? 8 YES 5554242 NIA SUBBED (32.125113 YES YES YES WA Dirks, '1 YES 13-52-11-629 W19 111131'21 USIZOIGE YES YES YES MIA Grey. Michael 12104r?12 YES P-531 82? EM 3 MIA 0326.312 YES YES YES MIA Hammer. Daniel G1i13i?? YES P218586 011 9 MIA ?Si23f2Ci 0112355 YES YES YES MIA Jackson. Thomas 091'131'11 YES 9529350 9 WA U1i031'19 USIDSHD YES YES YES MIA Kerman. Welter 12i11i12 YES P9524535 ABLE-011120 NM. 04i3?i26 121?22! 12 YES YES YES MIA 10. Lorren, Lee 09? YES 5554813 1 9 MA 05129196 09i28i'17 YES YES YES NIH 11. Tankeley, Jessica ?15.!r 1 0305 YES E-518925 GP 9 NRA 0301(19 YES YES YES NIA 12. Maddrey. James 11i18f14 YES P-524TBS WA 1 1 DIES UBISOIDB YES YES YES WA 13. Mays, Jan [1811041?1 5 YES 5532634 CPR-02119 MA 02i28i23 051'261?1 1 YES YES YES 14. McNamara, Stephanie 1Ui11f15 YES 182 AC 0 NM 0211 5:526 1?f14i16 YES YES YES Miller, Daniel QUEENS YES CPR-03H 9 MIA 12103J19 GEIGQH 5 YES YES YES WA Penroee, John DUO-CUBE YES P-14321 AC LS-DSH 81' NM 06411590 DSKUEISS YES YES YES MIA Reid. YES 11531328 9 NM. 07i13319 USHEH 3" YES YES YES NIH Selma-3r, Matthew 02.190111 5 YES P-521 WA 051? 1 SIZE 1 2f?7i03 YES YES YES MIA Shambc. Michael 11128!? YES E-558264 ?13 MIA U1f06i22 YES YES YES WA Solomon, Teria 05112 9H 3 YES ACLS-OSIZD NM 10f12i19 DSIMHB YES YES YES MIA TaylorI Cheryl 08i29i1 5 YES 13?531821 MIA D1f14i20 051'291'1 5 YES YES YES NM Thiemann..iohn D?i'12f18 YES 15-55-0434 R-02i1 9 Nix?. USIUHEU 0511 4H 8 YES YES YES MIA ATTACHMENT 7 3? . 3n" nLonIoa . OF HEALTH EMERGENCY MEDICAL SERVICES SERVICE RECORDS AND FACILITIES INSPECTION REPORT (SECTION 401.31, ES.) Service Name: Escambia County Inspection Date: Phone: 850471-6481] County: Est-am hia Type of Inspection: Announced I Di'l a License Type: Transport Date of Last Inspection: 15 license Expiration Date: Imd?s Inspection Codes: Rating Categories: 1 item meets inspection criteria I =Lifesaving equipment, medical supplies, drugs, records or procedures is Item corrected during inspection to meet criteria 2 Intermediate support equipment, medical supplies, drugs, records or procedures 2 items not in compliance with Inspection criteria. 3 Minimal support equipment, medical supplies, records or procedures I. commute AND RECORDS STORAGE (Chapter de?I, F.A.C.J 1. Records storage and security. 53-41-145 2. Records storage for 5 years. 4. Items are stored in a ciirnaoe controlled hooted and airIcoaditioaed] location. tr. naconns (Section dill, 11-3., Chapter 541.1, ram .31; 5. The area is clean and sanitary. 1' 1. Current service license on display. [Chapter de-I, 1 Observe if the following requirements for controlled substances are being met: 1' vaidmm?a? Records (Chapter T0 ?dude: I. The requirements listed in items 103 above are being met. Restitution. I 1 2. Medical director has registered storage areas with {Chapter 6414, sac.) *3 B. Veri?cation ofvelricie permit. . C. Written operating procedures for the storage and handling of ?uids and medications specify the . fullorvin g. 3. Previous Inspection Forms, (Chapter 64b1, RAIL) Er 1. Security pmcedura. 4. Personnel Records for each EMT, para medic (Chapter 2. Items stored in a climate controlled location (Le. Heated and air conditioned) To Include: . . A. Date of em ployment. -L1- 3. Deteriorahed or expired items stored in a quarantine am, separate from usable items. B. Record at" training. 1, 4.1mmtory procedures. I C. Current professional certi?cation 1 D. Written operating procednrm for the storage and handling of controlled substances specify the following; D. Documentation of completion ofthe 1983 D.0.T. Air Medical Crew 1. Storage proccdo res. -f National Standard Curriculum-Advanced, for Paramedic Crew members NM .r {Chapter 64.14, use.) 1: .: .. 5. Ambulance driver record {for each per Section ES.) 2. The positions that have access to controlled substances. 1_ Tn include: Statements rotating ho ARC. - A. ?18 years old. 1 3. Shift change inventory procedures for vehicles. if B. Not addicted to alcohol or controlled substances. 1 4. Procedures to be used For the documentation of use, disposal ot?excess and resupply of1'I' vehidu with controlled substances. - C. Free from physical or mental defect or disease that would impair 1 5. Procedures used for inventory discrepancies. 1'9 ability to drive. 5 D. Driving record veri?cation. 1 Verify that the following occurs with regard in controlled substances: E. Fossess valid class or chauffeur license. 1 1. Storage records are maintained on ?le at the location where be controlled substances are stored. F. Is trained in safe operation of emergency vehicle? 15 hour E.V.0.C. 1 2. All required inventories and records are maintained at least two year rs. G. Primes a valid American Red Cross First Aid and Personal NM. 3. Records are maintained scpa rateiy from other records. I I 1 __Ejrrfetv card or its equivalent. H. Possess: a valid American Red Cross or American Heart El. Equipment substitutions when authorization by medical director {Chapter 64.1?1. F.A.C.) . Association CPR or ACLS card. I I 1 NW3: Current EMT 01" paramedic certi?cation is evidence orcompliaoce with 9. Biomedial Waste operating procedures [Section 381.30, 2525. and Chapters oar-1, EAL.) to items A, B. and 13- above. [?es-lion 4011??). RS.) irreludtt: - - - - 6. Medical Director {Section Edd?1, A. Proper handling . A. Quali?cations: Current ACLS codi?cation or board certi?cation (Chapter 1 B. Proper storage "ll 641-1. . Duties and responsibilities {Chapter 641-1, IDLE.) C. disposal I f. . 1. operating procedures for patient care. 1 EMS providers disaster plan integrates both local and regional disaster plan (Chapter tidJ-l, - 1 FM.) 2. Written quality assurance program operating procedures that require the 11. Adult and pediatric CID approval in rvriting by medical director {Chapter EdJ?l, FAG.) I follorvin g: - a. Prompt review ot'run reports. 1 lil. Ii?arr EMS provider maintains an air ambulance license or has permitted arr-craft, the following record requirements that apply (Section 401.251 25.5. an?gtcr 64J-1. EAL.) b. Direct gbsewa?an ofpersonnel. 1 - A. Emergency protocol for overdue aircraft, when radio communications cannot be established, his" or when aircra? cannot he located. . . . 3. Documentation of im of #2 shove. 1 B. Documentation ol'i'light done every 15 minutes while enroute to and from patient?s location. NM 4. Documented ol'pariieipation in direct contract time with EMS Field Level C. Safety committee to include: Providers for a minimum ofll] hours per ymrr. - 1. Membership of one pilot, on ?ight medical crew member. medical director, EQ representative and one hospital administrator [if hospital based]. Inventory, storage and security procedures for medications, ?uids and controlled 2. Written safety procedures. substances {Sections 499. 393, F.S.. and Eispters ti-tJ-i. I . . A. Observe if the following requirements for medications and ?uids are being met: 3. Meetings held quarterly to review safety policies, procedures. unusual occu nearer. safety issues. and audit compliance with safety policies and procedures. 1. Storage area is secured by a Inciting mechanism. 1 4. Safety audit results communicated to all program personnel. MA- 3. All items are iaventdried at least :1 5. Iliiuutcs of meetings retarded and retained on ?le for 2 years. NM. 3. Deteriorated or expired items are stored in a quarantine area, separate from _gsalrlc items. Comments: ATTACHMENT 7 - STATE OF FLORIDA . 1 . . 3% DEPARTMENT or mun - EMERGENCY MEDICAL Essa: LIFE SUPPORT VEHICLE REPORT 401.31, ES.) - SBWICB Name: Esoambia Countyr Inspection Date: 07?1'31l18 Phone: 850-471?6400 County: Esoambia Type of Inspection: Random Announced Vehicle Mormatjon Med Year-Maire Permit Type ALS Permits! 1.7694 VIN 311'? Taglt 212363 CHEW: ??11 Il?l? meets mall-DI]. I . ?:Lifmvi?g anlpm??t, m?dical SOPPEES, drugs, regards i 111 Item noncctod dining moor criteria. 2 wintr-rmcdiatc sipportoquipmcut, modical supplics, drugs, roocrds 2 BItcms not in complimco with criteria 3 ll?uiinal support cquipmcut. modiral supplies, records or procedures km: ?25111me RTIFICATE NUMBER Crew cream?m: Section 4111,2711} . Jessica Tanirsley 513925 Add 4111.281, ES. "Hll I . Stephanie ll'IcNamai-a 531182 - . ll" llulmnm Duo EMT and Our. VEHICLE 121191311:st {31111119111315 and 401, F.S.. Chapner 54.1.1. 11.11.13. and d. 1 1 -. cit-1m . 1. Exhaust System 1:1; I-o. also {minimum 519 inch) pads . i 1.5.11.de Lighls: 1 2. Due pair ofBandagt Shears 3.1 A Road lights (high and law beam) 3.01m set each. paticnt rcshaints - wrist and cold: 1 B. Tum signals 1. 4. On: each blood pressure cu??s: infant; pediatric, and adult. 1 5. Doc podiahic and 111.111.1- Tail. lights s. Blankets E. Back-up lights and audible warning de?ne - .1 7. Sheets. [not required canon?transport whiclos) 12'. 3. Horn 3. Mom with covers and pillowcases or disposable single use pillows. {Not required on non-13 . - Wales.) 4. Windshield m?pcrs 9. One disposable. orpaticnr rain cmr. 1 5. Tires 1 1t}. One long spine board and three straps or squivulcut. 1 51 Vrhiolc of rust and dents . Ono short spinehoard and two straps or squiralcnt. Two-way radio communication ?-rud1'o test 12. One each adotr and pcdialzio cervical Mobilization dcvicc1C?3}, approved by the madical dircctot . 1 ofthn service. This approval must be in writing and mad: available by the provider-for the depamnnt to review. - - A. Hospital (cab and patina-u compuromm} 1 B. Set cfpadding for lateral lowcr spine immobilization cfpadjan-ic patients or equivalent. 1 B. Dispatch Center 1 14. Two po?ablc oxygen ranks or cylinder:, with one mgulator and gangs. Each tank mist has: 1 a minimum mason: of 1000 psi. C. 0111111321155 units 1 l5. Each transparent oxygen. masks; adult. child. and infant sins, with tubing 1 3. Emergency Liglm 1 16. Sotofpsdiatric and adulrunsal cannulac with tubing. 1 9. Stuart 1 l7. Ono each hand bag-valvc mask ramcimon, adult and podiam?c accumulator, including 1 Fun. child and infant nuns-11am masks capable afnso with supplemental oxygc_n_ 110. Two ABC ?re folly churgod and inspected in brackets. lVIinirmun 1 13. Due portable suction, electric orgas with aid: born tubing and tips, which meet the 1 ouch. minimum standards as ?hlishsd by the GSA in Speci?cations. i. Doors open properly, close securely. 1 1.9. Assorted sizes of nsocmity immobilization dc?ccs. 12. Rear and. side View minors. :1 21]. On: lower extremity traction splint. {Pediatic and Adult) 1 13. Windows and windshield 1 On: srcrilc kit to include, urminimum, bull: syringe. starilc scissors or scalpel and cord 1 . c?ps or cord-tics. . TRANSPORT was REQUIREMENTS {Section 4&1. ES, and Chapter 641-1, 22. Bum shoots inc. and 1. Primary stretcher and three straps, 1 23. Our: ?ashlight with batteries. 1 2. Auxiliary sketches and two straps. 1'1 1 24. Occlusive dressings. . 3. Two coiling mounted IV holders . 25. Assorrotl sins of orophan-ngcal airways. Psdialn'c and Adult 1 4. Two uo-amoidng signs. 26. Due installed oxygen with rcgulutor gauge: and wrench, minimum size cylindcr.(0tl1nr installod -- 1 oxygen {Saliva-y systems, Such as liquid oxygen. as allowed by medical director. This approval must be in lying and :rvailublc to thongm formviesv.) 5. Omhcad grab mil. 1 Suf?cicnt quantity ofglovcs ?snin1bln to provide banter prolnclion from bichurards for all crow 1 - 5. Squad bench and sets ofscat bolts. 1 .1- - Intodorlighrs. 1 23. Su?ciont quantity ofcach for all crow-members -?Facc Masks .. both surgical and reapiratory 8. Exterior doc-??ghts. 1 9mm? 1 9. Loading lj?gts. . 1 1 1t}. Host and air conditioningwith fan. '1 pediatric and adult sizes rigid ccrvioul collars as approved :11 outing by tho mdlC?i director 1 and available for review tar the doparlmcut. . ll. sidns, back and miourimagc fran 30. Nasopharyngeal airways. French or turn equivalents (infant, and adult 1 . MEDICAL EQUIPMENT FOR TESTING [Chapter 64.1-1, FAQ, 822 31. One approved biohazardous wast: plastic bag or impervious container par Chapter 645?}, FAQ. 1 3111. Pediatric loug?-I devicc for 111' must solcctiun and dru dcsa '1 1. Installed suction. {Transport only} 1 141-, 13 and 25 in section IV musrho tasted. Dun par urn-rambler, softly or Equivalent standard. 1 V. MEDICAL SUPPLIES AND EQUIPMENT (Chapter 643-1, F.A.C., GSA 33. Gun hull: syringe separate from obstetrical kit. 1 512 . l. Bandnging. dressing, and taping supplics: 1 3d. Du: dismal re?ective blankst. . Rolls adhcsivo, silk crplas?o'c tape. --1 35. Two urulli?h?aurna 1 I Sterile use . sizo GENERAL smanou [Section 401.151.1112Vehicle and Contents Satisfa?ory El Unsaiis factory LT?arrguiarbandagcs 1 Comments: ATTACHMENT 7 . 3T. 1T OF DEPARTMENT OF HEALTH MEDICAL SERVICES ADVANCED LIFE SUPPORT VEHICLE INSPECTION REPORT (SECTION 401.31, 17.5.} Service Name: Escambia County Inspection Date: DTBUIS Unit No. Med 32 Inspection Codes: 1 Item meets inspection criteria. la= Item corrected during inspection to meet criteria. 2 wIl'ernruiulio ?ance widr' action criteria. Rating Categories: 1 - lifesaring equipment, medical supplies, drugs, records 2 intermediate support equipment, medical supplies. drugs, records or procedrm 3 rbllinimelsn ort uim medicalau recordsor concourse ALB 13qu AND MEDICATIONS {Reference Chapter 54.14, EAL.) MEDICATION QT EQUIPMENT {Cont} 1. Atropine Sulfate a Intraosscous needles 13 or to gauge and three way stop- 31- - cocks. As allowed by medical director. . 2. Dextrose, St] 25 gmr'?llrn] 1 o. Syringes ?oor I art. To 20 ml. 1 meat 3. Epinephrine 1:1,000 rag/ml p. DC battery powered portable monitor de?brillator capable of HCL delivering energy below 25 with adult and pediatric 1 paddles {or pediatric paddle adapters] and EKG printout and spare battery. 4, Epinephrine 1: 10,900 i mgil?cc 1 or. Adult and pediatric monitoring electrodes. V-Ped I __l-lCL electrodes 5. Ventricular I r. Pacing electrodes, if monitor or de?brillator requires. 1 . 1 T. Naloxone 2 mg amp. 1 .Elcotronic waveform capnography capable ofreabtime '1 arena) Monitoring and printing record of the inrobated patient 8. NiooglyCer-in {1.4 mg Spray pump 1 EIMeth-zrd of blood glucose monitoring approved by medical 5'1. - . 9. Diascpam 5 1 o. Pediatric length based measurement tape for equipment 1 - selection and drug dosage. 10. lnhalant, Beta In uebulizcr v. Approved sharps comainer Chapter 543-1, FAG. Adrenergic agent apparatus with nebulizer 1 apparatus, approved by medical director SOLUTIONS MOUNTS w. Flexible suction catheters size 6-3, lit-12, and 14, French One each 1 MUM QTY 1. Lactated In any combination Other ALS Requirements Ringers or Normal 1 Saline Medical Equipment 1. Standing orders authorized by cunent medical director within last 24 months 1 a. handle with batteries 1 2. Controlled substances stored in stocked drug compartment, 1 blades, adult, child and 1 3. Controlled substance ?when vehicle log: 1 1 Sizes - c. Pediatric IV arm board or Splint 1 A. Inventory conducted at beginning and end ofsbi?. 1 appropriate forl?il stabilization -. i7d. Disposable endotrachea] tubes; adult, 3. Log consecutively, pernranentiy numbered pages. child and infant sizes (Two each within the 1 ranges 2.5mm 5.0mm shall be uncu??ed; range 5. moi?7.0mm; Harm?9.0mm} e. Pediatric and adult endotracbcal tube '1 C. Log on each vehicle speci?cs: 1 .. Pediatric and adult Magi]! forceps. 1 1. Vehicle unit or number, . 1 g. Device for meconiunr 1 2. Name of employee conducting inventory; 1 suctionin in newborns i h. Touroiquets 1 3- Date and time of inventory; 1 i. IV countries between 14 and 24 gauge 1 4. Name, weight, 1male me or quantity and expiration date of each controlled 1 substance; i. Micro drip sets 1 5. Run report no. {if admigistcred}; 1 Macro drip sets 1 5. Each amount administered or disposed; I 1. IV pressure infuser 7. Printed name and signature of administering Paramedic or other authorized 1 licensed professional. to. Needles between 18 and 25 gauge 1 Printed name and signature of person ndtnessing the disposal of each unused 1 carbon. Comments: ATTACHMENT 7 Service Name: Escamhis County Inspector Name: Shelly Lewis OF FLORIDA Equipment Test Results DEPARTMENT OF HEALTH EMERGENCY MEDICAL SERVICES inspection Date: 07131!? Unit Number: Med 32 F?t?i HEAL kale 5.). I. RESIPRATORY EQUIPMENT TEST Resume A. Aspiretcrs Built?in Portable Spare (Reservoir must be connected) Quick Test: . 1. Fiow rate or 30 Umin Yes Er No XYes Ci No Yes No 2. Vacuum or mm Hg within Yes seconds? 3. Maximum vacuum Aspiratcr tubing cciispsesOxygen Flew meters Buiit?in Portable Spare Quick Test: 1. Disl~type "clicks" into position? Yes I3 No XYes El No Yes No 2. Flow rate within 1.0 Umin when or 10 UminFlow rate within 1.5 Umin when or 11 Limin EiYes Comments: ATTACHMENT 7 STATE OF ?g DEPARTMENT OF HEALTH - EMERGENCY MEDICAL SERVICES Inspection Narrative (Section 401.31, .S.) - -. 3'30?: 5'39. HEAL Service Name: Escambia County Date: 07i31i18 Phone: 850-471-6400 County: Escambia Type of inspection: Random Type of Service: ALS Unit #1 Pvt-32 Page of ?1 Comments (Use additional sheet if necessary) Personnel Records inspection-u-No Deficiencies Service Records and Facilities inspection-v?No Deficiencies BLS Vehicle Inspectionw?No Deficiencies ALS Vehicle inspectionm-No Deficiencies Equipment Test Results inspection??No De?ciencies thank you and your staff for your help and cooperation during this inspection. Outstanding inepection. Excellent employee and service records. Med 32 crew members were polite and worked well together to locate required equipment. Good QAIQI program. EMS Section Chief Kate Kenny if there is anything the Department can do to assist you in the future please, feel free to call anytime.