The Multnomah County Board of Commissioners appointed 12 new members to the Emergency Medical System Advisory Council (EMSAC) during the regular Dec. 5, 2024 board meeting.
Health Officer Dr. Richard Bruno and Emergency Medical System Administrator Aaron Monnig presented the dozen candidates to be appointed to the advisory council required by both the County’s Ambulance Service Plan (ASP) and County Code. The council’s purpose, Monnig said, is to assess potential changes to the emergency medical system within the constraints of the ASP and to advise the EMS medical director and administrator. They do not make policy or hold authority to make decisions.
Monnig explained that at least one-third of the members are people who may access ambulance services in Multnomah County.
“They are knowledgeable healthcare professionals who live, work or spend time in Multnomah County and represent a variety of perspectives including EMS, coordinated care organizations and other system partners,” he said.
Dr. Bruno shared key reasons action to establish the advisory council was only being taken now despite the ASP, which went into effect Sept. 1, 2018, requiring it.
Since the adoption of the ASP in 2016, the EMS medical director and EMS administrator have received recommendations relating to clinical innovations and changes to the EMS system from the Tri-County Protocol Development Committee (PDC), a group of over 100 members that represent the agencies and users of the system, Dr. Bruno said. However, there are some redundancies and duplications between the Tri-County PDC and the EMSAC as it was originally envisioned in the ASP.
Multiple other committees also meet currently to advise the EMS team: the Contract Compliance Rate and Regulation Committee, Dispatch Committee, Operations Committee and a Continuing Quality Improvement Committee. In total, these five standing committees comprise more than 200 members who represent other county and city agencies, community groups, and other stakeholders.
“With all of these advisory committees, while they are not decision making bodies, we strive to elicit diverse perspectives, get honest feedback and expert advice as we sustain an equitable and efficient EMS system,” said Dr. Bruno.
Upcoming Ambulance Service Plan reassessment
As the Health Department begins to fully reassess the ASP over the next year, EMS consultants Healthcare Strategists will meet with many of these committees as part of their system assessment process.
“The re-evaluation process may result in recommended changes to the ASP, which could include augmenting, eliminating or otherwise changing the way that the EMSAC is referenced,” said Dr. Bruno.
“The ASP assessment will provide us with a great opportunity to consider the perspectives of this group of professionals in performing system improvement recommendations.”
Dr. Bruno said that he hopes to schedule the group’s first meeting in late January or early February. Their first convening will connect the group into the ASP assessment stakeholder engagement process.
The establishment of the Emergency Medical System Advisory Council should be seen “within the context of the possibility that the EMSAC may change pursuant to recommendations in the ASP assessment process,” said Dr. Bruno. “We’ll be balancing the work of this group with that reality and possibility.”
Board comments
“I absolutely believe that this group is a really excellent selection of folks who do have the knowledge and expertise that can speak up, speak out, identify appropriate policy and have the background to be able to identify when the County is going down the wrong path,” said Commissioner Sharon Meieran.
Commissioner Meieran also disclosed that her husband, a retired physician who works with Portland Street Medicine, is among the inaugural EMSAC members. However, she did not know he had been selected until later in the process.
“I just want to ensure that we are including throughout the multiple steps of that [ambulance services plan reassessment] process the frontline workers on the ambulance who know what that's like,” said Commissioner Shannon Singleton.
“When we had one of our multiple discussions about the delays in ambulance service, this committee hadn’t been created and I asked the County’s counsel what we should do if we are not in compliance with the ordinance and her recommendation was to get in compliance with the ordinance,” said Commissioner Julia Brim-Edwards. “So I’m glad we are getting in compliance with the ordinance.
“And I hope that we will be able to utilize their expertise to have a long-term sustained change in how services are provided. What the community went through the last two years should not be repeated.”
“I am interested in the work that this group is going to do, but also the work that is happening with the ASP and some of the recommendations coming forward so we can continue the discussion with our ambulance service plan,” said Chair Jessica Vega Pederson.
“We want to make sure we have a very robust functioning ambulance response system here in Multnomah County. We want to make sure we have the right structures in place so community voice, stakeholder voice and people with expertise are engaged in the work that is happening. This is a first step for this and I think we can continue.”
Emergency Medical System Advisory Council members
- Allison Empey, Vice Chair of Equity, Diversity and Inclusion, OHSU Pediatrics
- Andrew Mendenhall, CEO, Central City Concern
- Bill Conway, EMS administrator, Clackamas County Public Health
- Bill Toepper, Emergency Physician (Retired), Founder, Portland Street Medicine
- Dan Bissell, CMO, Legacy Good Samaritan
- Fred Cirillo, Emergency Physician (Retired), Volunteer, Portland Street Medicine
- Jeanne Savage, CMO, Trillium Community Health Plan
- Kate Felmet, Medical Director, OHSU Pediatric and Neonatal Doernbecher Transport
- Kinsley Hubel, Pulmonary and Critical Care Physician, OHSU
- Maggie Bennington-Davis, CMO, Health Share of Oregon
- Mohamud Daya, EMS Medical Director, Tualatin Valley Fire & Rescue, and EMS Section Chief, OHSU
- Shawn Baird, CEO, Metro West Ambulance
