EMS BullEtin

Virginia Office of Emergency Medical Services, Virginia Department of Health Summer 2007

Recognizing the EMS Response to VA TechBy: Gary Brown, Director

OnApril16,2007,astheeventsthatwereoccurringontheVirginiaTechcam-pusunfolded,ourNationwatched the response ofmultipleEMSagenciestoVirginiaTech.Whattheysawwasanorganizedre-sponse to a major EMSincident.

Virginia Tech RescueSquad tooka remarkableleadershiprolebyprovid-ingincidentcommandforEMS.Theydemonstratedthe training and knowl-edgethattheyhadlearnedthroughpractice,experience and pre-planning.Along withthehelpofotherregionalEMSagencies,Virginia Tech Rescue Squad displayed a

professional response in theface of a horrific event. The Staff of the Office of EMS(OEMS)would like torecognize the professional-ism,dedication,andstrengthdisplayedbythemembersofVirginiaTechRescueSquadand all other rescue squadsthat responded as theyworked to provide the high-est levelofcare to those in-juredduringtheevent.

Throughout the days ahead,OEMSwillcontinuetokeepthe EMS and first respond-

ers, the Virginia Tech staff and students,their families and the community in ourthoughtsandprayers.Thankyouforyourcompassion,skillandservice.

The next deadline for theRescue Squad AssistanceFund (RSAF) is Sept. 17,2007. All applications aredueinby5p.m.Itemseli-gible for funding can in-clude programs, services,equipment, vehicles, com-puters, EMS managementprograms, courses/classesand projects benefiting the recruitment and retentionof EMS members. Therehavebeenseveralchangesimplemented within the

RSAF grant program, allofwhichareeffectiveSept.17, 2007 and are outlinedbelow.

*Allsubmissionswillonlybeacceptedunderthegen-eral grant fund. The Office of EMS (OEMS) will de-termine if your grant ap-plicationfallswithinoneofthepriorityfundingcatego-ries. All grantees that areapplyingundertheintentoffundingaprioritycategory

must submit the SpecialPriorities Questionnairefor all priorities exclud-ing recruitment/retention.TheRecruitment/RetentionQuestionnairemustbesub-mittedforthatpriority.

OEMS has identified six priority levels for fundinginnoparticularorder.• Recruitment and Reten-tion (including Manage-mentandLeadership)Continued on Page 3

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In This Issue

Keeping The Best! WorkshopsAnswers on Strokes

RSAF ChangesBensley-Bermuda Scholarships

Staying Healthy in HeatHMERT in Jamestown

Are you a 10-percenter?EMS Communications Directory

Regulations Myths & MoreGet to Know Your Rep

Calendar of Events

Changes to the RSAF Application ProcessBy: Amanda Davis, Grants Administrator

Dateshavebeensetforthesummerandfall 2007classes for theKeepingTheBest! workbooks. Each workshop isonedayandwilllasteighthours.Thesessions will feature facilitated groupactivitiesandtipsonhowEMSleaderscangetthemostoutoftheworkbooks.

Class space is limited to encourageinteraction and discussion, so EMSagencyleadersareencouragedtolimittheirregistrationtotworepresentativesperagency.GototheOEMSWebsitefor dates and registration informationat www.vdh.virginia.gov/oems or gototheregistrationpageatwww.vaems.org/retention.

To learn more about each workbookpriortoregistration,youcandownloadyourowncopyattheOEMSWebsiteor e-mail emstechasst@vdh.virginia.gov for assistance. More classes arealso planned for 2008, so check theOEMSWebsiteforupdates.

Maximizing Your Retention Ef-

forts–ThisworkbookisdesignedforEMSagencyleaderswhoareworkingthrough retention issues while experi-encing significant growth and change such as the integration of career andvolunteerpersonnel. Participantswilllearn a systematic process to work

throughchangeandreviewtheimpor-tanceoftherecruitingprocessandtheapplicationofkeyretentionprinciples.Directors and chiefs of combination(volunteerandcareer)departmentswillfind this workshop particularly useful.

How To Use EMS Retention Prin-ciples –This workbook is targeted atappointedandelectedEMSleaders to

helpthemunderstandandusebasicre-tention principles in day-to-day EMSagency operations. Participants willlearn how the life-cycle, belonging,success,andfriendsandfamilyprinci-plesapplytoEMSretentionprograms.While this workbook was originallydesigned for volunteer EMS leaders,careeragencieshavefoundthesereten-tionprinciplesjustasuseful.

Train-the-Trainer classes – EMSleaders who complete the eight-hourclassesMaximizing Your Retention Ef-forts and/or How To Use EMS Reten-tion Principlesandwanttoteacheitheror both classes may apply to becometrainers. If you are interested in be-comingatrainer,pleasee-mailemstechasst@vdh.virginia.gov for thecriteriaandmoreinformation.

FormoreinformationabouttheKeep-ingTheBest!workbooksortrainings,contactRohnBrownatemstechasst@vdh.virginia.gov

Keeping The Best! Retention Workshops By: Rohn Brown, Technical Assistance Coordinator

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EMS Bulletin

The Virginia Stroke Systems of CareLeadership Team invites providers,physiciansandotherEMSprofession-alstousetheVirginiaStrokeSystemsAmbassadorPanel(VSSAP)whichal-lowsyoutotapintotheexpertisethatis available to Virginia stroke profes-sionals.

Since the inception and launch of theVSSAP, thegrouphas responded toawide variety of questions. The ques-tionssubmittedtothepanelhavecomefromnurses,strokecoordinators,phy-sicians and administrative personnelacrossthestate.

Topicshaveincluded:

•EMSandacutecareprotocols,•JointCommissionPrimaryStroke Center Certification, •Patientsatisfactionsurveys,•Theroleofneurologistsinacuteimaging,•Strokeprogramdesignand•Multi-mediaresourcesforcommunityandprofessionaleducation.

VSSAP is comprised of physiatrists,neuro-radiologists,neurologists,emer-gencyphysicians,nurses,EMSleader-ship,hospitaladministrators,legislativeand advocacy personnel, stroke pro-gramcoordinatorsandexpertsinstrokeprogram development and stroke sys-temsofcare.Thepanelhasbeenimple-

mentedtomeetapressingneedacrossthestateforasingleauthoritativeandfree resource for questions regardingstroke program design, development,evaluation and performance improve-ment.

Take advantage of this resource nowandsharethiswithyourcolleagueswhomay benefit, as well. E-mail your confi-dentialquestionstova.strokesystems@heart.org.

For more information contact KeltcieDelamar,StateHealthAlliancesDirec-tor,AmericanHeartAssociationat804-965-6571 or e-mail keltcie.dela-mar@heart.org.

Get Answers to Your Questions About StrokesSubmitted By: Keltcie Delamar, State Health Alliances Director, American Heart Association

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Summer 2007

•Training•EmergencyOperations•EmergencyMedicalDispatch•SpecialandInnovativeProjects•Multi-Jurisdictional/AgencyProjects

*Allgrantsmustbesubmittedonline.This may be done by downloadingthe Consolidated Grant ApplicationProgram (CGAP) software from theOEMSWebsiteorrequestingaCGAPsoftwareCD.

*TheMicrosoft(MS)Vistaoperatingsystem has replaced Windows XP. Ifyou have purchased a new computersince Jan. 30, 2007 you will now beoperatingunder theMSVistaoperat-ing system. The CGAP software isnot compatible with MS Vista, how-everOEMSis takingmeasures toef-fectively resolve this issue, althoughitwillnotberesolvedbytheSept.17grantdeadline. PleasemaintainyourhardwarepriortoJan.2007inordertoeffectivelydownload theCGAPsoft-ware. If you are having issues sub-mitting your RSAF grant applicationonline, the OEMS advises all grantapplicants to consult with your local

EMSRegionalCouncilforassistance.

* The Operational Medical Director(OMD) signature is required for allRSAF grant applications. An elec-tronic signature will be accepted fortheOMDoranoriginalsignaturemustbereceivedtenworkingdaysafterthefinal grant deadline. If the OMD is un-available,thesignatureoftheRegionalOMDwillbeaccepted.

* The grant affirmation page has been revised to include the signature ofthe Authorized Agent, Financial Of-ficer and the OMD. Electronic signa-tureswillbeacceptedforallpartiesororiginal signatures must be received

ten working days after the final grant deadline.YoumustalsoincludeyourFederal/Employer Identification Num-ber (FIN/EIN) and your official busi-nessname,asregisteredwiththeIRSand the Virginia State CorporationCommission.YoumustincludeacopyofyourmostrecentfederaltaxreturnfromtheIRS(Form990)

*Grantapplicationssubmittedunder$500.00 for line items will automati-cally be disqualified from the grant review process. Each line item sub-mitted on the grant application mustbe$500.00ormoretoprogresstothegrantreviewprocess.Likeitemsmaybeconsolidated inone line itemwithallindividualpricingcombined.

If you have any questions, want todownload the CGAP software, ques-tionnaires or need more informationon the RSAF grant program or pro-cess please visit the OEMSWeb siteatwww.vdh.virginia.gov/oemsorcallAmanda Davis, Grants Manager at(804) 864-7611 or Linwood Pulling,GrantsSpecialistat(804)864-7612.

Changes to the RSAF Application ProcessContinued from Page 1

The Bensley-BermudaVolunteer Res-cue Squad (BBVRS) announced theformation of the Patrick Gary Ma-sonMemorialAdvancedLifeSupport(ALS)Scholarship.Beginningin2007,the Squad will designate from amongitsmembersuptofourscholarsannu-allywhowillreceivefullfundingtoanaccreditedadvancedlifesupporttrain-ingcenter.

“PatMason,adevotedSquadmemberwho died in the line of duty in 1981,wascommittedtoadvancinghiseduca-tiontohelpthecommunity,”saidGary

Frame,PresidentofBBVRS.“Wefeelit is important to link his memory totoday’s members who are working toadvance themselves in support of thecommunity,andtohelpthemundertakethe financial burden of that education.”

PatrickGaryMasondiedinthelineofdutyonNovember8,1981,whileserv-ingonthecrashtruck,whattodaytheSquad calls its technical rescue team.Mason was struck by a vehicle alongJefferson Davis Highway while onthesceneofamotorvehicleaccident.Mason, a Virginia certified EMT at the

timeofhisdeath,wasplanningtoen-rollinALStrainingbeginningthatfol-lowingspring.

“Bensley is committed to recruitingandtrainingourpersonneltothehigh-est levels of certification available, and toworktoshowourselvesasaleaderintheretentionofpre-hospitalemergencycareproviders,”addedFrame.BBVRSis always seeking community-mindedindividuals to join their team. Visithttp://www.bbvrs.orgfordetails.

Paramedic Scholarships Aid Recruitment & RetentionSubmitted By: Dana Love, Bensley-Bermuda Volunteer Rescue Squad

RSAFgrantscanfundmedicalequipmentlikeAEDs.

Staying Healthy in the HeatBy: Karen Owens, Emergency Operations Officer

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With the warmer weather upon us, staying healthy in theheatisimportant,especiallywhileworkingonanemergencyscene.Thefollowingtipswillassistyouinstayinghealthyintheheat:

•Stayhydrated.Drinkwaterbefore,duringandafterinci-dentstomaintainproperhydration.

•Restoften. Tiredrespondersmaybecomeaproblemonthescene.

•Avoid sugary, carbonateddrinks. They can increase thepotentialfordehydration.

•Staycool.Usecooltowels,mistingfans,sprinklersorwa-terhosestostaycool.

•Knowthesymptomsofdehydration,heatstrokeandheatexhaustion. If you begin exhibiting signs and symptoms,seekhelpimmediately.

•Eatproperly. Proper eating canhelpwith energy levelswhileworking,whetheronthesceneorathome.

EMS Bulletin

After12monthsofplanningandprep-aration, the Office of EMS (OEMS) Health and Medical Emergency Re-sponseTeam(HMERT)resourceswereabletoputtheirskillstothetestduringAmerica’s400thAnniversaryCelebra-tion.

On May 11-13, 2007, OEMS pro-videdresourcestosupportJamesCityCounty’s EMS response to the Anni-versaryCelebration.ThreeEMSTaskForcesresponded:Western14,NoVa3andMetro11. Anewmemberof theHMERTsystemalsoparticipated,EastHanover Bike StrikeTeam. The taskforcesprovidedpersonnelandtruckstoassistwithmedicalneedsatthevariouscelebration sites, while the bike team

providedEMSintheareaslessacces-sibletoambulanceandwalkingteams.Alsodeployedinsupportoftheopera-tion were members of the Coordina-tion Teams, providing command andcontrol support and the Dog TherapyStrike Team, providing rehabilitationservices.

The deployment started Friday morn-ingwithteamsreceivinganoperationalbriefing and then heading to their des-ignatedworkareas.HMERTresourcesassisted with staffing of three First Aid tentssetupthroughouttheAnniversaryCelebration venues. The teams pre-pared themselves for massive crowdsandmedicalproblemsassociatedwithlarge crowds. Security and weather

playedan importantpart in theweek-end. With visits from President andMrs.BushandGovernorKaine,move-mentofpersonnelandtruckswaslim-itedduetosecurityconcerns.Weatherchangesfromsunnyandwarmtorainyand cold, throughout the weekendcaused medical problems related toheatandcoldexposure.However,withover70,000people in attendance, pa-tientinteractionwasminimal.

HMERT resources demobilized Sun-dayafternoonthroughSundayeveningandreturnedhome,withonceinalife-timememoriesofaneventrecognizedaroundtheworld.

HMERT Supports Jamestown CelebrationBy: Frank Cheatham, HMERT Coordinator

Emergencyworkersneedtotakeextracaretostaycoolandhydratedwhileworkingduringthesummermonths.

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Iknowwhatyouarethinking…“Greg,beforeIansweryou,whatisa10-per-center?” Ok, fair enough I’ll explainfurther.

The Office of EMS (OEMS) scannedover175,000continu-ing education (CE) cards, en-rollmentforms,tests,waivers,etc. in2006.Of all the formswe scanned, between 10-15%of them had an error. Thatmeans between 17,500 and26,250forms.

Thereareprimarily twotypesof errors. First there is incor-rect data, and the second isbubble error. The majorityof the errors OEMS sees arebubble errors. Which includeforgetting tobubble theentirecardorforgettingtobubbleasection(suchascertification number, date, course num-ber,topicnumberanddoublebubbling/mis-bubbling; i.e. the person bubblestwobubblesinthesamecolumn).Ev-erytimeamistakeismadeonabubblecard,anerrorisgenerated,eitheratthescannerorinthesystem.Anerrorinthe

systemmeans a provider doesnot re-ceivecreditforacourse,topicorexamuntil someone can fix it.

Now,Idon’tknowifyouhaveeverhadthepleasuretomeetorworkwithEr-nestine Sutton andToniTwyman, butthey are the ones who can truly saveyouifyouhavebecomea10-percenter- theproviderwhohasmadeanerroron a bubble sheet and submitted it toOEMS.

Ernestinereceives,sortsandscansbub-blecardseveryworkday.IfanyoneevertellsyouOEMSisbehindinscanning,

they’re incorrect. OEMSscans every day. As the“Queen of the Scanner”Ernestinehasthepleasureofdealingwithallof themis-bubbles.BothErnes-tineandTonispendmuchof their day trying to fix what they can. Thosethey can not correct arereturnedtoprovidersandinstructorswhenpossible,otherwisetheyareplacedinto the permanent errorfile.

Bubblingerrorscancausea delay in receiving CE

creditordelayprocessingyourtestre-sults.Don’t be a 10-percenter.Take afewextrasecondstobesureyouhavecompletedyourbubblecardcorrectly.Spendinganextra30secondstoassureproper bubbling will ensure smoothcertification/recertification.

Are You 10-Percenter?By: Greg Neiman, BLS Training Specialist

Properly filling in your bubble card can ensure that there will be no delayswithgettingcreditforyourclasses.

Summer 2007

A new communications directory isavailable from the Office of EMS (OEMS). This directory provides in-formation for all municipal publicsafetyansweringpoints(PSAP),EMSdispatch centers, licensed EMS des-ignated emergency response agencies(transportandnon-transport),helicop-ter medevac services and hospitals inthe commonwealth. All public safetyfirst responders, communications cen-ters and emergency managers will beabletousetheinformationthatispro-

vided.With the assistanceofnumerous stateandlocalagenciesandprofessionalor-ganizations, the information has beencompiledintoonedocumentandplacedon the OEMS Web site. Go to www.vdh.virginia.gov/oems. The directorycanbefoundin theemergencyopera-tionssectionoftheWebsite.

For thisdirectory toalwayshavecur-rent information,PSAPsandagenciescan provide corrections, updates and

edits to emscomms@vdh.virginia.gov.The updates will be confirmed and cor-rectionsmadeassoonaspossible.

Allpublicsafetyagenciesareencour-aged to download this document.Printed copies will be provided to alllicensedEMSagenciesandcommuni-cationscentersinthenearfuture.

Contact OEMS at (800) 523-6019 ore-mail emscomms@vdh.virginia.govwithanyquestionsorcomments.

Virginia EMS Communications Directory By: Ken Crumpler, Communications Coordinator

Get To Know Your Rep...

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Heather Phillips is an Office of EMS program representative located in theLord Fairfax area, Heather providessupportandassistancetoherregionandfinds the time and energy she spends travelingtolocationsveryrewarding.

What’s your favorite part of being a program representative?The best part of my job is my abilityto provide technical assistance to myregion and to actually see the agen-cies improve and meet the needs oftheircommunities.ToknowthatIhavehelpedthemreachahigherlevelofser-viceisverysatisfying.

What would you change about being a program rep if you could?There would be more of us, that waywe could spend more time with eachindividualagencyandlesstimetravel-ing to them. We would be able to domorespotinspectionsandprovideevenmorehelpandservices.

Which part of your region do you like

to travel through the best?IalwaysenjoyLu-ray in Page Coun-ty. It has such afriendly and invit-ing atmosphere.They have greatrestaurants, veryfriendly peopleandthesceneryisbreathtaking.Isug-gesteveryonetakethetimetotraveltoLuraytoexperiencealltheyhavetoof-fer.

So what do you do in your spare time other than continuing to assist your region?Well, when I get the chance I tattoo.I’manapprentice tattooist and Ihaveto fulfill 1500 hours of apprenticeship work plus 100 hours of performanceworkandInormallyonlygettoprac-ticeonSaturdays.Ialsolovetocampand spend time with my family. I’mparticularlyexcitedaboutourvacationthis summer. We’re going on a three

weektriptoSouthDakota.

What advise would you give to EMS Agencies?I alwaysadvocatebeing familiarwiththeEMSregulationsandcomplywiththem. The agencies are serving thepublic,thereforetheyneedtobeawareofwhattheycanandcannotdo.Ialsosuggest that agencies be honest withtheirprogramrep.Beinghonestaboutproblems, questions, incidents, etc. isalwaysthebestwaytogobecauseyourprogram rep will do everything thatthey can to help you fix the problems, betteryouragencyandhelpyouservethepublictothebestofyourability.

EMS Bulletin

Heather Phillips, Lord Fairfax Program Representative

Straight From The Rumor Mill... Regulations Myths & MoreBy: Michael Berg, Regulations & Compliance Manager

Here are a couple more commonlyasked questions and misconceptionsthat providers in the field may have. Thesefrequentlyaskedquestionshavebeen answered by Michael D. Berg,RegulationsandComplianceManager.

Q: “I was told by my chief that eventhough I was convicted of a misde-meanor drug possession charge, I canstilltakeanEMTcourse.”

A:Wrong.12VAC5-31-910(4)Crim-inal or enforcement history states inpart:“4.Hasneverbeenconvictedorfoundguiltyofanycrime involving theuse,possession, or distribution of illegaldrugsexceptthatpersoniseligiblefor

affiliation five years after the date of final release if no additional crimes of this typehavebeencommittedduringthattime.”

Date of final release is that time from any sentence imposed by theVirginiaCourt system AND any probationarytime issued. Individuals who are notsure if they are qualified to enter into an EMS training program in Virginiabecauseofapastissue,shouldcontactthe OEMS for clarification.

Q:“Wearehearingthatwemusthavean AED along with our combinationmonitor defibrillator (AED and Manual capable)onourunits.Wealsoweretoldwe had to change the energy settings

perOEMSRulesandRegulations”

A:Thisispartlycorrect.Wedorequirethat an AED be on every permittedEMSvehicle inVirginia,BUT,wedosay in 12VAC 5-31-860 required ve-hicle equipment that “This may be acombinationdevicethatalsohasman-ual defibrillation capability.” Regard-ing theenergysettingsfordeliveryofshock,thatisanissuethatisaddressedbyyourOperationalMedicalDirector,notOEMS.

For the most complete and direct an-swers,contacteitheryourlocalOEMSprogram representative or this Office, (800)523-6019.

The Virginia Department of Health Office of Emergency Medical Services publishes the EMS Bulletin quarterly. If you would like to receive this publication via e-mail please send your request to emstechasst@vdh.virginia.gov.

Gary R. Brown, Director, Office of EMSP. Scott Winston, Assistant Director, Office of EMSElizabeth H. Singer, EditorBrianne Slattery, Assistant Editor

109 Governor Street, Suite UB-55, Richmond, VA 23219 www.vdh.virginia.gov/oems

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Upcoming EventsJuly August September

7/11 - Professional Development Commit-tee,10:30a.m.7/12-MedicalDirectionCommittee,10:30a.m.;EMSCCommittee,3p.m.7/14-EMSInstructorUpdate,9a.m.7/20 - ALS Coordinator Meeting, contactTomNevetralfordetails7/21 - ALS Coordinator Seminar, contactTomNevetralfordetails7/26 - Medevac Committee, 10:30 a.m.;WorkforceDevelopmentCommittee,10:30a.m.

8/2 - Emergency Management Committee,10a.m.8/4-EMSInstructorUpdate,9a.m.8/6-TransportationCommittee,1p.m.8/8 - Critical Incident Stress ManagementCommittee,10a.m.8/16 - Regional EMS Council Director’smeeting, 9 a.m.; Financial Assistance Re-view Committee (FARC), 1 p.m.; Regual-tionsandPolicyCommittee,3p.m.8/17-CommunicationsCommittee,9a.m.;Financial Legislative & Planning Commit-tee,9a.m.;VAGEMSA,10a.m.,StateEMSAdvisoryBoard,1p.m.

9/6-TraumaSystemOversight&Manage-mentCommittee,10a.m.9/7-Governor’sAwardCommittee,10a.m.9/8-EMSInstructorUpdate,9a.m.9/15 - Deadline for RSAF Grant applica-tions,5p.m.9/20 - Trauma Performance ImprovementCommittee,10a.m.9/29-EMSInstructorUpdate,9a.m..

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Please check our Web site for event locations and possible changes at www.vdh.virginia.gov/oems

28th Annual Virginia EMS Symposium“An Education for Life”

November 7 - 11, 2007Norfolk Waterside Marriott, Norfolk, VA

• Over 200 classes to meet your CE needs• A full day of pre-conference classes on Nov. 7th• Experience the new ‘Critical Care Medics Gone Wild’ series• Compete in the new Stars for Life Championship hosted by Bob Page• Enjoy the Governor’s EMS Awards Banquet on Saturday, Nov. 11th and much more

The registration catalog will be coming to your agency’s mail-box and to our Web site www.vdh.virginia.gov/oems later this summer!

EMS Management Manuals Available for Download

Can you fire a volunteer? What docu-mentationshouldyoukeepwhenimple-mentingprogressivediscipline?Whataresometipstohelpavoiddisciplinaryproblems?Discipline and Due Process for the EMS Agencyisanexcellentre-sourcemanualforvolunteerandcareerEMSagencieslookingtostrengthenorassesses their discipline program. L.DaytonHaugh,anattorneyandveteranEMSmanager,backsupthisoutlineofkeytopicswithexamplesfromvolun-teerandcareerEMSsystems.

Why should an EMS agency have astrategicplan?Whatisamissionstate-ment?Howdoyoupreparetowriteastrategicplan?Whyisastrategicplanimportant?JimKelly,aveteranpara-medic and fire and EMS planner with

Chesterfield Fire and EMS, provides a structureforEMSagenciestostartthestrategic planning process and a vari-ety of examples from Virginia EMSagencies. Hismanualwillhelp“sell”theimportanceofstrategicplanningtoEMSagencyleadership.

Thesemanualsaredownloadablefromthe Office of EMS (OEMS) Web site at www.vdh.virginia.gov/oems/Locality_Resources/leadership.asporsendane-mail to emstechasst@vdh.virginia.govforassistance.

Office of EMS & State EMS Advisory Board Public Town Forums

OEMSstaffalongwithEMSAdvisoryBoard members will discuss and an-swerquestionsonhottopicsfacingtheVirginia EMS System including ALS

and BLS accreditation, EMS funding,theRegionalCouncilstudyandmore.

Theupcomingtownforumwillbeheldinthefollowingregionalcouncilarea:

Central Shenandoah October 16

VisittheOEMSWebsiteformorein-formation at www.vdh.virginia.gov/oems or e-mail emstechasst@vdh.vir-ginia.gov.

Office of Emergency Medical ServicesVirginiaDepartmentofHealthP.O.Box2448Richmond,VA23218-2448

ReturnServiceRequested517MA

PRSTSTDU.S.Postage

PAIDPermitNo.1001Richmond,VA

EMS in Brief