The State of Texas came closer to a decision on its allegations against Mark McMain and the Blanco Volunteer Ambulance Corps when Administrative Law Judge Ann Landeros sent her recommendation to Department of State Health Services Commissioner David LaKey on Thursday, July 25, in the case of DSHS vs. Mark McMain. The judge’s proposal noted the number of Blanco residents who spoke out in favor of McMain and testified about his ability, dedication and integrity. Landeros’ findings, however, led her to the opinion that McMain should have his EMT-P (Emergency Technician-Paramedic) certification revoked.

DSHS does not have criminal jurisdiction and does not address any criminal violations emanating from Respondent’s conduct, they can only find McMain guilty of violating the Code and the Department’s (DSHS) rules.

DSHS may revoke an EMS license or certificate for:

• Misappropriating drugs, medications, supplies, or equipment

• …administering…controlled substances

• Providing advanced level or invasive treatment without medical direction or supervision

• Engaging in any conduct that jeopardizes…the health or safety of any person

• Falsifying information on a department application

• Engaging in any activity that betrays the public trust and confidence in EMS

Judge Landeros heard testimony from Elizabeth Holimon, the staff investigator for the State, regarding what she found as a result of her investigation. Holimon introduced evidence of over 120 medication usage forms, each documenting two doses per form that she recovered from the BVAC station. Each form was initiated by McMain and signed off on by Suzy Armstead.

Suzy Armstead testified that she signed the forms because she believed that Dr. Larry Miller, Medical Director of the BVAC, was aware that McMain was removing them in order to treat his wife. Dr. Miller, however, later testified that he was not aware of the removal of the fentanyl until it was reported to the state and he did an audit in January of 2008.

DSHS staff presented the BVAC’s Clinical Operating Guidelines, protocols, which contained Dr. Miller’s directives governing all BVAC medical services. When questioned, McMain stated that yes, these protocols were in place in 2006 and 2007 and that he had received extensive training on them and that he considered the guidelines BVAC’s “Bible”.

Dr. Miller proposed to place McMain on a monitored probation, allowing him to continue working for the BVAC, but not allowing him to have access to or use controlled substances. He would also be required to work under another paramedic’s direction with an estimate of up to a year that it would take for him to work through the remediation process. Judge Landeros deemed this course of action as inappropriate based on the findings that the respect and esteem of the community and his fellow BVAC members have for him (McMain) contributed to his misconduct in this matter and they cannot be good monitors for McMain.

In regards to his failure to document on his renewal application that he had served deferred adjudication, the judge found that he knowingly and willingly falsified the document, citing a lack of responsibility and remorse.

In a phone interview with Nelson Skinner, McMain’s attorney, he supported McMain stating, “Mark McMain is a good man. I have spoken to many people and you can get an earful of good information about Mark from many, many, many, many, people… and then you can get some negative information and you’re not going to get it from nearly as many people.”

“He has saved many lives and helped many people. He is the kind of guy who would stop and help you fight a grass fire. He’s the kind of guy that’ll change a flat tire for you and raise the hood on your car and get you started. He’s the kind of guy who would stop if your sprinkler was left turned on - and he knew you were out of town. He’s just a good man.”

Additionally, Mr. Skinner went on to say that “if you had somebody who did all sorts of righteous things (like McMain has), the news media will never report on any of it… but in a moment of weakness this person makes a poor decision - why, that news will just travel like wild fire.”

McMain has been an avid supporter of Blanco, helping with fundraisers, not only for the BVAC, but also for Project Graduation and numerous others. Supporters cite his tireless work on behalf of the citizens of Blanco and his dedication to them as reasons why should be allowed to remain an EMT-P with BVAC. Many offer stories of lives saved and the compassion that McMain has for his patients and of a genuinely nice and caring man who would do whatever was necessary to help someone in their time of need.

The judge however, finds that this is the very trust and confidence that McMain betrayed.

In her opinion to the State, Judge Landeros asserts, “Despite admitting that his conduct was wrong, [McMain] continues to justify his misconduct on humanitarian grounds. His attitude showed a lack of remorse or understanding of the gravity of his misconduct.”

“The revocation is justified despite the fact that during the past twenty years, [McMain] has served his community as an EMT with a level of skill and dedication that has earned him the gratitude, admiration, trust, and respect of an impressive number of individuals in that community and that the community will feel his absence from public service.”

The State will now have to decide whether or not McMain should retain his certification.

The decision from Judge Landeros can be read online at: www.blancocountynews.com/files/McMainRecommendation.pdf.