Progressive EMS Reform Bills in Congress! - EMS ADVOCACY

[Summit]

There is a matching Senate bill with bipartisan support. There is a long list of supporters for this including FACEP ACS AAOS NAEMT, several EMS associations, and more.

The way I understand it, it would move primary responsibility for EMS management to Health and Human Services establishing an EMS office that reports directly to SECHHS. It establishes evaluations of cost effective care, national standards, evidenced based practice, and more. (It doesn't seem to completely remove EMS from DOT, but effectively so.)

http://beta.congress.gov/bill/113th-congress/house-bill/809

I don't see any fire organizations endorsing it.

So this has all the signs of something that is VERY good for EMS progression in the United States. The questions is going to be, will the IAFF fight EMS moving towards HEALTHcare and if they fight will the doctors and surgeons fight back, or are they passive in their support.

What will I do? First, I am going to learn more about this. If I still like it, I'll contact Senator Michael Bennet.

What do you think? What will you do?

 

[Tigger]

This is an excellent bill. As an agency we are looking to reach out to Bennett and Udall to try and better explain it's benefits to them. These days it feels like the chief is up in Denver trying to get stuff done at a state and national level than he is in his office, so I'm hoping he'll be able to have some effect.

The IAFF supports EMS being under Homeland Security. DHS has paid an incredible amount of money in grant funding to fire departments, so I am not especially surprised.

 

[polisciaggie]

The IAFF supports EMS being under Homeland Security. DHS has paid an incredible amount of money in grant funding to fire departments, so I am not especially surprised.

Other than prospective grant money, why would we want to be under DHS as opposed to HHS? A lot of people already think we're somehow related to law enforcement, I think this will only make things worse.

 

[rescue1]

Other than prospective grant money, why would we want to be under DHS as opposed to HHS? A lot of people already think we're somehow related to law enforcement, I think this will only make things worse.

The IAFF supports it because SAFER grants come through FEMA, which is part of DHS. I can't see the IAFF being actually against this bill though, as long as they can still get grant money from somewhere.

I wonder how that would work with combined Fire/EMS agencies. Could they receive both SAFER grants from DHS and then grants from HHS?

Either way, this bill looks like a good idea.

 

[PotatoMedic]

Well I just killed a few brain cells reading the bill. I like it for the most part. Not happy that they want the NFPA ambulance standards for ambulance design.

 

[Tigger]

Other than prospective grant money, why would we want to be under DHS as opposed to HHS? A lot of people already think we're somehow related to law enforcement, I think this will only make things worse.

I should have been more clear. I do not want EMS to fall under the auspices of of the DHS. I see the IAFF with having less than honest intentions by trying to do this. If all EMS agencies get their grant money from the same place there will be stronger competition and that doesn't help it's membership.

 

[socalmedic]

Well I just killed a few brain cells reading the bill. I like it for the most part. Not happy that they want the NFPA ambulance standards for ambulance design.

as opposed to what other standards? KKK? many states out there do not have any standards and as I see it the NFPA standards take a much better opinion on provider safety and ergonomics than KKK does. I am in full support of the NFPA ambulance standards.

 

[CFal]

what's wrong with EMS as part of DHS? At least from a municipal perspective EMS is closer to police and fire, they are our response partners when 911 calls come in, I can understand the IFT stuff being more HHS though

 

[MrJones]

Fire sees EMS as a cash cow.

Any position they take must take into account that simple fact.

 

[Summit]

what's wrong with EMS as part of DHS? At least from a municipal perspective EMS is closer to police and fire, they are our response partners when 911 calls come in, I can understand the IFT stuff being more HHS though

Does Emergency MEDICAL Services have more to do with hospitals and healthcare or with being a LEO and wearing a bullet proof vest and a badge?

WHERE DOES EMS FIT BETTER?

DHS:
TSA
Customs and Border Protection
Immigration and Customs Enforcement
Secret Service
Coast Guard
Citizenship and Immigration Services

or

HHS:
Surgeon General
Public Health Service
Office of Preparedness and Response
National Institutes of Health
Centers for Disease Control and Prevention
Agency for Healthcare Research and Quality
Food and Drug Admin
Indian Health Service

EMS doesn't fit in with DHS any more than it does with DOT. HHS is not perfect, but it is the closest fit. If you want EMS to transform into a profession of educated healthcare professionals, HHS is a better home.

 

[EMDispatch]

Does Emergency MEDICAL Services have more to do with hospitals and healthcare or with being a LEO and wearing a bullet proof vest and a badge?

Unfortunately that was the initial issue the fire service had with DHS. By throwing FEMA and the USFA under essentially LEOs had some major issues and still does. The federal organization chart could honestly use a lot of reorganizing. If ends up under HHS, it will probably end up under the OPEO under NDMS which could easily end up back under DHS and FEMA somewhere in the ODP or just under the USFA. All it takes is someone to screw up or upset the wrong government official.

 

[PotatoMedic]

as opposed to what other standards? KKK? many states out there do not have any standards and as I see it the NFPA standards take a much better opinion on provider safety and ergonomics than KKK does. I am in full support of the NFPA ambulance standards.

Or the new standard that is in affect? The one that limits ambulance speed to 65mph I believe. Even though there are many places in this country with a speed limit way over that. Or the fact with the new NFPA standard saying if an ambulance does not meet it the purchaser MUST sign a document saying that this ambulance is not to be used as an emergency vehicle. The NFPA has no need to be designing ambulance standards.

 

[Summit]

Unfortunately that was the initial issue the fire service had with DHS. By throwing FEMA and the USFA under essentially LEOs had some major issues and still does. The federal organization chart could honestly use a lot of reorganizing. If ends up under HHS, it will probably end up under the OPEO under NDMS which could easily end up back under DHS and FEMA somewhere in the ODP or just under the USFA. All it takes is someone to screw up or upset the wrong government official.

The way the bill is written it will require the establishment of the Office of Emergency Medical Services and Trauma which would almost certainly requires an Assistant Secretary position, not under ASPR. At worst it would be directly under ASPR, not a sub-office of OPEO or NDMS.

When setting national EMS policy, we can't look at EMS (or Fire or police) as primarily disaster responders. They are ALSO disaster responders.

 

[EMDispatch]

The way the bill is written it will require the establishment of the Office of Emergency Medical Services and Trauma which would almost certainly requires an Assistant Secretary position, not under ASPR. At worst it would be directly under ASPR, not a sub-office of OPEO or NDMS.

Cool, I haven't read through it all yet, but sounds pretty cool.

I just can't seem them creating a new Assistant Secretary position. It'd be nice, but taking what was a relatively small office tucked away in the DOT, and elevating that far would be a heck of stretch by our governments standards.

It would definitely be awesome though

 

[polisciaggie]

what's wrong with EMS as part of DHS? At least from a municipal perspective EMS is closer to police and fire, they are our response partners when 911 calls come in, I can understand the IFT stuff being more HHS though

Because we are medical professionals not law enforcement. I wouldn't object to having a "liaison" office at DHS to cover the areas that HHS would be unfamiliar with. The NHTSA makes more sense than DHS, which doesn't make sense when you have HHS.

Coming from a 911 non-fire medic I'd really consider the ED/hospital to be our siblings, whilst fire/police being our cousins.

 

[Tigger]

what's wrong with EMS as part of DHS? At least from a municipal perspective EMS is closer to police and fire, they are our response partners when 911 calls come in, I can understand the IFT stuff being more HHS though

What? So because we go to similar calls we should fall under the same regulatory body. I go to fire calls in my ambulance but don't know a thing about firefighting...

 

[socalmedic]

Or the new standard that is in affect? The one that limits ambulance speed to 65mph I believe. Even though there are many places in this country with a speed limit way over that. Or the fact with the new NFPA standard saying if an ambulance does not meet it the purchaser MUST sign a document saying that this ambulance is not to be used as an emergency vehicle. The NFPA has no need to be designing ambulance standards.

I am unaware of any new standards that are in effect, could you please post a link? the speed limit in NFPA1917 is 77mph which I believe is adequate for all states and in faster than I would ever want to be in the back of an ambulance anyway.

 

[pcbguy]

I come from a hospital based service in an area where Fire just runs first response. No ALS. So obviously I feel we belong more with HHS than DHS. In Florida EMS falls under the Dept of Health also. Not the department of law enforcement or the Florida Fire College or State Fire Marshalls office.

Our primary role is health and medicine.

Fire sees EMS as a cash cow.

This started happening in our area. None of the departments run anything but first response. Now they are starting to see if they run ALS response they can get more funding. They have started doing it but still do not transport as they run the calls with an engine. Stand alone fire departments don't generate income, at least not in our area. They are an expense and I believe are getting harder to justify. We have one city at home that refuses to even run first response. It's an ordeal to get them to respond to anything with us. The city commission is looking at this now. They are well paid and don't want to do anything. Not looking good for them.

 

[ExpatMedic0]

It sounds good to me, lets keep an eye on this situation.

 

[PotatoMedic]

I am unaware of any new standards that are in effect, could you please post a link? the speed limit in NFPA1917 is 77mph which I believe is adequate for all states and in faster than I would ever want to be in the back of an ambulance anyway.

77 is a much more reasonable speed and am ok with that. I must have either been told wrong information or it was changed.

Here is the link to NFPA1917.
http://www.nfpa.org/codes-and-standards/document-information-pages?mode=code&code=1917