Federal EMS Debate Highlights Providers` Passions

A passionate debate at EMS EXPO in New Orleans, just days before the city was devastated by Hurricane Katrina, featured industry leaders in an open forum on the future of federal EMS leadership. The discussion brought a fractured EMS community together to discuss the need for a unified front in gaining government support.

The forum at EMS EXPO was organized by EMS Magazine and moderated by John M. Becknell, publisher for EMS Best Practices, Inc. After a spirited debate among the panelists, the event grew livelier still, running overtime as attendees lined up to ask questions and voice their opinions.

What was particularly enlightening about the event to Becknell was the EMS community's show of passion and concern. "That was one of the most valuable outcomes of the forum," he says, "seeing the level of intensity that people felt."

The primary discussion centered around whether the EMS community should support a new federal EMS administration within the Department of Homeland Security-akin to the U.S. Fire Administration-or remain in the Department of Transportation and support the Federal Interagency Committee on EMS (FICEMS). The panel and the audience had more advocates for an administration in DHS than for FICEMS, but that isn't necessarily representative of the industry.

What came through clearly, however, says Becknell, is that "the concern was not so much about having an office in DHS as [the idea] that EMS people are tired of not having a solid, strong and equal voice in Washington."

Two of the most vocal and polarized voices on the panel were those of Paul Maniscalco, an assistant professor at George Washington University and co-chair of the university's Homeland Security Policy Institute (HSPI) task force, which recently published a report in favor of an EMS administration in DHS, and Dia Gainor, secretary of Advocates for EMS and past president of the National Association of State EMS Directors. While Maniscalco argued that an EMS administration would create that single, strong voice for EMS, Gainor argued that the EMS profession benefits by maintaining the interest and involvement of numerous agencies, and advocates supporting FICEMS.

The panel also included International Association of Fire Chiefs EMS Chair John Sinclair; National EMS Management Association President Darryl Coontz; National Association of Emergency Medical Technicians board member Gregg Lord; and Don Walsh, PhD, chair of Project USEMSA.

Several panelists vocalized their concern that FICEMS is unfunded and has accomplished little in the past. Gainor warned, however, that EMS should not move to DHS just for the money.

"It's not the time to prostitute EMS," she said, emphasizing that FICEMS was just strengthened in August and is now required to report annually to Congress. "They have a duty and obligation that's never before been articulated."

Coontz raised the need for an EMS political action committee to garner government funding and support. "The attention Congress is going to pay to EMS is directly related to the amount we participate in the legislative process," he said.

The panel agreed, noting that EMS can learn from how the fire service handles their legislative affairs. After watching the vast majority of public safety funding go to law enforcement, the fire service put in years of legislative involvement to successfully bring about the Assistance to Firefighters Grant Program (aka the FIRE Act). That political strength of the fire service could now have an impact on EMS, Becknell notes. He asked the panel how they would react if Congress decided to put EMS within the U.S. Fire Administration, rather than alongside it. The fire service already has the ear of the government and reports that it handles the majority of EMS in this country, although that claim is disputed by non-fire EMS leaders.

Walsh, who is also assistant deputy fire commissioner of the EMS division for the Chicago Fire Department, said he is not afraid of making EMS a secondary mission to the fire service, compared to the current situation.

"I can't even find EMS on DOT's organizational chart," he said.

However, Walsh also challenged dual-service agencies to change their names to reflect their alleged commitment to EMS. He suggested, to loud applause, that the IAFF become the International Association of Fire Fighters, EMTs and Paramedics, and that the IAFC become the International Association of Fire and EMS Chiefs.

What remains to be seen is whether the discussion on federal EMS leadership will take any new turns post-Katrina.

"Since Katrina, what is interesting now is the question: 'How well did the Department of Homeland Security do?'" Becknell says. "The verdict is still out on that, but some people are speculating that Katrina will force another look at exactly how emergency services are positioned within the federal government.

"The call for many of the EMS people listening and participating in that forum was for a single, consolidated EMS office within DHS on a par with the fire administration. But now it remains to be seen exactly how all that will ultimately be structured," he says.

Although Katrina may set back the decision on federal EMS leadership by raising these new questions, Becknell adds that the disaster has had one positive effect: It has propelled EMS to greater visibility on the national scene.