Working with Health Departments
It’s not unheard of for EMS agencies to have little or no contact with their local health departments. And while no one is suggesting EMS agencies can’t function perfectly well without day-to-day insight from municipal, county, regional or state health departments, those that don’t have an existing relationship with their local health officials are missing out on a wealth of knowledge public health officials can provide.
Recently, a delegation from the National Association of County and City Health Officials (NACCHO) attended the 2013 EMS World Expo in Las Vegas, NV, to learn more about the current trends facing the EMS sector, to look for opportunities to further collaborate and strengthen partnerships, and to ensure the voice of public health was represented in the national dialogue around the future of EMS.
NACCHO’s mission is to be a leader, partner, catalyst and voice for local health departments. As the national organization representing the 2,800 local health departments across the United States, NACCHO strives to strengthen the capacity of local health departments to respond to dynamic challenges and to improve health, says Andrew Roszak, JD, MPA, EMT-P and NACCHO senior director for Environmental Health, Pandemic Preparedness and Catastrophic Response.
“NACCHO’s programmatic work focuses on a wide range of public issues, including community health, environmental health, public health infrastructure and systems, workforce development, informatics, health and disability, and public health preparedness,” he explains. “Specifically, NACCHO is involved in the preparedness field because all disasters strike locally and local health departments are a critical part of any community’s first response to disease outbreaks, emergencies and acts of terrorism. As such, a vital part of our work is to create and disseminate tools, trainings and resources that are designed to help local health departments enhance their capacity to respond to public health emergencies and other disasters.”
Roszak says a critical component of emergency preparedness is building and strengthening community resilience. “Community resilience relies on building and maintaining partnerships with all sectors of a community—government officials, law enforcement, emergency management, healthcare, non-profit and religious groups and, of course, EMS. As EMS functions at the intersection of public health, public safety and healthcare, a strong, well-functioning, EMS system makes a big impact in the overall health of the public.”
According to Roszak, NACCHO staff attended sessions at EMS World Expo on measuring EMS system quality to learn more about how EMS systems are defining success and to identify quality measures that overlap with current local public health initiatives. Staff also attended a variety of sessions in the leadership track, looking to educate current and upcoming EMS leaders about the role of local public health and encourage partnerships between EMS and local public health departments.
Pandemic preparedness is a key topic for many local health departments, and NACCHO works collaboratively with the Centers for Disease Control and Prevention on developing tools, trainings and resources to better prepare for pandemics. “The session hosted by Ray Barishansky on pandemic preparedness was especially interesting,” Roszak notes, “as many EMS providers do not fully appreciate the essential role that they will play during a pandemic response. As a public health official, Ray did an excellent job of stressing the need for better EMS and local public health integration.”
Roszak says NACCHO strongly supports and encourages the establishment of partnerships between public health and EMS at the local level. In keeping with the EMS Agenda for the Future, NACCHO supports an EMS system that is community based and fully integrated with the overall health care system. “The agenda described that EMS of the future would be a component of a community-based health team and have the ability to not only provide acute illness and injury care, but perform services that would bolster the public’s health, such as identifying health risks, providing follow-up care, providing treatment for chronic conditions and conducting community health monitoring,” he says. “This vision was reaffirmed in the Rural and Frontier EMS Agenda of the Future, released in 2004, which also sought a community health role for EMS by utilizing providers not only for rapid response, but also for filling roles as a community resource for prevention, evaluation, triage, referral and education.”
As access to healthcare remains a leading indicator of overall health of a population, NACCHO supports and encourages innovation solutions to address healthcare shortages, according to Roszak. One innovative method is through the implementation of community paramedicine programs. Under a community paramedicine program, EMS providers are utilized as community based providers and provide a variety of healthcare and preventative services (such as IV antibiotic administration, wound care, phlebotomy, diabetes care and management, medication adherence, fall assessment and prevention, congestive heart failure (CHF) follow ups, influenza vaccinations, B12 injections and tetanus immunizations). “Increasing the number of healthcare providers in a community can have a major impact on the overall public health outcomes, especially in rural and frontier areas, where there are 50% fewer primary care physicians per capita than there are in urban settings,” says Roszak.
In addition, NACCHO also provides a variety of learning opportunities. Each year, NACCHO hosts the Preparedness Summit, a four-day annual event which provides cross-disciplinary learning opportunities to the preparedness community. A diverse range of nearly 2,000 attendees includes professionals working in all levels of government (local, state and federal), EMS, emergency management, volunteer organizations and healthcare coalitions. The 2014 Preparedness Summit will be held April 1–4 in Atlanta, GA, and additional information is available at www.preparednesssummit.org.
So, how can EMS and local health officials work more closely together to better serve vulnerable populations?
Roszak says over the past two years NACCHO has collaborated with national-level key stakeholders to discuss “whole community” inclusion planning for locations that would dispense medical countermeasures during public health emergencies. As a result of two stakeholder meetings and several webinars, NACCHO developed the Resource Guide: Including the Whole Community in Planning for Medical Countermeasure Dispensing during Public Health Emergencies and a website that discuses similar issues on whole community inclusion: www.wcphep.org. “The concept of whole community inclusion is to fully engage an entire society’s capacity in the planning conversation and action for emergencies. Such a planning approach accounts for all people regardless of, economic disadvantage, language and literacy, medical issues and disability, isolation, or age. EMS and local health departments can work together in whole community inclusion planning because both entities know their communities and the people who live within them well. Both sets of professionals are highly skilled and trained to account for all needs and proactively engage with new partners,” he says.
“In particular, EMS and local health departments can work together to offer coordinated public messaging during emergencies, update emergency preparedness plans together and include one another in relevant training exercises. Additionally, NACCHO supports the efforts of the Medical Reserve Corps, a national network of over 200,000 volunteers who are organized into nearly 1,000 local units who assist with routine public health education and disaster response. MRC volunteers augment the shrinking public health workforce, and can step in to continue the education and outreach efforts where the local health department is constrained due to funding or staffing concerns. Also, MRC volunteers understand the unique challenges of their community and know the most effective ways to reach their local vulnerable populations.”
For additional resources regarding NACCHO’s efforts on promoting partnership between local health departments and EMS, visit:
Building Partnerships before Disaster Strikes: A Guide for Public Health Preparedness and Emergency Management Leaders, available for free at: https://bit.ly/VQ7wvR
Four Tips for Building Partnerships before Disaster Strikes https://bit.ly/16NyAnB
Improving Community Resilience Through Public Health Preparedness Partnerships, J Public Health Management Practice, 2013; 19(4): 388–390 available at https://bit.ly/GJ4TYh
