Maryland EMS System Fights Dissolution

ANNAPOLIS, MD. -- Maryland EMS personnel responded to the state capital here Tuesday on a vital rescue mission -- to save themselves.

They are vehemently opposed to a proposal that would move the Maryland Institute for Emergency Medical Services Systems (MIEMSS) to the Department of Health and Mental Hygiene.

MIEMSS oversees all aspects of the state's EMS network, including establishing protocols and setting regulations for commercial ambulances. It also operates a sophisticated communications center and administers grants.

With Maryland's EMS system being lauded last year as a national model in the American College of Emergency Physicians' Institute of Medicine report, officials said it's "ludicrous" to consider dismantling it.

Delegate Dan Morhaim, who introduced the bill, said dissolving the independent agency would save money, possibly $1 million annually. He also believes the move would streamline operations, and give volunteer crews a stronger voice.

Morhaim, an emergency physician, said he understands his proposal is not popular; and has led to "spirited discussion." He also believes the move would not hurt the system.

Nearly 40 opponents waited more than four hours Tuesday to tell a House of Delegates committee they disagree with the proposal.

"MIEMSS is not only the finest EMS system in the U.S., it is world class...Conversely, DHMH presently is the most bureaucratic, dysfunctional agency in Maryland government," said Barbara Beckett, state coordinator for SAFE Kids and a consultant for National Highway Traffic Safety Administration (NHTSA).

During an independent review of Maryland's EMS system in 2004, investigators praised its concept and network approach.

The vice president of R Adams Cowley Shock Trauma Center reviewed the panel's findings, and urged lawmakers to keep MIEMSS intact.

"We have been asked to provide leadership to the entire nation as at a point when the challenge to national security and emergency preparedness is unquestioned. Now is not the time to begin stepping backward..." said John Spearman.

He also pointed out that Maryland's approach continues to be a foundation for the Health Resources Service Administration (HRSA) "Model Trauma System," published in 2006.

Beckett urged the committee to "eliminate the waste" in DHMH. "Do not jeopardize the lives of your constituents by lumping MIEMSS with DHMH."

Beckett, who assesses traffic safety programs throughout the country, offered the following analogy: "To take a hardy, healthy, robust patient and cut his head off (MIEMSS), and put it under a terminally ill and contagious patient (DHMH)..."

Dr. Carnell Cooper, president of Trauma Net, told the panel that Maryland is the only remaining integrated system after 30 years. "We are leaders. We do not want to become followers..."

To eliminate the state EMS board as proposed would eliminate the voice of the thousands of providers, a move that would kill the service, said Bobby Balta, president of the Maryland State Firemens Association.

MIEMSS Executive Director Dr. Robert Bass said the transfer would jeopardize the entire system as the expertise of veteran EMS officials would be lost.

Paramedic Jeff Hinebaugh urged the delegates to leave MIEMSS as an independent agency. It stands out as a model, he said, because similar links are connected.