Debate on Federal EMS Leadership Propelled by EMS Expo and Effects of Katrina

A passionate debate at EMS Expo in New Orleans, just before the city was devastated by Hurricane Katrina, featured industry leaders in an open forum on the future of federal EMS leadership.

The discussion was productive in bringing the fractured EMS community together to discuss the need for a unified front in gaining government support. However, the discussion has since been derailed by Hurricane Katrina and new questions about the performance of the Department of Homeland Security, which some EMS leaders advocate as the best home for a new federal EMS administration.

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

Becknell said what was particularly enlightening about the event was this show of passion and concern by the EMS community. "I thought that was one of the most valuable outcomes of the forum, to see the level of intensity that people felt," he said.

The primary discussion was whether the EMS community should support a new federal EMS administration within DHS, 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. Some attendees had organized in advance to make a show of support for DHS.

"One of the things I found most fascinating was the concern was not so much about having an office in DHS," Becknell said, "as, in my interpretation, EMS people are very tired of not feeling as though they have a solid, strong, equal voice in Washington. That was one of the things that came through very clearly."

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 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 a single, strong voice for EMS, Gainor argued that EMS benefits by maintaining the interest and involvement of numerous agencies, and advocates the support of 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 Dr. Don Walsh, chairman 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. She emphasized 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," she said.

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 handled 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.

That political strength of the fire service could now have an impact on EMS, Becknell noted. He asked the panel how they would react if Congress decides 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 they handle the majority of EMS in this country, although that claim is disputed by non-fire EMS leaders.

Dr. Walsh, who is also Assistant Deputy Fire Commissioner of the Division of Emergency Medical Services 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 of, 'How well did the Department of Homeland Security do?'" Becknell said. "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 is for a single, consolidated EMS office within the DHS on par with the fire administration, but now it remains to be seen exactly how all that will ultimately be structured in the future."

Although Katrina may set back the discussion on federal EMS leadership by raising these new questions, Becknell added that the disaster has had one positive effect; it has propelled EMS to a higher place of visibility on the national scene.