Ditch NHTSA, Task Force Says, and Move EMS Under DHS

Ditch NHTSA, Task Force Says, and Move EMS Under DHS

“The time is ripe for EMS to move to a more suitable federal agency.”

That’s the conclusion of a recently released report that supports the idea—recently broached and seemingly increasingly popular—of moving federal oversight of emergency medical services from under the Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) to a new home in the Department of Homeland Security (DHS).

The notion, already being promoted by one high-profile national task force (www.projectusemsa.org), received another boost in May with the release of a report compiled by a task force of the Homeland Security Policy Institute (HSPI) at George Washington University. The publication, Back to the Future: An Agenda for Federal Leadership of Emergency Medical Services, cites EMS as a “missing piece of the preparedness puzzle” that needs reevaluation at the federal level.

The authors’ conclusion: “While DOT might have been the appropriate home for EMS in the federal government during the early years of EMS, when its focus was on transporting automobile accident victims, EMS has long outgrown such vestigial ties.”

Like the Project USEMSA group, the HSPI group calls for the creation of a U.S. EMS Administration under DHS. Such an administration, it says, would lead national EMS policy; be the providers’ voice in the federal government; examine responder safety issues; collect and disseminate data; serve as a central clearinghouse for information, funding and standards; manage national training programs; and conduct research.

The task force behind the report brought together numerous top EMS leaders. It was cochaired by HSPI Director Frank Cilluffo, Deputy Director Daniel Kaniewski and Paul Maniscalco, an assistant professor at GWU and a veteran of the landmark Gilmore Commission. Other representatives included field providers, educators and chief officers from a range of agencies and institutions.

While creating an EMS Administration under DHS has its promoters, support for the idea is not universal. In response to the HSPI report, Advocates for EMS issued a statement supporting an EMS office under DHS, with a strengthened FICEMS (the Federal Interagency Committee on EMS) serving to coordinate the EMS activities of various federal agencies and offices.

NHTSA, notes Advocates, “has a productive history as a lead federal EMS coordinating agency since the late 1960s.” The Advocates opinion represented the National Association of State EMS Directors, the National Association of EMS Physicians and the National Association of EMS Educators.

For the full HSPI report, see http://homelandsecurity.gwu.edu/newsroom.htm. For the Advocates response, see www.advocatesforems.org/Library/upload/GW_Report_Response.pdf.

For more on the issue of where EMS best belongs in the post-9/11 era, watch future issues of EMS.

—John Erich, Associate Editor

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Second Draft of Scope of Practice Model Out

Having absorbed comments on a first draft, task force members charged with crafting the National EMS Scope of Practice Model produced a second draft of the document in April.

The Model’s second draft includes what principal investigator Dan Manz terms a few “significant themes.” Among these are the proposed retention of an EMT level with skills similar to those specified in the U.S. DOT’s 1994 EMT-B National Standard Curriculum; inclusion of an “Advanced EMT” level between EMT-B and EMT-P; addressing implementation issues specific to the model; and clarifying the purpose of the model and its relation to current state-approved scopes of practice and licensure levels for EMS providers.

Further discussion/development of the Advanced Practice Paramedic level broached in the first draft has been shelved pending a NHTSA forum on the idea.