FICEMS Asks for Comments

Report on federal role in EMS due May 15

The Federal Interagency Committee on Emergency Medical Services (FICEMS) held a stakeholder teleconference April 11 to receive input on whether to establish a lead federal agency for EMS. The resounding answer was “yes.” Further, the lead agency should be within the healthcare system.


FICEMS was established in 2005 by the U.S. Department of Transportation to help ensure coordination among federal agencies involved with state, local, tribal and regional EMS providers and 9-1-1 systems. The April 11 meeting was the last of several seeking input on the topic. The first, which was held Dec. 16, assessed the current and future role of the federal government in EMS. Another meeting was held in March at the EMS Today Conference & Exposition in Baltimore. The April meeting was the final opportunity for stakeholders to provide verbal input before an options paper is developed and delivered to the National Security Staff Resilience Directorate by May 15.


The April meeting was moderated by FICEMS Chair Alexander Garza, MD, MPH, assistant secretary for health affairs and chief medical officer for the U.S. Department of Homeland Security. Eight of the nine FICEMS committee members participated in the teleconference.


“EMS as a whole needs to be primarily driven by health and medicine, and be patient-centric and really be focused on patient care,” said American College of Emergency Physicians EMS Chair Sabina Braithwaite, MD, FACEP.


National EMS Management Association President and Wake County (N.C.) EMS Division Chief Skip Kirkwood, MS, JD, EMT-P, EFO, CMO, agreed, saying EMS plays a role greater than transportation. He envisions a move away from a transportation-based payment system.


Speaking from a position paper his organization is preparing, Kirkwood stated that a lead agency is needed to coordinate EMS efforts. He called for a national policy definition “that supports the delivery of EMS at the individual patient and incident level.” At present, the current definition of EMS starts before the 9-1-1 call and ends with the back door of the rehabilitation hospital, leading to myriad programs and agencies that are “not necessarily coordinated and not leading to measurable outcomes in the EMS community.”


In addition, his organization would like to see a national policy-level statement that declares EMS an essential public service that should be available in every community “in the same manner that other essential services are provided,” he said. Kirkwood sees a need for a center for EMS doctrine, similar to the Department of Justice and the U.S. Fire Administration.


David Boyd, MD, an Illinois trauma surgeon and EMS visionary responsible for helping implement EMS systems throughout the country, discussed the federal history of EMS, or as they used to call it “EMSS, emergency medical services systems, because it was more inclusive,” he said. Boyd is a strong advocate that EMS must be part of a federal healthcare system, He recommended that the lead agency be the Department of Health and Human Services in Health Resources and Services Administration. “That’s where it was initially and where it should return,” he said.


International Association of EMS Chiefs’ Lawrence Tan, JD, NREMT-P, said improvement of EMS is an essential element of healthcare reform and national preparedness.


Kathy McMahon, representing the Association of Public Safety Communications Officials International, reminded FICEMS members that medical dispatch is a critical component of EMS and shouldn’t be forgotten.


Dan Gerard, MS, RN, NREMT-P, secretary for the Inter­national Association of Fire Chiefs, asked the committee to remember the needs of field providers. “That’s where the battle is being fought day in and day out,” he said.


Minutes and audio from the April session are available at under the FICEMS tab.

No posts to display