Emergency Medical Services (EMS) agencies regardless of service
delivery model have sought guidance on how to better integrate
their emergency preparedness and response activities into similar
processes occurring at the local, regional, State, tribal and
Federal levels. The primary purpose of this project is to begin the
process of providing that guidance as it relates to mass care
incident deployment. The World Bank reported in 2005 that on
aggregate, the reported number of natural disasters worldwide has
been rapidly increasing, from fewer than 100 in 1975 to more than
400 in 2005. Terrorism, pandemic surge, and natural disasters have
had a major impact on the science of planning for and responding to
mass care incidents and remain a significant threat to the
homeland. From the attacks of September 11th, 2001, the subsequent
use of anthrax as a biological weapon, to the more recent surge
concerns following the outbreak of H1N1 influenza, EMS have a real
and immediate need for integration with the emergency management
process, and to coordinate efforts with partners across the
spectrum of the response community. The barriers identified from
the literature review and interviews with national EMS leadership
include: lack of access to emergency preparedness grant funding;
underrepresentation on local, regional, and State level planning
committees; and lack of systematic mandatory inclusion of all EMS
provider types in State, regional, and local emergency plans. In
December 2004, New York University's Center for Catastrophe
Preparedness and Response held a national roundtable that included
experts from major organizations representing the EMS system as a
whole. The report from that meeting concluded that: "EMS providers,
such as fire departments and hospital-based, commercial, and air
ambulance services, ensure that patients receive the medical care
they need during a terrorist attack. While EMS personnel, including
Emergency Medical Technicians and paramedics, represent roughly
one-third of traditional first responders (which also include law
enforcement and fire service personnel), the EMS system receives
only four percent of first responder funding. If EMS personnel are
not prepared for a terrorist attack, their ability to provide
medical care and transport to victims of an attack will be
compromised. There will be an inadequate medical first response."
In 2007, the Institute of Medicine in its landmark report Emergency
Medical Services at the Crossroads issued a recommendation that
stated: "The Department of Health and Human Services (DHHS), the
Department of Homeland Security and the States should elevate
emergency and trauma care to a position of parity with other public
safety entities in disaster planning and operations." Since the
time of these reports Federal progress to address these issues has
included the creation of the Office of Health Affairs (OHA) within
the Department of Homeland Security (DHS), the creation of the
Emergency Care Coordination Center (ECCC) within HHS, and the
creation of the Federal Interagency Committee on EMS (FICEMS)
Preparedness Committee. In an effort to increase the level of
preparedness among EMS agencies, the National Emergency Medical
Services Management Association (NEMSMA) approached the DHS and OHA
to engage them in a partnership that would provide a greater
understanding of the shortfalls in EMS emergency preparedness and
provide resources to fill those gaps. The primary objective of this
project is to understand model policies and practices across a
spectrum of disciplines and provider types that will lead to a
better prepared EMS deployment to mass care incidents. This project
should serve as a foundation for further development of EMS
specific policies and templates that improve EMS readiness to
manage the full spectrum of hazards that face their communities.
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