NEMSAC Chair: Your Voice is Heard in Washington, DC

The National EMS Advisory Council Chair John Sinclair, Chief of Kittitas Valley Fire and Rescue in Washington, discusses the council’s priorities for 2016

photo of John Sinclair

NEMSAC Chair John Sinclair shares ways the EMS community can be involved at the Federal level.

Last year, I was honored to be elected chair of the National EMS Advisory Council, also known as NEMSAC. The council was created by the U.S. Department of Transportation in 2007 and made permanent by an act of Congress in 2012 to help ensure communication and coordination between the EMS community — people like you — and the federal officials in Washington who help support EMS systems.

On behalf of the council’s vice chair, Anne Montera, and the other 23 members of the council, I want to thank you for your dedication to your communities and your patients. I also want to tell you a little bit about what NEMSAC does and how you can play a role in helping shape EMS policy at the federal level.

NEMSAC discusses topics and issues currently facing EMS providers across the country, from data to drug shortages, Ebola to education. The council gathers input from across the spectrum of the EMS community and recommends specific actions and policies to the many federal agencies that regularly work with the EMS profession.

The council meets several times a year in Washington, and the public is invited to attend and provide comment. We know that many of you cannot be there in person, so there are multiple ways you can contribute, such as contacting the national stakeholder groups whose representatives attend the meetings, and contacting the Office of EMS or reaching out to a member of the council.

My priority as chair is to continue to look at EMS holistically and ensure that EMS is integrated into the healthcare system. We must ensure that the EMS profession continues to mature and adapt to the challenges it faces, including a growing number of non-emergency calls, the threats of terrorism and emerging disease and the changing landscape of the provision of and payment for healthcare services.

While we cannot predict what other issues may emerge throughout the year and beyond, the council will focus on several overarching themes, as reflected by the five committees established at our meeting in December.

Data Integration and Technology: The success of the National EMS Information System (NEMSIS) over the last decade has been unprecedented; nearly every EMS response to a 911 call in the country is now recorded in the national database, and the NEMSIS Version 3 standard will allow for even more in-depth analysis at the local, state and national levels. NEMSAC will continue to look for ways to make it even easier for local EMS agencies to use data to improve patient care, such as access to and integration with hospital and other healthcare data as well as education for EMS providers on how to meaningfully use data to improve care. We are on the cusp of an era when decision making in EMS, from treatment protocols to system design to safety procedures, will be entirely data-driven and evidence-based.

Funding and Reimbursement: Our EMS reimbursement system was created before the modern age of EMS, with President Johnson signing the authorizing language for what would become Medicare and Medicaid in 1965. Fifty years later we are still dealing with a system that doesn’t pay for out-of-hospital care, only the transportation of the patient. It is still unclear how healthcare reform will ultimately impact EMS, but what is clear is that things are changing. While hundreds of different mobile integrated healthcare and community paramedic programs have popped up across the country, we don’t know exactly what the best solutions are or what services EMS should be providing in every community. But we do know that EMS needs to be a part of the discussions at every level, including federally, in order to ensure that any changes help EMS continue to safely and effectively serve our communities and our patients.

Provider and Community Education: The future of EMS depends on a solid foundational education for providers at all levels. We need to ensure that the education received by first responders, EMTs and paramedics matches the care they are expected to provide in the field. At the same time, the EMS educational system needs to allow for the profession’s continued growth and advancement but also remain accessible in order to make sure we have competent, qualified caregivers in every community across the nation.

Innovative Practices of EMS Workforce: The changes in healthcare mean changes in the roles played by EMS providers around the country. EMS providers are an integral piece of the healthcare system, and should be recognized as medical decision makers who can have a significant impact on patient outcomes, the patient experience, and healthcare costs. More research and funding is needed to examine the critical role EMS providers can play and how it might differ across the diverse communities served by EMS in the United States.

Patient Care, Quality Improvement, and General Safety: In everything we do, we consider its impact on the safety of our patients, the EMS workforce and the public. Access to patient outcome information, for example, is a priority because it is the most effective way for EMS providers to truly know how well they are performing. Drug shortages are also interfering with our ability to effectively treat patients and represent a critical issue that needs to be addressed.

Our recommendations to the Federal Interagency Committee on EMS and the Department of Transportation have helped shape federal policy and programs that have a direct impact on what you do every day. Visit to learn more, or email me with comments and questions. And thank you for your service.