National EMS Issues with a Local Impact

Vince Robbins, chair of the National EMS Advisory Council, discusses the panel’s role as a link between members of the EMS community and federal policymakers

Four decades ago, when I took my first EMT course, I knew little about how my agency in New Jersey fit into the bigger picture of EMS systems in this country—and how federal policy impacted what I was doing on the street.

I have learned a lot since then, which is one of the reasons I was thrilled to be appointed to represent hospital-based EMS on the National EMS Advisory Council in 2015 and elected the council’s chair last year.

NEMSAC plays an important role in EMS. Authorized by Congress to provide recommendations to the US Department of Transportation (home of the NHTSA Office of EMS) and the Federal Interagency Committee on EMS (FICEMS), NEMSAC members serve as a bridge between stakeholders throughout the nation and the policymakers whose work impacts the EMS profession and the communities and patients we serve.

Our industry is diverse and oftentimes struggles to speak with a common voice. NEMSAC brings together every provider of EMS through its representative structure and speaks for everyone on the critical issues that we face. It’s your opportunity as a local provider or leader of EMS to have input on national issues through your representatives on NEMSAC and by attending meetings, reading NEMSAC draft advisories and recommendations and providing public comment.

This year, the Secretary of Transportation will be making new appointments to the council as the current members’ terms end. Information on applying to the council is available online. This appointment cycle will include the addition of a council member who represents EMS Quality Improvement. This seat will replace the at-large spot on the 25-member panel.

The addition of this seat signals an increased emphasis on improving patient outcomes and the quality of care in prehospital medicine. As the rest of healthcare emphasizes quality and value, we must be prepared to do the same. It’s a positive step and one whose time has come.

NEMSAC priorities

During my nearly two years on the council, we have had vigorous discussions covering some of the most pressing issues in EMS, and I’m proud of the recommendations and positions the council has taken. Two priorities emerged early on, and they continue to shape most of the council’s actions.

The first, creating a more appropriate financing and funding scheme for EMS, has been a priority of NEMSAC since the first council was established ten years ago. Last year, the council approved an advisory that recommends NHTSA support efforts to conduct a comprehensive analysis of EMS system finance. The advisory also urges NHTSA and FICEMS to support efforts to change regulations that currently identify EMS as a supplier, rather than a provider, for the purposes of Medicare and Medicaid reimbursement.

The second theme that has emerged in the work of the current NEMSAC is the coming of age for EMS in this country. Several of last year’s advisories and drafts the council is working on now speak to the professionalization of EMS. We are so much more than what we once thought of as EMS—we are mobile integrated healthcare, we work in prevention, we provide post-acute care. We’ve evolved from just another small segment of public safety into our own subspecialty of medicine.

Recognizing that trend, NEMSAC members have made a bold statement that we need to continue in this direction, and that includes enhancing education opportunities for providers and ensuring that our practitioners are recognized and respected as members of the healthcare continuum. Several advisories approved last year address the issue, and the discussion will continue when the current NEMSAC meets later this year and almost certainly when the new panel is appointed and begins its work.

EMS providers focus on the task at hand—for field practitioners, they worry first and foremost about patient care and safety. Administrators take a broader view, looking at how to best deliver efficient and effective care to their communities. I know I certainly do.

But the work happening at the national level can impact what happens locally, from budgets right down to the care delivered in the back of an ambulance. NEMSAC serves as a vital link between local communities and the federal policymakers whose work impacts EMS care. I am honored to serve as the chair and look forward to hearing from you as we work together to advance our profession and better serve our patients.

Be sure to check the NEMSAC webpage or sign up for email updates for the latest information about the application process, advisories and upcoming meetings.