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Leaders of Federal Agencies Meet to Discuss EMS Priorities

Coordinating efforts across the nation and among various agencies and disciplines is key to fighting the drug overdose epidemic currently taking the lives of tens of thousands of Americans each year. That was one of the key points raised by Dr. Duane Caneva, chief medical officer with the US Department of Homeland Security Office of Countering Weapons of Mass Destruction, at the most recent meeting of the Federal Interagency Committee on EMS.

Caneva was updating the committee, which coordinates federal activities across the government related to EMS, on a proposed initiative to improve and expand community-based response to drug overdoses, or CReDO. Caneva shared stories about how the overdose crisis is impacting not just the individuals who overdose and their families, but also the healthcare and public health systems as a whole. During one incident in California, he shared, a community’s entire healthcare system was “destabilized” for days after a particularly dangerous batch of drugs came through the community. He cited a lack of coordination among responding entities as part of the problem.

“Public health didn’t recognize it as a public health emergency because it wasn’t contagious,” Dr. Caneva added.

In response to these types of emergencies, the Department of Homeland Security is working with other federal, state and local organizations to identify best practices and ways to share them across the country. Federal officials approached the National Fire Protection Association (NFPA) about the possibility of developing an NFPA standard for community response to drug overdoses, modeled after the recently developed standard for active shooter or hostile event response. The NFPA is conducting a public comment period to gather community input on the need for a CReDO standard.

In addition to the possibility of a standard, the CReDO project could also include many other efforts, such as finding ways to build competency in chemical forensics at the local level and better use available data to prevent overdose deaths. The idea of enhancing coordination at every level appealed to state and local officials at the meeting.

“We need coordination at the federal level,” said Joe Schmider, the Texas State EMS Director who represents state EMS officials on FICEMS. “I’m spending 25 percent of my time on this now, but we just have to coordinate this.”

FICEMS members also heard updates on a number of other federal and national programs. Brenda Staffan, who recently joined the Center for Medicare and Medicaid Innovation, reviewed the status of ET3, the new model being developed by Medicare to pilot reimbursement to EMS for treatment-in-place and transport to alternative destinations, in addition to transport to hospital emergency departments. Staffan said the first round of ET3 applicants included agencies from more than 70 percent of states and representing a diverse range of different service models and community types. She said CMMI anticipates announcing the initial ET3 pilot participants in early 2020 with a “go live” date in the spring.

NHTSA Office of EMS staff shared details with the committee about an invitation-only meeting on January 29 that will bring together stakeholders from the Federal Government, state and local EMS and healthcare systems and the private sector to talk about linking EMS and hospital data. The meeting, co-hosted by the HHS Office of the National Coordinator for Healthcare Technology (ONC), is intended to focus the conversation at a high level and determine what steps could be taken next to help overcome barriers to data sharing and integration.

FICEMS officials also heard from a representative of the firm hired to help the committee develop a new strategic plan. Following an analysis of the previous FICEMS strategic plan and interviews with stakeholders across the EMS community, the next step is development of a white paper to evaluate progress on the first strategic plan’s objectives and also discuss how the evolution of EMS might impact FICEMS priorities.

For more information about FICEMS, including members of the committee and previous meeting materials, visit FICEMS at