The “Field EMS” Bill

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Recently a friend of mine emailed me to say that he had been contacted by a member of the Board of Directors of the National Association of EMTs about the “Field EMS Bill” that is sitting in Congress right now. My friend has a blog and this board member wanted him to write a post telling his readers what a great idea this is bill is. Apparently people from the NAEMT have read my blog and know that contacting me about this would result in a derisive email telling them where they can stick their bill.

My friend has decided not to write a blog post because like me, he thinks the bill is crap on a cracker. He did address his concerns to me in an email and I’m including his non attributed comments in my post. A couple of the players here are the NAEMT and the “Advocates for EMS”. When that particular group was founded some years back I predicted it would become a group of doctors who would decide that they knew what EMS should be and that no actual EMS providers would be included in the bill. Prescient, that’s me. If you go to www.advocatesforems.org, you are redirected to the National Association of EMS Physicians. Which is a group made up of physicians who are involved in EMS. That’s not a bad thing, but you would think that a group that is advocating for EMS and supporting a bill that is supposed to benefit field providers would, you know, seek the input of EMS field providers. I guess that’s whee the NAEMT comes in, but that organization seems to only care that field providers pony up $40.00 a year for membership or take one of their alphabet soup of add on “merit badge” courses.

At least that was my impression of NAEMT back when I was a member. I stopped sending them that money several years ago and have lost interest in whatever it is they are doing. Whatever it is, it doesn’t seem to involve actually asking field providers what they think of the bill.

Here are my friend’s comments on what the NAEMT is saying about the bill,

The bill is divided up into 4 grants per se. The grant money is designed to help THE STATES with financing EMS (they will argue this but this was heavily debated during theĀ  drafting process). They will try to tell you this will generate $300 Million in grant dollars but when presented with the stats that the “political check off” for the presidential elections has historically only ever generated $98M (and that was back in the late 80s), they don’t respond.

The bill its self was a great idea. The problem was the Advocates for EMS and NAEMT sold out to the other healthcare agencies (like Trauma) because the law firm they had drafting the bill for initial drop also represented trauma and hospitals…AND they had the knee jerk reaction that “OMG, we don’t dare go into DHS even though they have money already available to develop an Office of EMS on the same organizational level as Fire because they THOUGHT they could control it under HHS.

You should have seen the posturing and propaganda coming out of HHS to avoid losing the potential dollars this bill could have generated. You would have thought Fire was going to rape your daughters and pillage your village when the fact was, we (as in EMS) could have gone in there with a strong voice and pointed out that FIRE NEEDS EMS, EMS does NOT need fire…but NOOOOOOOO, had to cave to our existing buddies in Federal government who have been running EMS ineffectively for the past 40 years.

PLUS no one wanted to hear about the historical fact that HHS has always dumped EMS whenever the funding disappeared.

The part about funding that my friend is talking about is in this language from the bill,

`PART IX–DESIGNATION OF INCOME TAX OVERPAYMENTS AND ADDITIONAL
CONTRIBUTIONS FOR EMERGENCY MEDICAL SERVICES

“SEC. 6097. DESIGNATION BY INDIVIDUALS.

“(a) In General.–Every individual (other than a nonresident
alien)–
“(1) may designate that a specified portion of any
overpayment of tax for a taxable year, and
“(2) may designate that an amount in addition to any
payment of tax for such taxable year and any designation under
paragraph (1),
shall be used to fund the Emergency Medical Services Trust Fund.

What this means is that anyone who files their federal income tax and is owed a refund “tax overpayment”, can opt to have some or all of that refund put into the EMS trust fund. That’s it, no funding from the federal government general fund. That’s a similar mechanism to the federal campaign fund. Note how that works out. Of course it’s the government who decides to whom that grant funding will be distributed. Which as my friend notes will likely be the fire service.

Note that I think that having a federal office of EMS under any federal agency is a very, very, bad idea. The federal government always seems to prefer a “one size fits all” approach to every problem. Which in reality is always a “one size fits none” reality.

Or as my friend said,

Because, as you know, the Health and Human Services bureaucracy is so responsive and all that we need to fix EMS is more Federal involvement and money.

And trust me when I tell you, it’s all about the money. I don’t know what it will go to, but chances are it will not go to anything that makes the lives of actual field providers any easier.

Again, quoting my friend,

Spread it around to the usual suspects of politically connected EMS systems that know how to write a good grant application. Meanwhile, most rural EMS systems will be holding bake sales to get batteries for their old defibrillator.

Sounds exactly right. It will be a grant writing contest and only the biggest systems can afford to have either a full time grant writer or hire a professional grant writer to do the applications.

I suspect that there are people in the organizations humping this bill that see a potential benefit to their fiefdoms and good old boys clubs if this bill becomes law and there is actual money for it.

Hence the “outreach” to EMS bloggers by the organizations that purport to represent EMS.

Politics as usual.

Or as Captain Renault, Prefect of Police in Casablanca once said, “Round up the usual suspects.”

If you’re one of my readers that is in EMS and this comes up during a discussion or someone from NAEMT contacts you, ask them a few pointed questions about what my friend said.

4 COMMENTS

  1. This keeps rearing it’s ugly head, and a word to the wise, ANY money not spent by March of the fiscal year automatically gets ‘swept up’, and then is the department’s (e.g. HHS) to do with as they wish…

    • Which should come as no surprise and gives HHS an incentive to sit on approvals until it’s “Sorry, too late, try again next year.” time.

      • Yeah, that’s a problem at DHS for ‘projects’ that are funded but the latest political appointee doesn’t like… Delay, then take the money…

        • Why do I have a feeling that it’s not just DHS, but a lot of agencies under the current Administration? Must be cynicism, I guess.

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