The House of Representatives passed a bill in November 2009 that would improve and reauthorize for five years the Assistance to Firefighter Grants (AFG) Act and the Staffing for Adequate Fire and Emergency Response (SAFER) programs. The bill also included the Firefighter Fatality Reduction Act as a provision (see October 2009 Best Practices).
The bill would increase AFG program funding available to larger departments for fire prevention and firefighter safety programs; reduce local funding matches from 20 to 10 percent or allow them to be waived or reduced in case of economic hardship; and limit training grants for training that complies with applicable national voluntary consensus standards. The bill would also require 25 percent of grant amounts to be allocated to each of career fire departments, volunteer fire departments and combination fire departments, with the remaining amount awarded on a competitive basis among the same fire departments, among other provisions.
SAFER would be amended to limit the period of program grants to three years, require grantees to retain firefighters hired for the entire grant period and limit the portion of the salary covered by the grant to 80 percent. Under the bill, grants would be made to increase the number of firefighters to help communities meet industry minimum standards and attain 24-hour staffing.
The Firefighter Fatality Reduction Act provision requires a survey of all fire departments nationwide to determine if they are in compliance with the national voluntary consensus standards for staffing, training, safe operations, personal protective equipment and fitness.
The Senate must approve the bill before it can be sent to President Obama for signing.
The Institute of Medicine (IOM) recently released two documents that help to further the debate over, and development of, crisis standards of care policies and protocols.“Crisis Standards of Care: A Summary of a Workshop Series,” available at nap.edu/catalog/12787.html, summarizes a series of regional IOM workshops held in 2009. During the workshops, stakeholders discussed standards already developed and areas requiring development; they also discussed how to facilitate the dissemination of best practices. In addition, participants discussed the resources, guidance and expertise they had established, including the legal and ethical issues involved; and identified the federal, state and regional resources they needed to further the establishment of coordinated and consistent crisis standards of care protocols. A section on emergency medical services noted that a recurring theme throughout the workshop was the critical role EMS plays in directing emergency response and the limited extent to which it has been incorporated into crisis standards of care planning. The workshops were held in Irvine, Calif.; Orlando, Fla.; New York; and Chicago between March and May of 2009.
A separate publication, “Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report,” available at nap.edu/catalog/12749.html, relies on the workshop series as a background, but was authored independently at the request of the Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response. This document offers a series of consensus recommendations that resulted from discussions of the IOM Committee on Guidance for Establishing Standards of Care for Use in Disaster Situations.
The guidance document puts forth the committee’s vision for crisis standards of care:Fairness: Standards must be recognized as fair, evidence-based and responsive to the community.
Equitable: Processes and procedures for ensuring that decisions and implementations of standards are made equitably.
Transparent: In design and decision-making.
Consistent: In application across population and among individuals, regardless of their race, age, disability, ability to pay, pre-existing health conditions, and perceived obstacles to treatment or use of resources.
Proportional: Public and individual requirements must be commensurate with the scale of the emergency and degree of scarce resources.
The group made specific recommendations for the development of such standards, covering the various elements involved with each recommendation. It also recommended ensuring intrastate and interstate consistency among neighboring jurisdictions, providing legal protections for health care practitioners and facilities, adhering to ethical norms during crisis standards of care, and seeking community and provider engagement in the development process. The guide also includes indicators for assessment management and triggers for action.
On May 4–5, The National Association of Emergency Medical Technicians (NAEMT) will host “EMS on the Hill,” a lobbying effort in Washington, D.C. The group bills the event as the first coordinated effort to give EMS organization representatives a chance to meet with congressional members and staff about key issues affecting the industry. “We have no event like this for EMS,” said Rebecca Dinan, NAEMT’s communications manager. “We thought EMS as a whole needed an event to represent the average EMS practitioner.”
The organization plans to include representation from all sectors of the EMS community and to present a consistent message to legislators. On the evening of May 4, participants will attend a pre-Hill visit briefing and receive visit kits and appointment schedules. The following day, participants will visit congressional offices; later, NAEMT will host a reception for participants, congressional leaders and their staffs, and federal agency staffs.
Registration can be done online. Visit naemt.org and click on the “EMS on the Hill” logo at the bottom of the page.
— Aimee J. Frank, contributing writer
