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Stop waiting for an EMS invite to citywide policy discussions

City leaders attempt to address a worsening panhandling problem, but ignore EMS, the experts most likely to understand why people are on the streets


We are in the community, in people's homes, at the bars at closing time, in the parking lots after bar time, in the emergency rooms, jail cells, dorm rooms, on the protest lines, in the motorcades and present when people take their final breath. We have an understanding of the world around us that doesn't come from only reading the paper, watching the news or glancing at social media feeds.

We are present. We are aware.

When world events become the talk of the day, we have perspective that few will know. We experience things that shape our opinions and sometimes those opinions seem harsh to people who have not walked in our shoes.

We have seen, up close and personal, failed social programs. We see, feel and smell the result of cuts in health care, reduced spending for mental health emergencies and the lack of substance abuse understanding and training. 

We know the abusers, the needy, the players and the played.

Our experiences and opinions are a valuable voice that needs to be heard. Why then, is EMS seldom invited to the table?

Providence (R.I.) is undergoing a panhandling epidemic. The mayor's office held a meeting with city leaders to discuss the problem and offer suggestions to improve the situation.

Representatives at the meeting included people from the mayor's office, public safety commission, police department, private real estate developers, parks and recreation and at least 10 other individuals.

EMS knows
EMS was not represented at this meeting. EMS knows many of the panhandlers by name. I am sure it is the same in your city.

We know the panhandlers — their history, their medications or lack thereof, their personalities and their needs and desires. We are on their level, as providers of emergency medical treatment, a warm vehicle on a freezing night and transportation to the emergency room for medical problems — real or imagined. We are another living, breathing human being to talk to when nobody else will.

We are on the streets with the panhandlers, not in a lofty tower looking down on them.

We can offer ideas that may become solutions based on fact, not speculation and statistics. Having feet on the ground is imperative for a successful implementation and outcome of a plan. 

Who better than us to contribute valuable information at one of these meetings? Who better than us to hold policy makers feet to the fire? Who better than us to offer solutions to a problem that is difficult to understand?

Nobody is better, that's who. Well, perhaps the people in distress, the panhandlers, who might have something to contribute, but will have a far more difficult time than EMS getting themselves invited.

Make it happen
Getting invited to these meetings of city leaders will not happen without us making it happen. Individuals have options; we can email our representatives, make phone calls, leave messages and simply show up.

Chances are less than good that we will be allowed to participate. Without a clear, concise and uniform message, EMS as a whole will continue to be on the outside looking in.

Any journey worth taking needs planning, patience and perseverance. Somebody is in charge of getting people to the table. That person will be brainstorming, trying to figure out who best to invite. Identifying that person is a great first step. Convincing that person to include EMS comes next, and from there we can begin to be recognized as the valuable asset to city planning that we know we are.

EMS is seldom invited for a reason. We are not perceived by civic leaders and their staff as people with significant presence in government or civic affairs. We are too often not considered public safety and not accepted as health care professionals. We are not seen as social workers, street workers, drug and alcohol counselors, advocates for children, advocates for the elderly or having much of anything worthwhile to say to the powers that be.

Change perception to match reality
Perception and reality are two different things. We know how valuable our experience is. Getting others to see and appreciate that value is the trick. Simply saying that we understand the problem at hand, better than most, is just white noise to officials. A written record of what EMS can offer to policy makers could be the difference between which side of the door we are on.

A simple solution would be to send an official document to the chief of the department, the commissioner of public safety, the mayor and his chief of staff and the press requesting inclusion in the solution making process. The document must include:

  • The name of the EMS spokesperson that will attend the meetings, preferably a chief officer or equivalent with street experience or a good rapport with people who have it.
  • Reasons why the unique perspective of EMS and community understanding will enhance policy implementation.
  • Our willingness to participate as a group of professionals in future discussions that are designed to improve relations between the people we protect and serve and the city or town we work in.

Perception is everything. Stating a need and earning a seat at the table gives visibility to EMS and allows us to be heard not as a sub-division of the fire department, but as an entity of our own, with viable solutions learned through experience exclusive to our vocation.

We know how important and valuable our services are. It's time that the people with the power to make changes know it too.

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