Seeding innovation and racial equity in EMS

Tanir Ami, CEO of California’s CARESTAR Foundation on diversifying the prehospital care workforce and improving health outcomes


Recently, EMS1 featured an interesting article by Marianne Meyers outlining the “10 things to know about the changing scope of out-of-hospital care.” In it, she describes the evolving role of EMS and prehospital care providers and highlights some key notable opportunities and challenges to watch out for as a result. As the CEO of a new healthcare foundation focused on supporting innovations in emergency and prehospital care, I was really inspired by what I read.

As Meyers notes, this was a year of change for many in the field. COVID-19 not only challenged emergency and prehospital care providers like never before, but it also gave us a unique opportunity to be more expansive in our thinking and use of a healthcare workforce that sees community members in our homes and on street corners, when we are at our most vulnerable.

The article's predictions on the integration of social services, mental health services, and more targeted care to meet folks where they are really resonated with me and the work that we are doing at the CARESTAR Foundation.

"I would love for those of us in the field to think more about what we can do to expand, nurture and diversify the emergency and prehospital care workforce to include more women, more people of color, and more people from the local communities being served," Ami writes. (Photo/Columbus Division of Fire)

The CARESTAR Foundation was established in 2017 to improve health outcomes for all Californians, using a racial equity lens to fund and advocate for improvements to our emergency response system (e.g., stop the bleed training, software that helps paramedics gain better electronic communication with hospitals).

EMS and prehospital care providers can, should and are starting to use their intimate understanding of the social, emotional and physical needs of our communities to develop innovations that save lives, improve health and reduce costs.

A racial equity lens

As a funder, we have seen the potential of first responders to transform the field of emergency and prehospital care; and for us, that potential is greatest when looked at through a racial equity lens.

What do we mean by this? We mean getting to a state in which there are no statistical differences in the health, treatment or outcomes of patients in emergency and prehospital care based on race.

COVID-19 revealed what some have known for a long time – that health status is highly dependent on race, and that health outcomes are highly predictable based on race and ethnicity. Race also plays a role in the type of treatment patients receive in their emergency and prehospital care.

Although the body of literature on this is still small in comparison to other fields, we anticipate this will grow in the years to come and we will all have the data we need to address this issue as we build new delivery models.

And as we examine the ways this industry is changing and evolving, I would love for those of us in the field to think more about what we can do to expand, nurture and diversify the emergency and prehospital care workforce to include more women, more people of color, and more people from the local communities being served. Some, like the EMS Corps program, in Alameda, Calif., are already doing amazing work in this space.

With studies showing that the paramedic workforce is overwhelmingly white and overwhelmingly male, as we come out of COVID-19 with the scope of emergency and prehospital care evolving, I am excited about the potential for equally transformative changes to the workforce so that it reflects the diversity of our communities.

To support some of these changes, CARESTAR has devoted nearly $1.5M to community paramedicine programs throughout California, expanding education and training for this important community health model. We are also funding initiatives to start reimagining what first response could look like in our state, gathering community input through small focus groups and listening sessions, asking individuals at the local level what they need and want in terms of social services, at-home care and mental health services in their community.

We are hopeful this way of looking at our work – examining emergency and prehospital care through a racial equity lens – is something that catches on and takes hold across our state and beyond.


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