Unnecessary and impractical: The laws EMS gets vs. the laws EMS needs
We need our legislators to enact laws that focus on the real issues of reimbursement, enabling ET3 and recognizing EMS as an essential service
For too long, EMS has toiled in anonymity with inadequate attention from state legislators. The good news is that state elected officials are finally giving EMS some long-overdue attention, but the bad news is that unfortunately, much of that attention is misdirected at problems based on single incidents and not on fixing the serious and persistent underlying problems afflicting EMS. Here are three recently enacted state laws.
1. Legislation for common sense and human decency
EMTs and paramedics, as well as cops and firefighters, who post a crime victim’s photo online can now be charged with a misdemeanor in New York. The origin of this new law goes back to 2009, when Caroline Wimmer was murdered in her home. An EMT who responded to the scene posted images of her body on Facebook.
I am definitely opposed to anyone in public safety sharing a crime victim’s photo, outside of their allowed uses for investigation and patient care, but I don't think we need a law for what should be common sense, already prohibited by department policy and a violation of basic human decency.
2. Legislation that makes the job harder
A new Arizona law, written by State Rep. Amish Shah, a medical doctor, attempts to prevent EMTs from coercing patients to not be transported to the hospital. The likely impact of the law, which prohibits EMTs from diagnosing patients, is to make the job of assessing and treating patients with minor complaints harder. HB 2431, based on an encounter a colleague of Shah had with EMS, instructs EMTs to not make a diagnosis, to follow their protocols and to not counsel a patient on refusing transport, but to make sure patients know the risks of refusing transport. Are you as confused as me? David Givot, Rob Lawrence and Matt Zavadsky, EMS1 columnists, do their best to untangle the practical implications of this confusing new law.
3. Legislation that takes away local control
Finally, the Colorado legislature responded to the tragic death of Elijah McClain by making new requirements for the use ketamine, including weighing the patient. There needs to be consequences for medics who violate their department’s protocols and the investigation is ongoing, with two paramedics facing criminal charges for their actions. But legislative requirements for prehospital drug administration, rather than local medical control, puts medics and their patients who might benefit from ketamine at risk.
When the new Colorado law went into effect, Scott Sholes, president of the Emergency Medical Services Association of Colorado, told a local news station, “The consequences of this bill, likely unforeseen and unintended by the Colorado General Assembly, will dramatically impact our ability to safely treat and transport mental health and other patients experiencing life-threatening emergencies.”
Legislation needed for the most significant EMS challenges
EMS providers in Arizona, Colorado and New York are updating their training, policies and protocols in response to these new laws for two reasons. The first reason is the erosion of public trust that results from wrongdoing. The misdeeds and potentially criminal actions of one or two EMS providers have created a perception that the existing processes to investigate and adjudicate were inadequate. Perhaps, and even worse, the public loses trust when they perceive departments have failed to learn from their incidents or anticipate new risks to make changes to training, policies and discipline.
The second reason is that for years, EMS has been absent from or underrepresented in the political arena. The presence of EMS topics in legislator committee hearings or discussions on the floor of statehouses is welcome and needed. Unfortunately, recent legislation for EMS doesn’t make a significant impact on the real challenges facing the profession. EMS in every state need laws that:
Recognize EMS as an essential service and fund EMS like it is an essential service.
Fix persistent reimbursement problems that have continued to worsen in the midst of a pandemic, steep inflation and crisis-level staffing.
Enable and fund the Emergency Triage, Treat and Transport Model (ET3) which allows participating EMS agencies to deliver treatment in place and transport patients to alternative destinations.
Legislators need to hear from you
Here’s what you can do to help your state’s legislators focus on the real and significant issues impacting the survival of every EMS agency.
Run for office. The NAEMT is offering its inaugural Political Academy at this year’s Pinnacle EMS conference.
Support candidates who support EMS. Back EMS knowledgeable and friendly candidates with donations, campaign volunteering and – most importantly – your vote.
Join professional associations. Become a member of state and national organizations who represent and advocate for EMS.
Show up for EMS. The annual NAEMT EMS on the Hill Day and similar state-level events connect EMS professionals with their elected officials.
Write to your legislators. Your state and federal representatives need to hear from you about the EMS issues that matter most to the survival of the profession.
For EMS to survive, we don’t need more laws that legislate common sense, cause confusion or remove local authority because of a single incident. Instead, we need legislators that recognize EMS as an essential service, provide funding for the increasing volume and acuity of patients, and enable reimbursement for new models of service.