National Commission on Children and Disasters. 2010 Report to the ...

In 2006, the Institute of Medicine (IOM) reported that “[t]he scattered nature of Federal
responsibility for emergency care makes it difficult for the public to identify a clear point of
contact, limits the visibility necessary to secure and maintain funding, and creates overlaps
and gaps in program funding.” 179 Accordingly, IOM recommended that Congress establish a
lead agency that has “primary programmatic responsibility for the full continuum of
emergency medical services and emergency and trauma care for adults and children,”
including pre-hospital care and medical-related disaster preparedness. 180 The <strong>Commission</strong>
finds that Federal agency leadership and oversight for pre-hospital EMS is still unclear and
supports IOM’s recommendation that Congress clearly designate and appropriately resource
a lead Federal agency for EMS.
The <strong>Commission</strong> also recommends that Congress establish a dedicated Federal grant
program to improve EMS disaster preparedness and response. The <strong>National</strong> EMS Advisory
Council released a position statement in June 2009 stating: “Providing core funding
specifically for EMS, regardless of delivery model, to ensure surge capacity and response to
public health emergencies and natural or man-made disasters is an essential public
interest.” 181 Unlike other first responder entities, including emergency management
agencies, law enforcement, fire departments, public health departments and hospitals, the
majority of EMS systems in the Nation do not receive Federal grant support for disaster
preparedness and response. 182 In addition, the American Recovery and Reinvestment Act of
2009 183 did not authorize funds for EMS organizations. Grants are necessary to support
State-level coordination and disaster planning, field-level staffing, pediatric supply and
equipment needs, pediatric-specific training and exercises, and, in general, the expansion of
pediatric surge capacity for disasters. A lead Federal agency is also necessary to ensure
existing emergency preparedness grant programs establish pediatric EMS performance
measures.
179 Committee on the Future of Emergency Care in the United States Health System, Board on Health Care
Services, Emergency Care for Children: Growing Pains, ed. Institute of Medicine (Washington, DC: <strong>National</strong>
Academies Press, 2007), 6-7, http://books.nap.edu/catalog.php?record_id=11655.
180 Committee on the Future of Emergency Care in the United States Health System, Board on Health Care
Services, Hospital-Based Emergency Care: At the Breaking Point, ed. Institute of Medicine (Washington, DC:
<strong>National</strong> Academies Press, 2007), 368, http://www.nap.edu/openbook.php?record_id=11621.
181 <strong>National</strong> EMS Advisory Council, Position Statement adopted June 3, 2009,
http://www.ems.gov/pdf/NEMSAC_PositionStatement_HealthcareReform.pdf.
182 <strong>National</strong> Association of State Emergency Medical Services Officials, State EMS Office Involvement in
Domestic Preparedness Efforts: NASEMSO 2008 Addendum, (Falls Church, VA: NASEMSO, 2008), 5,
http://www.nasemso.org/Projects/DomesticPreparedness/documents/08DPAddendumReport-2.pdf.
183 P.L.111-5 (2009).
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NATIONAL COMMISSION ON CHILDREN AND DISASTERS: 2010 REPORT