Emergency Medical Services Task Force
Recommendations press release
September 20, 2007

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Emergency Medical Services Task Force Presents Recommendations to Fenty 

Today, the Task Force on Emergency Services presented its recommendations to Mayor Adrian M. Fenty and the District of Columbia at the group’s final meeting. The Task Force was created as part of the District’s settlement with the family of David Rosenbaum, a journalist who was tragically slain after being assaulted on January 6, 2006, in the District of Columbia. As part of the agenda for the final meeting, the task force also worked on its final report, which will be issued at a later date. 

“The EMS Task Force has worked diligently to research best practices and identify the barriers that keep Fire and EMS from being the best in the nation,” said Mayor Fenty. “I applaud the thorough work of this task force in taking on a tremendous challenge and giving us the recommendations to reform and improve our emergency response agency.” 

The task force made two major recommendations to address the structure, culture and capabilities of the city's Fire and Emergency Medical Services (FEMS). To elevate and strengthen the EMS mission within the agency, the task force recommended a major reform of the organizational structure of FEMS to improve services for those who call on FEMS for assistance. More than 75 percent of 911 calls to FEMS are for medical assistance. Recommended changes to the structure include a well-resourced Medical Director and Assistant Chief for EMS as well as enhanced field supervision of EMS providers. 

The task force also has recommended to the Mayor that FEMS become a fully integrated, all-hazards agency. All-hazards agency personnel will be required to have minimum qualifications in basic levels of emergency medical services, fire prevention, fire suppression, hazardous materials and technical rescue. Implementation of this recommendation will result in uniform standards for all agency personnel as well as equal pay and benefits, eliminating a historical cultural divide between fire and EMS personnel. While a minimum of basic all-hazards training has been recommended by the task force, it has also recommended that a specialized paramedic track be created for those who want to focus on EMS work.

Summary of EMS Task Force Recommendations

Recommendation 1: One Force, One Standard

The Department of Fire and Emergency Medical Services shall transition to a fully integrated, all-hazards agency.  

• Same basic requirements for all EMS and fire personnel through basic training courses, while maintaining various levels of specialization within the force. 
• Basic pay and benefits parity between current single-role medical providers and dual-role providers. 

Recommendation II: Raise EMS Standards Through Strong Leadership

Reform Department structure to elevate and strengthen the EMS mission.

• Appointment of Assistant Chief for EMS - appoint an Assistant Chief for Emergency Medical Services (EMS) responsible for analysis and planning for all medical units, including strategic planning, budgeting, program evaluation, special operations, and prevention. 
• Maintain Medical Director –Medical Director at the rank of Assistant Fire Chief will provide medical oversight for all aspects of emergency medical services provided by FEMS.  
• More EMS Management - increase number of EMS Battalion Chiefs and Captains who are specialized EMS providers at various levels of the agency and update current standards for EMS personnel and protocols. 

Recommendation III: Improve Patient Services 

Improve the level of compassionate, professional, clinically competent patient care through enhanced training and education, performance evaluation, quality assurance, and employee qualifications and discipline.

• Training and Education - comprehensive training and educational programs for emergency medical technicians and paramedics as well as evaluation of current employee proficiency. 
• Performance Evaluations with Excellence in Mind – annual clinical performance evaluation of all personnel with medical certification based on clearly documented protocols for patient care.  
• Quality Assurance - institute a comprehensive system to assess quality of EMS service with an eye to improving response time evaluation and overall quality of EMS service.

Recommendation IV: Enhance Emergency Responsiveness 

Enhance responsiveness and crew readiness by revising deployment and staffing procedures.

• Response Time Evaluation – 100 percent compliance with National Fire Protection Association Standards to achieve more rapid transport responses.
• Employee Preparedness - consider shorter shifts for all employees and other recommendations to ensure employee alertness. 
• Continuity of Service – assign employees to ambulance duty for fixed periods. 
• District-wide Coverage - enable an adequate number of units to meet response time targets and provide coverage when any area of the District is short staffed. 
• Service Delivery Alternatives – make full range of District vehicles and personnel available for EMS service. 

Recommendation V: Improve Public Education and Coordination

Reduce misuse of EMS and delays in patient transfers by ensuring public awareness, interagency coordination and hospital accessibility.

• Patient Outreach and Education –develop a public education program about appropriate use of the 911 system to teach patients with chronic needs about services available to them and how to most efficiently and rapidly get emergency medical services. 
• 911 Service Employee Training – ensure that call takers and dispatchers have improved training and enhanced ability to distinguish between emergency and non-emergency medical calls. 
• Hospital Partnerships – District government will meet regularly with local hospitals to clarify and improve issues such as drop times, diversion, and closure, and to improve procedures for tracking patient outcomes. 

Recommendation 6: Increased Oversight for Enhanced Enforcement 

Strengthen Department of Health (DOH) oversight of emergency medical services.

• Improved Oversight of Emergency Service Providers - draft legislation or regulations or other administrative actions to improve oversight of all EMS providers and ambulance companies in the District of Columbia to include certification and reporting requirements through DOH.  
• Adoption of National Transportation Standards – immediate adoption of the National Highway Traffic Safety Administration standards for EMS certification at all levels of training and as the minimum standard for the District of Columbia.