Two quick observations….

About EMS legal/political issues.

1) Most EMS legal issues aren’t actually analyzed by an attorney.  Rather, they’re analyzed by a person with no legal training who is making an exceptionally uneducated guess about what they think a lawyer might tell them.  You know, it’d be like the random attorney reading a 12-lead with no education.

2) People seem to think that if a definition in the law is changed to make EMS an “essential, ” “emergency, ” or some other word attached to service, then the “powers that be” will HAVE to fund EMS.  Anytime anyone says that a definitional change to the law will ensure EMS funding, it’s obvious that they don’t understand law, politics, public policy, economics, or the political process.  If you believe a change in law will fund EMS, look at the amount of lawsuits over the equity (actually, the amount) of public school funding.  This kind of simplistic thinking shows why EMS still isn’t invited to the “big kids’ table.”  And EMS’s simplistic fascination with the next big funding bill is shown in the mindless support of the so-called “Field EMS Bill” that NAEMT hawks as a snake-oil panacea to every EMS problem.  After all, we all know that endless streams of Federal money fixes every problem.


  1. Skip Kirkwood says:

    I agreed completely with everything you said, right up until the slam on the Field EMS Bill.

    Somebody famous once said that “Politics is the art of the possible.” If EMS wants to play at the big kids table, it has to show the ability to get SOMETHING done. Even if it is token, the field EMS bill is something that we all can and should support. This COULD be the “camel’s nose under the tent,” the “chink in the armor,” etc. – a good STARTING point. It doesn’t have to be an end-all to be worthwhile.

    • Wrong “something” Skip. The something that EMS has to prove is that we actually provide any benefit to patients beyond a ride to the hospital.

      Even if “EMS” (whatever that is?) could get it’s version of the field EMS bill passed, it wouldn’t change much. Except of course to feed more money to the fire service for it’s version of EMS.

      And please stop short of saying “baby steps”. That’s just another way of saying “table scraps”.

  2. theambulancechaser says:

    Skip, we’re going to have to agree to disagree. I really am not seeing how a Field EMS Bill, at least the one currently under debate, will help EMS long-term. To me, it merely moves EMS into a different place in the Federal bureaucracy and gives some grant money out.

    My wish list for EMS legislation would top out with national reciprocity (which I hear is a topic of discussion). If we’re actually looking at doling out cash, I’d much prefer block grants. I think local entities know where the funds are really needed, rather than the continual grantsmanship that seems to permeate the Federal grant process where the usual grant recipients get the usual grants for the usual pet programs.

  3. Steve Pike says:

    The only advantage to the proposed legislation is that it may protect some small town EMS agencies from getting disbanded when politicians are trying to protect their pet, vote buying projects.

  4. “law is changed to make EMS an ‘essential’, ’emergency’, or some other word attached to service”

    Kinda like calling the thing you get cash from an “ATM Machine” makes it more mechanized?

    “Emergency” is already attached to the service. It’s in the fscking NAME. If that hasn’t stopped TPTB from stiffing it when funding time comes around, what makes these people think adding something else to the text will?

    To get ongoing funding priority, one must maintain ongoing political pull. There’s no short-cut.

  5. AC, I disagree with you about the block grants for local agencies. My experience with a number of services is that the operate in vacuums and do not know how to measure success. Some would define it as getting 5 paramedics on scene quickly, or charts that indicate protocols were followed, or getting the volunteer ambulance out of the barn within 10 minutes, or whatever. The bill would allow data sharing between EMS and hospitals so that outcomes would be tracked. Data could be reported across town, county, and state lines. Wouldn’t it be nice for EMS to have something like what law enforcement has with crime statistics? The Field EMS Bill would bring some universal, apples-to-apples comparison of system performance among all the delivery models. It won’t fix everything, but is a good start.