Sec. 2. Findings
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Congress finds the following: Patients with emergency medical conditions depend upon field emergency medical services (referred to in this section as EMS ) for essential life-saving or unscheduled medical care. All people in the United States should have access to and receive high-quality emergency medical care as part of a coordinated EMS system. The Institute of Medicine, in its 2006 report Emergency Medical Services at the Crossroads , outlined its vision of a 21st century emergency care system that is integrated, regionalized, accountable, and prepared for both routine emergency medical care and public health emergencies.
Such a modernized system would be characterized by a highly trained and capable field EMS practitioner workforce that delivers high-quality, evidence-based, innovative, value-based, and patient-centered emergency care in the field and across the emergency care continuum. In such 2006 report, the Institute of Medicine also outlined systemic problems plaguing field EMS that impede achievement of a 21st century emergency care system, including insufficient coordination, disparate response times, uncertain quality of care, lack of readiness for disasters, divided professional identity of field EMS practitioners, and a limited evidence base for the emergency medical care provided in the field.
To modernize the field EMS system, the Institute of Medicine recommended that advancements be made in several priority areas, including readiness, innovation, preparedness, education and workforce development, safety, financing, quality, standards, and research. The Institutes of Medicine also recommended recognition of a lead programmatic Federal agency for emergency medical services within the Department of Health and Human Services to provide a more streamlined, cost-efficient, and comprehensive approach for field EMS, and a focal point for practitioners and agencies to interface with the Federal Government.
Under an amendment made by the Pandemic and All-Hazards Preparedness Act ( Public Law 109–417 ), the Secretary of Health and Human Services is already established as the lead of all Federal public health and medical response for public health emergencies and incidents. Preparedness and capability to deliver routine emergency medical care is a prerequisite for preparedness and capability to respond to public health emergencies and incidents. In 2007, the Homeland Security Presidential Directive HSPD–21 called for the establishment within the Department of Health and Human Services of an Office for Emergency Medical Care to lead an enterprise to promote and fund research in emergency medicine and trauma care; promote regional partnerships and more effective emergency medical systems in order to enhance appropriate triage, distribution, and care of routine community patients; and promote local, regional, and State emergency medical systems’ preparedness for and response to public health events.
Under the Directive, the Office would address the full spectrum of issues that have an impact on care in hospital emergency departments, including the entire continuum of patient care from prehospital to disposition from emergency or trauma care. Properly functioning EMS systems encompass fully mobile resources that are able to address patient needs 24 hours per day, 7 days per week, 365 days a year. Field EMS serves as an essential health care safety net by providing emergency, urgent, and mobile medical care throughout the health care continuum, including medical and trauma care provided in the field, hospital, rehabilitation, and other settings.
Ensuring high-quality and cost-effective emergency medical services systems requires readiness, preparedness, medical oversight, and innovation throughout the continuum of emergency medical care through Federal, State, and local multi-jurisdictional collaboration and sufficient resources for EMS agencies and practitioners. Field EMS is the delivery of health care, not simply a transportation benefit having evolved from a patient transport model to a health care service delivery model that provides a variety of targeted medical services to meet the specific needs of their communities.
This includes the development of community paramedicine as a health care service provided by field EMS agencies and mobile integrated health care as a health care service provided collaboratively by a group of health care providers in a community, including local field EMS agencies. These new delivery models are filling gaps in patient care identified by a community's health care providers, including preventing recurrent medical episodes through reliable post-discharge follow up and chronic disease management.
Facilitating reimbursement for such services, including under the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ), is necessary to the continued development and sustainability of such services. Field EMS is uniquely positioned to support the transformation of health care to a value and outcomes based model to improve the patient experience and the health of populations, and to reduce the per capita cost of health care. Field EMS provides highly reliable patient assessment and intervention at any hour of any day in response to urgent or unscheduled episodes of illness or injury and effectively navigates patients to ensure they receive the right care, in the right place, and at the right time.
Field EMS helps contain health care costs by navigating the patient down a cost-effective pathway that is evidence-based. Coordinated and high-quality field EMS is essential to the Nation's security. Field EMS is an essential public service provided by governmental and nongovernmental agencies and practitioners every day and during catastrophic incidents. To ensure disaster and all-hazards preparedness for field EMS operations as part of the Nation's comprehensive disaster preparedness, Federal funding for preparedness activities, including catastrophic training and exercises, must be provided to governmental and nongovernmental field EMS agencies to ensure a greater capability within each of these areas.
The essential role of field EMS in disaster preparedness and response must be incorporated into the national preparedness and response strategy and implementation as provided and overseen by the Department of Homeland Security and the Department of Health and Human Services, pursuant to their respective jurisdictions. Field EMS agencies must be capable of meeting the routine emergency care needs of patients to be capable of meeting the extraordinary medical needs during a catastrophic event.
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- Pub. L. 109-417
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