Please Do Not Forget EMS!

Last summer, while attending the International Association of Fire Chiefs (IAFC) conference in Dallas, I accompanied a friend to the National Society of Executive Fire Officers' hospitality get-together in one of the many convention hotels. Many fire service leaders were in attendance, sampling the many refreshments while making small talk.

The National Society of Executive Fire Officers is a group of chief fire officers who have graduated from the National Fire Academy's Executive Fire Officer (EFO) program. The EFO program consists of a three-year core curriculum, with an additional year consisting of a choice between five elective courses. The curriculum is designed to enhance a chief officer's leadership, problem-solving and decision-making abilities. For those of you who do not know, the National Fire Academy is one arm of the U.S. Fire Administration (USFA), which in turn operates under the Federal Emergency Management Agency (FEMA).

During the Dallas get-together, the usual introductions and speeches were made from the podium. One of those who gave a brief talk was Dr. Denis Onieal, the superintendent of the National Fire Academy. Dr. Onieal began his talk by announcing that the curriculum in the EFO program was going to change. He announced that the three-year core curriculum was to remain, but instead of choosing between the five elective classes, the additional year would be devoted to a risk-reduction class.

Wait a minute! Removing the elective classes eliminates the option of taking another class the academy offers, "Advanced Leadership in EMS." Having the "Advanced Leadership in EMS" class as an elective in the EFO program only made sense. Many budget, operational and administrative issues many chief officers deal with are related to EMS. Show me one fire department in this country that performs any level of EMS (first response and/or transport) and that goes on more fire calls than EMS calls. I think you would be hard pressed to find one. In all my travels and dealings with fire people all over the country, I have not found one yet. Most fire departments that perform any level of EMS service find that anywhere from 65% to over 85% of their runs are EMS.

So why would the USFA remove a course that covers the vast majority of work which the fire service performs?

Although this was bothersome, since the bulk of work performed by the fire service in this country relates to EMS, I chalked it up to the USFA establishing priorities. But then something disturbing happened in mid-January, when the USFA gathered fire service leaders to explain how the $100 million in grants from the watered-down $5 billion FIRE Act would be doled out to fire departments that applied.

In the program's first year, fire departments will be able to submit applications in more than two grant categories to:

• Train firefighters.
• Establish wellness and fitness programs for firefighters.
• Buy firefighting vehicles, including fire trucks.
• Buy firefighting equipment, including that for communications and monitoring.
• Buy personal protective equipment.
• Fund fire prevention programs.

But where is EMS equipment? Where is EMS training? Where are the ambulances? Isn't an automatic external defibrillator (AED) just as valuable of life-saving equipment as a charged hoseline? Don't many ambulances in this country, just like fire trucks, have lettering on them that proclaim they are a part of a fire department? Isn't the vast majority of workload in this country performed by the fire service related to EMS?

After a little research, I discovered another disconcerting item - the post of EMS program manager for the USFA has been vacant for the past six years, since the previous manager resigned. Why has such a key position remained unfilled?

Unfortunately, it certainly looks like a trend is developing. The clear message from the USFA is that EMS in the fire service is not that important. But the move of the fire service into the EMS arena in the past 30 years, and especially in the past 10 years, has been unprecedented. So why is the USFA going backwards with respect to EMS in the fire service?

One can only conjecture. Hopefully, the appointment of a new chief operating officer in the past year will reverse this trend of closing the USFA's eyes to the delivery of emergency medical service.