Any NAEMT member who reads the by-laws should ask the question:
"Would I be able to run?"
If you are good enough to represent your state or local EMS organization, and you have skills and talent, in my opinion, that should make you the perfect candidate for a national office.
How valuable you would be to your local agency or state office, after spending some time on the board of NAEMT, meeting federal government officials, and then being able to come back and capitalize on that experience in your community.
If you cannot run for an office in NAEMT, because of the by-laws change, and you have skills and talent, just ask yourself 'Why'?
Lets try and apply the by-laws change to any member of NAEMT.
What if you are a member of NAEMT, but you are not an instructor. Well you would not be able to run.
OK, you say, but if you go to the conference, that would make you eligible to run.
But what do you do if you cannot afford to go to the NAEMT Conference on your own or your employer in these tight economic times cannot pay to send you to the NAEMT conference?
How will you meet the first two parameters of the by-laws change?
Well you can be appointed a liaison or serve on a committee.
How do you come to the attention of NAEMT to become appointed a liaison or representative?
Look at most of the liaisons. They are all appointed by the president of the Association. Most of them are people from the presidents home state, with some being holdovers from previous presidents (who knew them, etc.).
Please do not get me wrong. They are good people, qualified to do the liaison job. But if the president makes the appointments, and historically he appoints people he knows, if you are an unknown, how will you get appointed as liaison or a representative on a committee?
Look at the last category, the affiliate advisory committee. That was the old Board of Governors. Historically it has been the president or past president of the state association, or some other board member for the state association. Few state associations have travel budgets, so if the president of the state association is going, they will frequently have him be the affiliate advisory representative.
Look at the affiliate advisory committee:
http://www.naemt.org/affiliates/affiliates_landing/our_affiliates.aspx
All of those people are excellent well respected leaders, with many years of experience and knowledge. But there is very little turn over there. If we look back at the OLD Board of Governors for NAEMT you will see most of the same people from then, still sitting on the advisory council now!
How does someone who has valuable knowledge, who is hard-working, with great skills, and organizational capabilities, bump some of these tremendous state leaders out of the way?
I am not saying they should, those state leaders and their experience is invaluable to NAEMT and to their states, but it doesn't present a wide-range of opportunities for people to present themselves to NAEMT to run for a leadership position.
Vote against the by-laws change, we do not limit the people who can run for office in a free and open society, we shouldn't do it here,
Stay safe, I hope to see everyone in Atlanta,
Daniel R. Gerard, MS, RN, NREMT-P
http://www.linkedin.com/in/dangerard
Thursday, September 24, 2009
Sunday, September 20, 2009
Why?
In 2000 and 2001 while I was the Chairman of the National Paramedic Division for NAEMT, I authored a report on occupational injuries in our profession. If you would like a copy of this report, please email me at daniel.gerard@comcast.net. The scope and purpose of this report was to survey ALL of the nation’s EMS offices and various departments of labor, to try and find out the answer to these pressing questions:
How many EMT’s and Paramedics are injured in the line of duty?
How many EMT’s and Paramedics die in the line of duty?
How are they injured or killed?
The report, in summary, stated that we do not collect critical information and we don’t know how EMT’s and paramedics are injured in the line of duty. Now I know what you are going to say, ‘But Dan, guys are injured from lifting and moving and generally get killed from motor vehicle collisions’.
True, from my gut feeling I would tend to agree, but if we don’t measure numbers, how do we know when we do institute measures to reduce injuries, that what we are doing is effective?
We need to make comparisons within our own organizations, but also between other organizations as well.
If we were to compare injury rates in one location, to injury rates in another location, with similar populations, similar call volumes, and we found one had a significantly lower EMS occupational injury rate than the other, wouldn’t you want to know why?
EMT’s and paramedics are our most precious asset for any organization. We need to protect them, take care of them, provide as safe an environment for them as possible.
Let me ask another question: How many EMT’s and paramedics were injured due to acts of intentional violence?
I don’t know, no one does.
Even more important, what can we do that is effective in limiting career ending injuries and line of duty deaths?
Another excellent question.
If you or anyone else were to ask the National Institute of Justice, which is the scientific research arm for law enforcement nationwide (which would be nice if EMS had something comparable…) they will tell you that since the mid-1970’s, body armor has reduced line of duty deaths by over 600%.
Was the investment and development of life-saving body armor worth the time and effort?
Without good data, we cannot even begin to assess if the methods we are employing are working or aren’t working. Let me give you an EMS example. A member based organization developed a poster to reduce an aspect of EMS occupational injuries. They disseminated the poster.
That was it.
Some people will say, what was wrong with that?
In a better designed program, you would measure injuries associated with what you are trying to reduce for a 6 months to 2 period prior to implementing the poster.
You would create an EDUCATIONAL piece to go with the poster, incorporating the information from the prior 6 months to 2 year period. You would then deploy the poster, and then collect information for the next 6 months to 2 year period. You would then compare the results.
In this example of the poster, none of this was done.
Was the poster effective? We will never know. If you can’t tell me there is a correlation between your poster and injury reduction, then you probably just wasted your members money.
If you talk to the National Institute of Justice, their body armor program was a resounding success. In 2006, the last year complete data is available, motor vehicle collisions exceeded penetrating trauma as the leading cause of death for law-enforcement officers in the United States.
What area of law enforcement occupational injury do you think the National Institute of Justice is concentrating on now?
Even better, why can’t EMS have that same information?
A good question…
I always thought it was interesting that this national EMS organization choose a poster. It is almost like they are out of touch with how we communicate. Is a poster how we communicate most effectively?
EMT’s and paramedics Tweet, watch YouTube, have Facebook and MySpace pages. They text message one another. They email and surf the net at least once a day. The best PSA of the year was done by an EMS agency in Scotland, which was then posted on YouTube and has gone viral around the world (http://www.youtube.com/watch?v=6biw3LEq_0c ). I know guys who have it bookmarked on their PDA’s so that they can show people during impromptu educational sessions.
A poster? Is that how they are trying to get their message out?
We are talking about the lives of our brother and sister EMT’s and paramedics. THAT was their best effort?
This same organization is developing an EMS Safety Officer Course. Again, how will we know the course is success if we don’t measure injuries from year to year? How will I, or you, or your organization KNOW that the EMS Safety Officer is doing a good job?
An EMS Safety Officer Course? Why develop a course for one person? Why not a program for an entire organization? How about a complete program for reducing injury, hazard, and death in our profession? How about working with other agencies, who may have programs of excellence to develop a complete program that we could distribute?
EUREKA! What we need is an EMS Safety PROGRAM!
A comprehensive program that will incorporate safety into it all aspects of the organizational culture, where all managers and staff members are empowered with and tasked with being a part of the Safety Team. That was part of the original proposal to the Association. Give organizations the tools for a comprehensive approach for safety, and how to measure success, how to incorporate safety into all phases of the organization, from orientation, to training, to response, on-scene, during a large scale incident. Again this was part of my original set of recommendations for the Association, to identify programs of excellence, and then look to incorporate what they have accomplished into a COMPREHENSIVE program.
For some strange reason, after I wrote my report to NAEMT, my recommendation to examine programs of excellence was not acted upon.
Yet everyday EMT’s and paramedics are still being injured or losing their lives in the line of duty.
EMS need’s a program, with a toolbox full of tools for organizations large to small, volunteer to paid, to help reduce EMS occupational injuries. Something that encompasses all phases and flavors of what we are. We could partner with insurance companies to develop meaningful programs to identify hazards, reduce risk, and eliminate line of duty death and disability. This will reduce the cost for program development, in addition to we can leverage the knowledge of insurance companies to develop MEANINGFUL programs for injury prevention. In addition they will provide us with tools to measure our success.
If this sounds like I have done this before, I have, with the Royal and Prudential Insurance Companies back in NJ.
Let us have an honest discussion. If you can’t tell me that you have made any inroads in reducing death and disability, because you don’t have a quantifiable number of how many people are being injured, we will never know if our efforts are effective because we won’t have any information to compare it to.
If anyone read my report, and if we followed my recommendations, we would have had 8 years worth of data by now, 8 years worth of information in order to develop programs to reduce death and disability. All we needed was one or two years worth of data to begin identifying and working toward reducing death and disability.
Wow. 8 solid years of working on reducing injuries and deaths in our profession. How many people could we have helped...
The first question I think of when I think that SOMEONE or SOME ORGANIZATION is going to develop an EMS Safety Officer Course is: how much money is this organization going to charge for this program?
Most of the EMT’s and paramedics in our field pay to take courses like ACLS, PALS, PHTLS, AMLS, PEPP, and EPC out of their own pocket because they want quality education. What will someone charge to give them the requisite training to protect their lives and the lives of their co-workers?
Yet no national organization or even anyone in the federal government still cannot answer the fundamental questions:
How many EMT’s and paramedics were injured and killed in the line of duty last year?
How did they get injured or killed?
No national EMS organization can say that their injury reduction efforts have made any impact on EMS occupational injuries, and they never will be able to say that. Right now who suffers? EMT's and paramedics in the field are suffering and we as a profession aren’t doing anything effective.
I have been to funerals for EMS personnel. We owe it to them and their families to get this one right.
WHO STANDS UP FOR YOU?
WHO PROTECTS YOU?
WHO UNDERSTANDS YOU AND WHAT YOU NEED?
WHO IS INTERESTED IN PROTECTING YOU IN THE FIELD, AND WILL ASK THE HARD QUESTIONS AND DO THE HARD WORK NEEDED TO GET THE JOB DONE RIGHT?
I WILL.
I am Dan Gerard, and I am running for the Region IV Director for NAEMT.
I am not interested in a travel a club or free trips, I want to work hard for you the dues paying member.
I know this issue thoroughly. I authored the first two reports on EMS occupational injuries for NAEMT. I know the topic and the national leaders for EMS occupational injuries. I will follow through on the initial recommendations for reducing EMS occupational injuries by:
Working with the U.S. Dept. of Labor to develop a unique coding mechanism for EMS Occupational Injuries. Then we can begin to collect meaningful, useful data to analyze on how we are injured in the field.
Partner with one of the 13 Injury Control Research Centers funded by the National Center for injury Prevention and Control at the Centers for Disease Control and Prevention, in order to analyze our data and develop programs for reducing workplace hazards and improving health and safety
Develop a program in concert with our partner Injury Control Research Center/CDC to identify and recognize programs of excellence. From these programs, develop the tools and guides for organizations to incorporate so that they too may be able to reduce occupational injuries and deaths.
Don’t let another EMT or paramedic suffer a needless injury. Stand TOGETHER with ME, TOGETHER vote for ME, and TOGETHER WE will carry the banner to a new tomorrow.
Daniel R. Gerard, MS, RN, NREMT-P
http://www.linkedin.com/in/dangerard
How many EMT’s and Paramedics are injured in the line of duty?
How many EMT’s and Paramedics die in the line of duty?
How are they injured or killed?
The report, in summary, stated that we do not collect critical information and we don’t know how EMT’s and paramedics are injured in the line of duty. Now I know what you are going to say, ‘But Dan, guys are injured from lifting and moving and generally get killed from motor vehicle collisions’.
True, from my gut feeling I would tend to agree, but if we don’t measure numbers, how do we know when we do institute measures to reduce injuries, that what we are doing is effective?
We need to make comparisons within our own organizations, but also between other organizations as well.
If we were to compare injury rates in one location, to injury rates in another location, with similar populations, similar call volumes, and we found one had a significantly lower EMS occupational injury rate than the other, wouldn’t you want to know why?
EMT’s and paramedics are our most precious asset for any organization. We need to protect them, take care of them, provide as safe an environment for them as possible.
Let me ask another question: How many EMT’s and paramedics were injured due to acts of intentional violence?
I don’t know, no one does.
Even more important, what can we do that is effective in limiting career ending injuries and line of duty deaths?
Another excellent question.
If you or anyone else were to ask the National Institute of Justice, which is the scientific research arm for law enforcement nationwide (which would be nice if EMS had something comparable…) they will tell you that since the mid-1970’s, body armor has reduced line of duty deaths by over 600%.
Was the investment and development of life-saving body armor worth the time and effort?
Without good data, we cannot even begin to assess if the methods we are employing are working or aren’t working. Let me give you an EMS example. A member based organization developed a poster to reduce an aspect of EMS occupational injuries. They disseminated the poster.
That was it.
Some people will say, what was wrong with that?
In a better designed program, you would measure injuries associated with what you are trying to reduce for a 6 months to 2 period prior to implementing the poster.
You would create an EDUCATIONAL piece to go with the poster, incorporating the information from the prior 6 months to 2 year period. You would then deploy the poster, and then collect information for the next 6 months to 2 year period. You would then compare the results.
In this example of the poster, none of this was done.
Was the poster effective? We will never know. If you can’t tell me there is a correlation between your poster and injury reduction, then you probably just wasted your members money.
If you talk to the National Institute of Justice, their body armor program was a resounding success. In 2006, the last year complete data is available, motor vehicle collisions exceeded penetrating trauma as the leading cause of death for law-enforcement officers in the United States.
What area of law enforcement occupational injury do you think the National Institute of Justice is concentrating on now?
Even better, why can’t EMS have that same information?
A good question…
I always thought it was interesting that this national EMS organization choose a poster. It is almost like they are out of touch with how we communicate. Is a poster how we communicate most effectively?
EMT’s and paramedics Tweet, watch YouTube, have Facebook and MySpace pages. They text message one another. They email and surf the net at least once a day. The best PSA of the year was done by an EMS agency in Scotland, which was then posted on YouTube and has gone viral around the world (http://www.youtube.com/watch?v=6biw3LEq_0c ). I know guys who have it bookmarked on their PDA’s so that they can show people during impromptu educational sessions.
A poster? Is that how they are trying to get their message out?
We are talking about the lives of our brother and sister EMT’s and paramedics. THAT was their best effort?
This same organization is developing an EMS Safety Officer Course. Again, how will we know the course is success if we don’t measure injuries from year to year? How will I, or you, or your organization KNOW that the EMS Safety Officer is doing a good job?
An EMS Safety Officer Course? Why develop a course for one person? Why not a program for an entire organization? How about a complete program for reducing injury, hazard, and death in our profession? How about working with other agencies, who may have programs of excellence to develop a complete program that we could distribute?
EUREKA! What we need is an EMS Safety PROGRAM!
A comprehensive program that will incorporate safety into it all aspects of the organizational culture, where all managers and staff members are empowered with and tasked with being a part of the Safety Team. That was part of the original proposal to the Association. Give organizations the tools for a comprehensive approach for safety, and how to measure success, how to incorporate safety into all phases of the organization, from orientation, to training, to response, on-scene, during a large scale incident. Again this was part of my original set of recommendations for the Association, to identify programs of excellence, and then look to incorporate what they have accomplished into a COMPREHENSIVE program.
For some strange reason, after I wrote my report to NAEMT, my recommendation to examine programs of excellence was not acted upon.
Yet everyday EMT’s and paramedics are still being injured or losing their lives in the line of duty.
EMS need’s a program, with a toolbox full of tools for organizations large to small, volunteer to paid, to help reduce EMS occupational injuries. Something that encompasses all phases and flavors of what we are. We could partner with insurance companies to develop meaningful programs to identify hazards, reduce risk, and eliminate line of duty death and disability. This will reduce the cost for program development, in addition to we can leverage the knowledge of insurance companies to develop MEANINGFUL programs for injury prevention. In addition they will provide us with tools to measure our success.
If this sounds like I have done this before, I have, with the Royal and Prudential Insurance Companies back in NJ.
Let us have an honest discussion. If you can’t tell me that you have made any inroads in reducing death and disability, because you don’t have a quantifiable number of how many people are being injured, we will never know if our efforts are effective because we won’t have any information to compare it to.
If anyone read my report, and if we followed my recommendations, we would have had 8 years worth of data by now, 8 years worth of information in order to develop programs to reduce death and disability. All we needed was one or two years worth of data to begin identifying and working toward reducing death and disability.
Wow. 8 solid years of working on reducing injuries and deaths in our profession. How many people could we have helped...
The first question I think of when I think that SOMEONE or SOME ORGANIZATION is going to develop an EMS Safety Officer Course is: how much money is this organization going to charge for this program?
Most of the EMT’s and paramedics in our field pay to take courses like ACLS, PALS, PHTLS, AMLS, PEPP, and EPC out of their own pocket because they want quality education. What will someone charge to give them the requisite training to protect their lives and the lives of their co-workers?
Yet no national organization or even anyone in the federal government still cannot answer the fundamental questions:
How many EMT’s and paramedics were injured and killed in the line of duty last year?
How did they get injured or killed?
No national EMS organization can say that their injury reduction efforts have made any impact on EMS occupational injuries, and they never will be able to say that. Right now who suffers? EMT's and paramedics in the field are suffering and we as a profession aren’t doing anything effective.
I have been to funerals for EMS personnel. We owe it to them and their families to get this one right.
WHO STANDS UP FOR YOU?
WHO PROTECTS YOU?
WHO UNDERSTANDS YOU AND WHAT YOU NEED?
WHO IS INTERESTED IN PROTECTING YOU IN THE FIELD, AND WILL ASK THE HARD QUESTIONS AND DO THE HARD WORK NEEDED TO GET THE JOB DONE RIGHT?
I WILL.
I am Dan Gerard, and I am running for the Region IV Director for NAEMT.
I am not interested in a travel a club or free trips, I want to work hard for you the dues paying member.
I know this issue thoroughly. I authored the first two reports on EMS occupational injuries for NAEMT. I know the topic and the national leaders for EMS occupational injuries. I will follow through on the initial recommendations for reducing EMS occupational injuries by:
Working with the U.S. Dept. of Labor to develop a unique coding mechanism for EMS Occupational Injuries. Then we can begin to collect meaningful, useful data to analyze on how we are injured in the field.
Partner with one of the 13 Injury Control Research Centers funded by the National Center for injury Prevention and Control at the Centers for Disease Control and Prevention, in order to analyze our data and develop programs for reducing workplace hazards and improving health and safety
Develop a program in concert with our partner Injury Control Research Center/CDC to identify and recognize programs of excellence. From these programs, develop the tools and guides for organizations to incorporate so that they too may be able to reduce occupational injuries and deaths.
Don’t let another EMT or paramedic suffer a needless injury. Stand TOGETHER with ME, TOGETHER vote for ME, and TOGETHER WE will carry the banner to a new tomorrow.
Daniel R. Gerard, MS, RN, NREMT-P
http://www.linkedin.com/in/dangerard
Thursday, September 17, 2009
What is Best for EMS
I think back to when my cousin served in Congress. Even as the population continued to change, he did one thing that was crucial…he continued to serve and REPRESENT the needs of his community.
What federal government agency represents us?
When we look at our police and fire service brothers, they have a clear identity. When they go to the federal government, they can go to U.S. Fire Administration and the Department of Justice. The Department of Justice has a huge budget, and the capability to hire and fire, as well as give out grants, underwrite programs. They have a national training academy run by the FBI in Virginia. The U.S. Fire Administration has a large budget, and the capability to hire and fire, as well as give out grants, and underwrite programs. They have a training academy in Maryland.
What federal agency represents EMS?
EMS, while it responds to more calls than it’s fire service brethren, has been relegated to the Federal Interagency Committee on EMS or FICEMS for short, an arrangement that has no program budget, no hiring or firing capability, cannot issue grants, and it’s ‘biggest’ stick so to speak is to an issue a report to Congress, that Congress is under no obligation to act-upon. Some people will over that this is just as good.
It isn’t. Someone explain to me how is this just as good as the Department of Justice or the U.S. Fire Administration? Doesn’t EMS deserve better?
For those of you who don’t know, FICEMS has existed in the federal government in one form or another since the 1970’s. Yes ladies and gentlemen, FICEMS has been around since the 1970’s, being re-authorized in the mid-80’s and again in 2005. It didn’t do anything for EMS in the 1970’s and FICEMS hasn’t done anything for us now.
There are at least 10 different federal agencies that compose FICEMS. Ten. TEN SEPARATE directors, with SEPARATE employees, TEN SEPARATE budgets, TEN SEPARATE mission statements, and TEN SEPARATE grant programs.
What does FICEMS do? The 10 different agencies that compose FICEMS is tasked with discussing EMS issues and writing reports and recommendations to Congress.
FICEMS CANNOT make policy. FICEMS CANNOT institute programs. FICEMS has no budget, FICEMS CANNOT hire or fire anyone. FICEMS CANNOT issue any grants. FICEMS does not provide any training or education
NOT one of those members of FICEMS is dedicated to EMS. All of them have different missions and different goals. Have you ever read the mission statement for the Department of Transportation or for the National Highway Transportation Safety Administration where the EMS office lives? It doesn’t mention EMS at all in their mission statements.
In my current state of California and where I was originally from in NJ, EMS has one agency, in California it is the EMS Authority in Sacramento and in NJ it is the Office of EMS in Trenton. No other state in the United States breaks up EMS between 10 different agencies and then tries to manage it by committee.
Isn’t it just possible, that what has been working in the individual states over the last 40+ years, that ONE agency, with ONE purpose and ONE mission is the right way to do this?
Yes EMS overlaps with the fire service, as well as the police. Just as EMS overlaps with the fire and police services, fire overlaps police, and police overlaps fire.
No one would ever say that the police service or the fire service do not deserve their own departments or agencies in the federal government. No one is suggesting that police and fire aren’t multidisciplinary services, they are, and they are UNIQUE and extremely complex, JUST AS UNIQUE AND COMPLEX AS EMS.
The Institute of Medicine is a learned scientific body. In 1966 they saw a need for change in our community. EMS was horrible hodge podge of service delivery models, running from one extreme to another. Private funeral homes, without any training to first aid and rescue squads, providing the best they could with text’s from the American Red Cross.
In 1966 the Institute of Medicine realized that we were in danger, researched the issue and published this report ‘Accidental Death and Disability: The Neglected Disease of Modern Society’.
Consider this:
Do you and your community need EMT’s?
Do you and your community need paramedics?
Do you and your community need an EMS system?
Do you and your community need a trauma system?
All of these components of the EMS system were proposed and written about in the Institute of Medicine in their 1966 report ‘Accidental Death and Disability: The Neglected Disease of Modern Society’. If it wasn’t for this report we would not have EMT’s, paramedics, EMS Systems, and trauma systems, or even the National Registry.
Where is the science or expert opinion to support an assertion that FICEMS was the best option for EMS?
In 2007 the Institute of Medicine published a new report, ‘Emergency Medical Services: At the Crossroads’. One of their most important recommendations - Create a lead federal EMS agency, that the federal government should consolidate all functions related to emergency care that are currently scattered among multiple agencies into a single agency in the Department of Health and Human Services (DHHS).
Let me ask you a question: why, would anyone not support the Institute of Medicine’s recommendation for a single federal agency for EMS?
EMT’s and paramedics are smart. They already knew we needed our own EMS agency! Prior to the IOM report, EMT’s and paramedics in several nationwide polls OVERWHELMINGLY stated that they wanted a single federal agency, with one purpose, to advance the mission of EMS and to represent EMS as effectively as police and fire within the federal government.
What do we need? We need somebody to say that the FICEMS isn’t the best for us, somebody who is supposed to FIGHT and not take the easy way out. That isn’t the EMS way, we do a job no one else can handle. We don’t take the easy way out.
In my personal opinion, FICEMS is doing EMS a disservice.
I am a paramedic. I earned my EMT-A card in 1981 and my paramedic certification in 1985. Am I not an equal to my brothers and sisters in the police and fire services?
In my personal opinion, FICEMS doesn’t work and this is an example why:
Everyone knows the EMT-Basic curriculum. When Medicare came out with the negotiated rule making committee for the Ambulance Fee Schedule, they stated that Medicare wouldn’t re-imburse service providers for an IV, because it was a basic skill.
Everyone knows initiating of an IV, by and large, is the domain of Intermediates and Paramedics. Where was the EMS Office from NHTSA during this process? Better yet, where was FICEMS? As FICEMS stood idly by, show me where did they weigh in on the fee schedule? What was FICEMS recommendations? If FICEMS really worked, this would never have happened.
We need our own federal EMS agency. Please read the IOM report, 'Emergency Medical Services: At the Crossroads' you can access it here for free: http://www.nap.edu/catalog.php?record_id=11629#podcast
My name is Daniel R. Gerard, I am a paramedic, and I want to represent EMT’s and paramedics. I have 28 years in the field and I am proud of my service to the community.
I am running for the NAEMT Region IV Director. If you haven’t voted for me, vote today, I will fight for what is right and for what you want. I will make it my mission to get a federal EMS agency, one that will effectively represent the needs of the EMS community.
I will represent the profession passionately, with pride, and without prejudice. I am not afraid to say what I believe in. I am not afraid to do what is right.
Stay safe my brothers and sisters, I will see you in the street,
Daniel R. Gerard, MS, RN, NREMT-P
http://www.linkedin.com/in/dangerard
What federal government agency represents us?
When we look at our police and fire service brothers, they have a clear identity. When they go to the federal government, they can go to U.S. Fire Administration and the Department of Justice. The Department of Justice has a huge budget, and the capability to hire and fire, as well as give out grants, underwrite programs. They have a national training academy run by the FBI in Virginia. The U.S. Fire Administration has a large budget, and the capability to hire and fire, as well as give out grants, and underwrite programs. They have a training academy in Maryland.
What federal agency represents EMS?
EMS, while it responds to more calls than it’s fire service brethren, has been relegated to the Federal Interagency Committee on EMS or FICEMS for short, an arrangement that has no program budget, no hiring or firing capability, cannot issue grants, and it’s ‘biggest’ stick so to speak is to an issue a report to Congress, that Congress is under no obligation to act-upon. Some people will over that this is just as good.
It isn’t. Someone explain to me how is this just as good as the Department of Justice or the U.S. Fire Administration? Doesn’t EMS deserve better?
For those of you who don’t know, FICEMS has existed in the federal government in one form or another since the 1970’s. Yes ladies and gentlemen, FICEMS has been around since the 1970’s, being re-authorized in the mid-80’s and again in 2005. It didn’t do anything for EMS in the 1970’s and FICEMS hasn’t done anything for us now.
There are at least 10 different federal agencies that compose FICEMS. Ten. TEN SEPARATE directors, with SEPARATE employees, TEN SEPARATE budgets, TEN SEPARATE mission statements, and TEN SEPARATE grant programs.
What does FICEMS do? The 10 different agencies that compose FICEMS is tasked with discussing EMS issues and writing reports and recommendations to Congress.
FICEMS CANNOT make policy. FICEMS CANNOT institute programs. FICEMS has no budget, FICEMS CANNOT hire or fire anyone. FICEMS CANNOT issue any grants. FICEMS does not provide any training or education
NOT one of those members of FICEMS is dedicated to EMS. All of them have different missions and different goals. Have you ever read the mission statement for the Department of Transportation or for the National Highway Transportation Safety Administration where the EMS office lives? It doesn’t mention EMS at all in their mission statements.
In my current state of California and where I was originally from in NJ, EMS has one agency, in California it is the EMS Authority in Sacramento and in NJ it is the Office of EMS in Trenton. No other state in the United States breaks up EMS between 10 different agencies and then tries to manage it by committee.
Isn’t it just possible, that what has been working in the individual states over the last 40+ years, that ONE agency, with ONE purpose and ONE mission is the right way to do this?
Yes EMS overlaps with the fire service, as well as the police. Just as EMS overlaps with the fire and police services, fire overlaps police, and police overlaps fire.
No one would ever say that the police service or the fire service do not deserve their own departments or agencies in the federal government. No one is suggesting that police and fire aren’t multidisciplinary services, they are, and they are UNIQUE and extremely complex, JUST AS UNIQUE AND COMPLEX AS EMS.
The Institute of Medicine is a learned scientific body. In 1966 they saw a need for change in our community. EMS was horrible hodge podge of service delivery models, running from one extreme to another. Private funeral homes, without any training to first aid and rescue squads, providing the best they could with text’s from the American Red Cross.
In 1966 the Institute of Medicine realized that we were in danger, researched the issue and published this report ‘Accidental Death and Disability: The Neglected Disease of Modern Society’.
Consider this:
Do you and your community need EMT’s?
Do you and your community need paramedics?
Do you and your community need an EMS system?
Do you and your community need a trauma system?
All of these components of the EMS system were proposed and written about in the Institute of Medicine in their 1966 report ‘Accidental Death and Disability: The Neglected Disease of Modern Society’. If it wasn’t for this report we would not have EMT’s, paramedics, EMS Systems, and trauma systems, or even the National Registry.
Where is the science or expert opinion to support an assertion that FICEMS was the best option for EMS?
In 2007 the Institute of Medicine published a new report, ‘Emergency Medical Services: At the Crossroads’. One of their most important recommendations - Create a lead federal EMS agency, that the federal government should consolidate all functions related to emergency care that are currently scattered among multiple agencies into a single agency in the Department of Health and Human Services (DHHS).
Let me ask you a question: why, would anyone not support the Institute of Medicine’s recommendation for a single federal agency for EMS?
EMT’s and paramedics are smart. They already knew we needed our own EMS agency! Prior to the IOM report, EMT’s and paramedics in several nationwide polls OVERWHELMINGLY stated that they wanted a single federal agency, with one purpose, to advance the mission of EMS and to represent EMS as effectively as police and fire within the federal government.
What do we need? We need somebody to say that the FICEMS isn’t the best for us, somebody who is supposed to FIGHT and not take the easy way out. That isn’t the EMS way, we do a job no one else can handle. We don’t take the easy way out.
In my personal opinion, FICEMS is doing EMS a disservice.
I am a paramedic. I earned my EMT-A card in 1981 and my paramedic certification in 1985. Am I not an equal to my brothers and sisters in the police and fire services?
In my personal opinion, FICEMS doesn’t work and this is an example why:
Everyone knows the EMT-Basic curriculum. When Medicare came out with the negotiated rule making committee for the Ambulance Fee Schedule, they stated that Medicare wouldn’t re-imburse service providers for an IV, because it was a basic skill.
Everyone knows initiating of an IV, by and large, is the domain of Intermediates and Paramedics. Where was the EMS Office from NHTSA during this process? Better yet, where was FICEMS? As FICEMS stood idly by, show me where did they weigh in on the fee schedule? What was FICEMS recommendations? If FICEMS really worked, this would never have happened.
We need our own federal EMS agency. Please read the IOM report, 'Emergency Medical Services: At the Crossroads' you can access it here for free: http://www.nap.edu/catalog.php?record_id=11629#podcast
My name is Daniel R. Gerard, I am a paramedic, and I want to represent EMT’s and paramedics. I have 28 years in the field and I am proud of my service to the community.
I am running for the NAEMT Region IV Director. If you haven’t voted for me, vote today, I will fight for what is right and for what you want. I will make it my mission to get a federal EMS agency, one that will effectively represent the needs of the EMS community.
I will represent the profession passionately, with pride, and without prejudice. I am not afraid to say what I believe in. I am not afraid to do what is right.
Stay safe my brothers and sisters, I will see you in the street,
Daniel R. Gerard, MS, RN, NREMT-P
http://www.linkedin.com/in/dangerard
Sunday, September 13, 2009
An open letter to the members of Region IV
My name is Daniel R. Gerard, MS, RN, NREMT-P, and I am running for the NAEMT Region IV Director. I have worked the streets as an EMT and paramedic in one of the busiest EMS systems per capita in the United States for over 20 years. I know what we do and how difficult our job is.
I started as a volunteer EMT in Newark, NJ in 1981, switching over to a career position in 1983. I became a paramedic in 1985, and I have served as an EMT Instructor, dispatcher, EMS Tour Chief, paramedic instructor, continuing education coordinator, college professor, clinical coordinator, QI coordinator, and EMS director. I have served NAEMT as Chair of the Paramedic Division, program development for AMLS, liaison to CECBEMS, and CAAHEP. Other leadership positions I have held, I am the past-President of the NJ EMT Association, past-Treasurer of the San Francisco Paramedic Association, and I currently serve as the Chairman of the Occupational Injury Prevention Committee for the International Association of EMS Chiefs. In addition I was the lead consultant for the ambulance service re-design in Hong Kong and I worked with the Pan American Health Organization in the Bahamas.
NAEMT is a member driven organization. As a member of NAEMT I have consistently dedicated myself to the Association and the membership.
I am not running to advance my resume, to get a new job, or to make money. I am running because I believe in who we are and what we do. I believe that we deserve better. I believe that as a profession we deserve equal consideration with other healthcare and public safety professions.
I seek this position with no illusions.
In my personal opinion NAEMT has let us down in regards to how they manage our finances and responding to EMS occupational injuries.
How much money does NAEMT spend on travel? What is the result of the travel that the leaders of NAEMT have engaged in? What happened to the financial audit that the membership was told was going to take place? What happens with OUR money? Don’t we deserve to know?
Previous officers have said that this year we are budgeted for 21% travel. Twenty-one cents out of every dollar goes to travel. My question is how many DOLLARS did we spend?
No one has answered that question.
Out of the 79 cents left, we still have to pay salaries, benefits, of the staff in Clinton, operate and maintain the building, taxes, print and mail the newsletter, correspondence, computers, paper, and last but not least, benefits to the membership.
If we spend 21% of every dollar on travel, how much money do we spend on the members?
If I am paying you my money what do I get from the Association, in dollars and as a percentage of the total budget for my dues that I paid during the last completed fiscal year?
I have not received a response yet.
The officer making comment on first class travel asked for the information that I had regarding travel, and another officer stated that no one had any upgrades to first class. I then referred them to the Clinton Travel Agency records for the last three years, specifically the credit card receipts and to please look for the 500 Mile Upgrades purchased to be utilized for upgrades in travel.
I have not had a response yet.
I am also stating that the Association has paid for the frequent flyer club membership for officers. They maintain they haven’t. This is a misstatement of facts by the Association.
Last but not least, the biggest problem I have is that the Association flew several officers to the retirement party for another officer of the Association. I am sorry, this is wrong. We don’t fly officers/board members to a party.
I am against the new by-laws change. My opponent is for the new by-laws. Let me state clearly that the by-laws change does not affect my opponent or myself. I believe that I am speaking for the membership by being against the change. I feel in my personal opinion, that the by-laws will not open opportunities for members to run for office, but instead limit the opportunity to a narrow group of people. Again this is my personal opinion, but what I would ask you to look at the by-laws change, and say ‘if I wanted to run for office, under these by-laws, would I be able to run?’
I think at that point, it will be clear.
There is a letter from the attorney of NAEMT regarding the by-laws change. I have asked that the letter be provided to the membership so that they can make an informed choice. For whatever reason, the Association has not or will not provide the letter to the membership. Various people have quoted from the letter, but no one will make the entire letter available to the members. Why?
If it is a positive letter, let us see it and then we can get behind the by-laws change. If it has negative comments or ascertains, let us see that as well, so that we can be well-informed and make a decision that is right for us.
In regards to a single federal EMS agency, I will ask you a couple of questions:
Are you better off today than you were last year, 2 years ago, 5 years ago?
Do you think we have equal representation with the police and fire services on a federal level?
Do you think we have a powerful voice in the federal government, to advocate for us, and to advance an agenda to improve our profession?
If you say yes, then I would have to disagree, please read my previous posts. If you say no, then you and I are on the same page.
Every one deserves to have a safe environment to work in. In regards to health and safety issues let me ask one more question:
Do you feel any safer than you did last year, 2 years ago, 5 years ago?
If your answer is no, who has been representing you?
My goals if elected:
Work toward creation of a national EMS administration, as the membership has stated in previous polls
Working with the U.S. Dept. of Labor to develop a unique coding mechanism for EMS Occupational Injuries
Develop a program to identify and recognize programs of excellence. From these programs, develop the tools and guides for organizations to incorporate so that they too may be able to reduce occupational injuries and deaths.
Responsibly manage your money, reduce cost, by eliminating frivolous travel
Answer and be accountable to the membership
Do you work hard for your money? Do you work hard for the money that you make to pay your dues to NAEMT? What do you get for that NAEMT membership money?
How much money does NAEMT spend on travel? What is the result of the travel that the leaders of NAEMT have engaged in? What happened to the financial audit that the membership was told was going to take place? What happens with OUR money? Don’t we deserve to know?
In all of my time in EMS, I have always felt that EMT’s and Paramedics must stand up and defend their own rights. There is no end to this battle, when we are old and no longer able to carry on the fight, what we fought for will live on in the future of our brother and sister EMT’s and paramedics.
I have answered every question, EVERY question that has been put forth by the membership.
Stand TOGETHER with ME, TOGETHER vote for ME, and TOGETHER WE will carry the banner to a new tomorrow.
Stay safe, I will see you in the street,
Daniel R. Gerard, MS, RN, NREMT-P
I started as a volunteer EMT in Newark, NJ in 1981, switching over to a career position in 1983. I became a paramedic in 1985, and I have served as an EMT Instructor, dispatcher, EMS Tour Chief, paramedic instructor, continuing education coordinator, college professor, clinical coordinator, QI coordinator, and EMS director. I have served NAEMT as Chair of the Paramedic Division, program development for AMLS, liaison to CECBEMS, and CAAHEP. Other leadership positions I have held, I am the past-President of the NJ EMT Association, past-Treasurer of the San Francisco Paramedic Association, and I currently serve as the Chairman of the Occupational Injury Prevention Committee for the International Association of EMS Chiefs. In addition I was the lead consultant for the ambulance service re-design in Hong Kong and I worked with the Pan American Health Organization in the Bahamas.
NAEMT is a member driven organization. As a member of NAEMT I have consistently dedicated myself to the Association and the membership.
I am not running to advance my resume, to get a new job, or to make money. I am running because I believe in who we are and what we do. I believe that we deserve better. I believe that as a profession we deserve equal consideration with other healthcare and public safety professions.
I seek this position with no illusions.
In my personal opinion NAEMT has let us down in regards to how they manage our finances and responding to EMS occupational injuries.
How much money does NAEMT spend on travel? What is the result of the travel that the leaders of NAEMT have engaged in? What happened to the financial audit that the membership was told was going to take place? What happens with OUR money? Don’t we deserve to know?
Previous officers have said that this year we are budgeted for 21% travel. Twenty-one cents out of every dollar goes to travel. My question is how many DOLLARS did we spend?
No one has answered that question.
Out of the 79 cents left, we still have to pay salaries, benefits, of the staff in Clinton, operate and maintain the building, taxes, print and mail the newsletter, correspondence, computers, paper, and last but not least, benefits to the membership.
If we spend 21% of every dollar on travel, how much money do we spend on the members?
If I am paying you my money what do I get from the Association, in dollars and as a percentage of the total budget for my dues that I paid during the last completed fiscal year?
I have not received a response yet.
The officer making comment on first class travel asked for the information that I had regarding travel, and another officer stated that no one had any upgrades to first class. I then referred them to the Clinton Travel Agency records for the last three years, specifically the credit card receipts and to please look for the 500 Mile Upgrades purchased to be utilized for upgrades in travel.
I have not had a response yet.
I am also stating that the Association has paid for the frequent flyer club membership for officers. They maintain they haven’t. This is a misstatement of facts by the Association.
Last but not least, the biggest problem I have is that the Association flew several officers to the retirement party for another officer of the Association. I am sorry, this is wrong. We don’t fly officers/board members to a party.
I am against the new by-laws change. My opponent is for the new by-laws. Let me state clearly that the by-laws change does not affect my opponent or myself. I believe that I am speaking for the membership by being against the change. I feel in my personal opinion, that the by-laws will not open opportunities for members to run for office, but instead limit the opportunity to a narrow group of people. Again this is my personal opinion, but what I would ask you to look at the by-laws change, and say ‘if I wanted to run for office, under these by-laws, would I be able to run?’
I think at that point, it will be clear.
There is a letter from the attorney of NAEMT regarding the by-laws change. I have asked that the letter be provided to the membership so that they can make an informed choice. For whatever reason, the Association has not or will not provide the letter to the membership. Various people have quoted from the letter, but no one will make the entire letter available to the members. Why?
If it is a positive letter, let us see it and then we can get behind the by-laws change. If it has negative comments or ascertains, let us see that as well, so that we can be well-informed and make a decision that is right for us.
In regards to a single federal EMS agency, I will ask you a couple of questions:
Are you better off today than you were last year, 2 years ago, 5 years ago?
Do you think we have equal representation with the police and fire services on a federal level?
Do you think we have a powerful voice in the federal government, to advocate for us, and to advance an agenda to improve our profession?
If you say yes, then I would have to disagree, please read my previous posts. If you say no, then you and I are on the same page.
Every one deserves to have a safe environment to work in. In regards to health and safety issues let me ask one more question:
Do you feel any safer than you did last year, 2 years ago, 5 years ago?
If your answer is no, who has been representing you?
My goals if elected:
Work toward creation of a national EMS administration, as the membership has stated in previous polls
Working with the U.S. Dept. of Labor to develop a unique coding mechanism for EMS Occupational Injuries
Develop a program to identify and recognize programs of excellence. From these programs, develop the tools and guides for organizations to incorporate so that they too may be able to reduce occupational injuries and deaths.
Responsibly manage your money, reduce cost, by eliminating frivolous travel
Answer and be accountable to the membership
Do you work hard for your money? Do you work hard for the money that you make to pay your dues to NAEMT? What do you get for that NAEMT membership money?
How much money does NAEMT spend on travel? What is the result of the travel that the leaders of NAEMT have engaged in? What happened to the financial audit that the membership was told was going to take place? What happens with OUR money? Don’t we deserve to know?
In all of my time in EMS, I have always felt that EMT’s and Paramedics must stand up and defend their own rights. There is no end to this battle, when we are old and no longer able to carry on the fight, what we fought for will live on in the future of our brother and sister EMT’s and paramedics.
I have answered every question, EVERY question that has been put forth by the membership.
Stand TOGETHER with ME, TOGETHER vote for ME, and TOGETHER WE will carry the banner to a new tomorrow.
Stay safe, I will see you in the street,
Daniel R. Gerard, MS, RN, NREMT-P
WOW 2 in a row!
Another GREAT question from GAEMTPARA:
To GAEMTPARA:
As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.
As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”
If you want additional information, or documentation, email me at daniel.gerard@comcast.net
GAEMTPARA, thank you for the excellent question.
“What are your priorities with regards to EMS at the National Level?”
To answer your question GAEMTPARA:
First and foremost I would seek to have NAEMT adopt a resolution supporting the creation of a federal agency or administration as proposed by the Institute of Medicine. I would also make it our mission to work with other stakeholders in advocating for and ultimately the creation of a single federal agency. We desperately need a single federal agency to raise our identity within the federal government, and to advocate for issues that are important for EMT’s, paramedics, and EMS systems.
The Department of Justice has a huge budget, and the capability to hire and fire, as well as give out grants, underwrite programs. They have a national training academy run by the FBI in Virginia. The U.S. Fire Administration has a large budget, and the capability to hire and fire, as well as give out grants, and underwrite programs. They have a training academy in Maryland.
EMS, while it responds to more calls than it’s fire service brethren, has been relegated to FICEMS, an arrangement that has no program budget, no hiring or firing capability, cannot issue grants, and it’s ‘biggest’ stick so to speak is to an issue a report to Congress, that Congress is under no obligation to act-upon.
FICEMS has existed in the federal government in one form or another since the 1970’s. I was amazed too when I learned this fact, yes has been around since the 1970’s, being re-authorized in the mid-80’s and again in 2005. It has always been weak and ineffective, and to date still has not accomplished anything.
There are at least 10 different federal agencies that compose FICEMS. Ten. They all have SEPARATE directors, SEPARATE budgets, SEPARATE mission statements, SEPARATE grant programs, and SEPARATE employees. Not one of those 10 agencies of FICEMS is dedicated to EMS. All of them have different missions and different goals.
If you ever read the mission statement for the Department of Transportation or for the National Highway Transportation Safety Administration, neither one of them mentions EMS in their mission statements.
In my current state of California and where I was originally from in NJ, EMS has one agency, in California it is the EMS Authority in Sacramento and in NJ it is the Office of EMS in Trenton. No other state in the United States breaks up EMS between 10 different agencies and then tries to manage it by committee.
The Alameda County EMS Agency, in California has a budget of almost $30 Million and a staff of 28 people. The only office that comes close to being identifiable with EMS national is the National Highway and Transportation Administration, and it has a staff of 7 people and a budget of around $4 Million.
Isn’t it just possible, that what has been working in the individual states over the last 40+ years, that ONE agency, with ONE purpose and ONE mission is the right way to do this? FICEMS = 10 different agencies. EMS in your state = ONE agency.
No one would ever say that the police service or the fire service do not deserve their own departments or agencies in the federal government. No one is suggesting that police and fire aren’t multidisciplinary services, they are, and they are UNIQUE and extremely complex, JUST AS UNIQUE AND COMPLEX AS EMS.
All of the essential components of an EMS system were proposed and written about by the Institute of Medicine. NAEMT supports these ideas. The Institute of Medicine says we need a single federal agency. NAEMT does not, they think we are better off with FICEMS.
If it wasn’t for the Institute of Medicines report ‘Death and Disability on America’s Highways’ we would not have EMT’s, paramedics, EMS Systems, and trauma systems. We wouldn’t have the National Registry. If we didn’t have the National Registry, we wouldn’t have NAEMT!
Please GAEMTPARA remember that EMT’s and paramedics nationwide in several polls, wanted a single federal agency, with one purpose, to advance the mission of EMS and to represent EMS as effectively as police and fire within the federal government.
This why we need a single federal agency, and why I will press for this, and keep the membership updated as to out progress.
GAEMTPARA the other issue I am passionate about is occupational injuries in EMS.
I wrote a report when I was Chairman of the Paramedic Division concerning occupational injuries in EMS. The greatest problem we have as an industry is that we have no quantifiable information on how many EMT’s and paramedics are injured in the line of duty or how they getting injured. My suggestions were that we work with the U.S. Department of Labor to devise a unique coding mechanism to begin to collect this information. My other suggestion, is that we identify programs of excellence that have been successful within a particular jurisdiction or company to reduce injuries.
Why is data important? Without data, we cannot design effective programs to reduce injuries/deaths because we cannot make a meaningful comparison. This would tell us if our efforts are making an impact on the EMT and paramedic in the field.
If you or anyone else talk to the National Institute of Justice, which is the scientific research arm for law enforcement nationwide (which would be nice if EMS had something comparable…) they will tell you that since the mid-1970’s, body armor has reduced line of duty deaths by over 600%.
If you talk to the NFPA, they can make specific reference to reductions in line of duty injuries and deaths due to addition of bunker gear for firefighters.
NAEMT spent money and developed a ‘Buckel-up’ poster campaign. We don’t know if anyone was positively affected by the poster because we have no data to do a comparison. We don’t know if poster program did any good. Are we using methods to distribute information to the public that isn’t reaching the intended audience?
EMT’s and paramedics Tweet, watch YouTube, have Facebook and MySpace pages. They text message one another. They email and surf the net at least once a day. The best PSA of the year was done by an EMS agency in Scotland, which was then posted on YouTube and has gone viral around the world (http://www.youtube.com/watch?v=6biw3LEq_0c )
The poster was not our best effort to reduce occupational injuries. How many people here have seen the NAEMT poster for the ‘Buckle-up’ campaign? The members need better.
NAEMT is developing an EMS Safety Officer Course. We will be in the same situation as we were with the poster, we will develop a program, market it to EMTs and paramedics, but because there is no data on how EMT’s and paramedics are injured/killed in the line, we will never be able to tell you if the program is effective.
The first question I think of when I think of regarding an EMS Safety Officer Course is: how much money are we going to charge for this program?
Most of our members pay to take NAEMT courses like PHTLS, AMLS, and EPC out of their own pocket because they want quality education. The economy is in a downturn, there is less money in the pockets of EMT’s and paramedics, and while I understand that NAEMT needs to generate revenue, going to the pockets of EMT’s and paramedics by developing another course is not the way to do it.
What we need is an EMS Safety PROGRAM. A comprehensive program that will incorporate safety into it all aspects of the organizational culture, where all managers and staff members are empowered with and tasked with being a part of the Safety Team. That was part of my original proposal to the Association. Give organizations the tools for a comprehensive approach for safety, and how to measure success, how to incorporate safety into all phases of the organization, from orientation, to continual training, to response, on-scene, during a large scale incident, etc. Again this was part of my original set of recommendations for the Association.
If this sounds like I have done this before, I have, with the Royal and Prudential Insurance Companies back in NJ.
If you want a copy of the Paramedic Division Occupational Injury report, email me at daniel.gerard@comcast.net
If you get a chance to read my report and recommendations, we already could have begun to identify programs of excellence for reducing death and disability, and we could then begin to develop a national PROGRAM from these programs of excellence. We could then use this program we develop to assist organizations in reducing death and disability, something any agency could use.
A course for one person? Why not a program for an entire organization?
I have been to funerals for EMS personnel. We owe it to EMT’s, paramedics, and their families to get this one right. This is where we have the chance to give back to the EMS profession. Develop an entire program that we can give to the EMS community, so that they in turn can reduce death and disability to our profession.
In summary the three priorities I have regarding EMS on a national level:
Creation of a national EMS administration
Working with the U.S. Dept. of Labor to develop a unique coding mechanism for EMS Occupational Injuries
Develop a program to identify and recognize programs of excellence. From these programs, develop the tools and guides for organizations to incorporate so that they too may be able to reduce occupational injuries and deaths.
Thank you GAEMTPARA for your excellent question, stay safe and I will see you in the streets.
Daniel R. Gerard, MS, RN, NREMT-P
To GAEMTPARA:
As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.
As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”
If you want additional information, or documentation, email me at daniel.gerard@comcast.net
GAEMTPARA, thank you for the excellent question.
“What are your priorities with regards to EMS at the National Level?”
To answer your question GAEMTPARA:
First and foremost I would seek to have NAEMT adopt a resolution supporting the creation of a federal agency or administration as proposed by the Institute of Medicine. I would also make it our mission to work with other stakeholders in advocating for and ultimately the creation of a single federal agency. We desperately need a single federal agency to raise our identity within the federal government, and to advocate for issues that are important for EMT’s, paramedics, and EMS systems.
The Department of Justice has a huge budget, and the capability to hire and fire, as well as give out grants, underwrite programs. They have a national training academy run by the FBI in Virginia. The U.S. Fire Administration has a large budget, and the capability to hire and fire, as well as give out grants, and underwrite programs. They have a training academy in Maryland.
EMS, while it responds to more calls than it’s fire service brethren, has been relegated to FICEMS, an arrangement that has no program budget, no hiring or firing capability, cannot issue grants, and it’s ‘biggest’ stick so to speak is to an issue a report to Congress, that Congress is under no obligation to act-upon.
FICEMS has existed in the federal government in one form or another since the 1970’s. I was amazed too when I learned this fact, yes has been around since the 1970’s, being re-authorized in the mid-80’s and again in 2005. It has always been weak and ineffective, and to date still has not accomplished anything.
There are at least 10 different federal agencies that compose FICEMS. Ten. They all have SEPARATE directors, SEPARATE budgets, SEPARATE mission statements, SEPARATE grant programs, and SEPARATE employees. Not one of those 10 agencies of FICEMS is dedicated to EMS. All of them have different missions and different goals.
If you ever read the mission statement for the Department of Transportation or for the National Highway Transportation Safety Administration, neither one of them mentions EMS in their mission statements.
In my current state of California and where I was originally from in NJ, EMS has one agency, in California it is the EMS Authority in Sacramento and in NJ it is the Office of EMS in Trenton. No other state in the United States breaks up EMS between 10 different agencies and then tries to manage it by committee.
The Alameda County EMS Agency, in California has a budget of almost $30 Million and a staff of 28 people. The only office that comes close to being identifiable with EMS national is the National Highway and Transportation Administration, and it has a staff of 7 people and a budget of around $4 Million.
Isn’t it just possible, that what has been working in the individual states over the last 40+ years, that ONE agency, with ONE purpose and ONE mission is the right way to do this? FICEMS = 10 different agencies. EMS in your state = ONE agency.
No one would ever say that the police service or the fire service do not deserve their own departments or agencies in the federal government. No one is suggesting that police and fire aren’t multidisciplinary services, they are, and they are UNIQUE and extremely complex, JUST AS UNIQUE AND COMPLEX AS EMS.
All of the essential components of an EMS system were proposed and written about by the Institute of Medicine. NAEMT supports these ideas. The Institute of Medicine says we need a single federal agency. NAEMT does not, they think we are better off with FICEMS.
If it wasn’t for the Institute of Medicines report ‘Death and Disability on America’s Highways’ we would not have EMT’s, paramedics, EMS Systems, and trauma systems. We wouldn’t have the National Registry. If we didn’t have the National Registry, we wouldn’t have NAEMT!
Please GAEMTPARA remember that EMT’s and paramedics nationwide in several polls, wanted a single federal agency, with one purpose, to advance the mission of EMS and to represent EMS as effectively as police and fire within the federal government.
This why we need a single federal agency, and why I will press for this, and keep the membership updated as to out progress.
GAEMTPARA the other issue I am passionate about is occupational injuries in EMS.
I wrote a report when I was Chairman of the Paramedic Division concerning occupational injuries in EMS. The greatest problem we have as an industry is that we have no quantifiable information on how many EMT’s and paramedics are injured in the line of duty or how they getting injured. My suggestions were that we work with the U.S. Department of Labor to devise a unique coding mechanism to begin to collect this information. My other suggestion, is that we identify programs of excellence that have been successful within a particular jurisdiction or company to reduce injuries.
Why is data important? Without data, we cannot design effective programs to reduce injuries/deaths because we cannot make a meaningful comparison. This would tell us if our efforts are making an impact on the EMT and paramedic in the field.
If you or anyone else talk to the National Institute of Justice, which is the scientific research arm for law enforcement nationwide (which would be nice if EMS had something comparable…) they will tell you that since the mid-1970’s, body armor has reduced line of duty deaths by over 600%.
If you talk to the NFPA, they can make specific reference to reductions in line of duty injuries and deaths due to addition of bunker gear for firefighters.
NAEMT spent money and developed a ‘Buckel-up’ poster campaign. We don’t know if anyone was positively affected by the poster because we have no data to do a comparison. We don’t know if poster program did any good. Are we using methods to distribute information to the public that isn’t reaching the intended audience?
EMT’s and paramedics Tweet, watch YouTube, have Facebook and MySpace pages. They text message one another. They email and surf the net at least once a day. The best PSA of the year was done by an EMS agency in Scotland, which was then posted on YouTube and has gone viral around the world (http://www.youtube.com/watch?v=6biw3LEq_0c )
The poster was not our best effort to reduce occupational injuries. How many people here have seen the NAEMT poster for the ‘Buckle-up’ campaign? The members need better.
NAEMT is developing an EMS Safety Officer Course. We will be in the same situation as we were with the poster, we will develop a program, market it to EMTs and paramedics, but because there is no data on how EMT’s and paramedics are injured/killed in the line, we will never be able to tell you if the program is effective.
The first question I think of when I think of regarding an EMS Safety Officer Course is: how much money are we going to charge for this program?
Most of our members pay to take NAEMT courses like PHTLS, AMLS, and EPC out of their own pocket because they want quality education. The economy is in a downturn, there is less money in the pockets of EMT’s and paramedics, and while I understand that NAEMT needs to generate revenue, going to the pockets of EMT’s and paramedics by developing another course is not the way to do it.
What we need is an EMS Safety PROGRAM. A comprehensive program that will incorporate safety into it all aspects of the organizational culture, where all managers and staff members are empowered with and tasked with being a part of the Safety Team. That was part of my original proposal to the Association. Give organizations the tools for a comprehensive approach for safety, and how to measure success, how to incorporate safety into all phases of the organization, from orientation, to continual training, to response, on-scene, during a large scale incident, etc. Again this was part of my original set of recommendations for the Association.
If this sounds like I have done this before, I have, with the Royal and Prudential Insurance Companies back in NJ.
If you want a copy of the Paramedic Division Occupational Injury report, email me at daniel.gerard@comcast.net
If you get a chance to read my report and recommendations, we already could have begun to identify programs of excellence for reducing death and disability, and we could then begin to develop a national PROGRAM from these programs of excellence. We could then use this program we develop to assist organizations in reducing death and disability, something any agency could use.
A course for one person? Why not a program for an entire organization?
I have been to funerals for EMS personnel. We owe it to EMT’s, paramedics, and their families to get this one right. This is where we have the chance to give back to the EMS profession. Develop an entire program that we can give to the EMS community, so that they in turn can reduce death and disability to our profession.
In summary the three priorities I have regarding EMS on a national level:
Creation of a national EMS administration
Working with the U.S. Dept. of Labor to develop a unique coding mechanism for EMS Occupational Injuries
Develop a program to identify and recognize programs of excellence. From these programs, develop the tools and guides for organizations to incorporate so that they too may be able to reduce occupational injuries and deaths.
Thank you GAEMTPARA for your excellent question, stay safe and I will see you in the streets.
Daniel R. Gerard, MS, RN, NREMT-P
FINALLY A GOOD QUESTION!
From Michael Hay, Reno, NV:
Dan
I appreciate your long service and accomplishments during your career. Your strong advocacy efforts in the field are well known in the Bay Area and are appreciated by many people. There are a couple of questions that I am curious to hear your take on. These are areas that I feel will have an impact on each of us as we continue to evolve as a profession in the next few decades.
1. Do you see ems as public safety or public health? why
2. What is your opinion of the new educational standards requiring all paramedic applicants to come thru an accrediated program (2012 I think), and what do you think the impact will be on rural/ frontier areas? Do you have an idea on how we can assist the rural or frontier areas in this endeavour?
3. What is your opinion on advanced scope medics and do you support allowing paramedics providing limited primary care in the rural and underserved areas?
4.Would you advocate moving the association in conjunction with an organization such as the American College of Surgeons in the direction of assisting with the development of regional and local trauma infrastructure/plans in both the U.S. and abroad helping those who really need our assistance and expertise?
Would you support a bylaw change advocating term limits for board members? why or why not
Thank you for your attention and good luck in the election
My response to Micheal:
Michael:
As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.
As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”
If you want additional information, or documentation, email me at daniel.gerard@comcast.net
Thank you Michael for your excellent comments.
To answer your question:
1. Do you see EMS as public safety or public health? Why?
I view EMS as having feet in both camps, but most importantly I think we have not paid as much attention to public health as we should have. There are 2 distinct traits of public health that interface perfectly with the mission of EMS, the first is dealing with prevention and the second is identifying at risk populations and dealing with health care issues for a given population.
The fire service has been providing fire prevention services in the community for decades. It is through these efforts that they have made fantastic strides in reducing damage to property, death, and disability over time.
If EMS applied that same model, in the context of public health, and put forth the same effort and achieved the same level of success, what would EMS be able to do in our own communities to reduce death and disability? It boggles the imagination.
If we used the public health template to develop service delivery models to target our at risk populations, we would achieve greater efficiency in service delivery, by concentrating on efforts and resources on large portions of the population.
It is also critically important to maintain a foot inside the public health arena as well, in order to provide them the resources they require for emergency response. As we deal with issues such as large scale disasters, H1 N1, bio-terrorism, health consequences related to hazardous materials exposure, public health needs to be able to have access to an emergency response capability and infrastructure. EMS allows public health to have the capability, command, communications, and control capacities that they require to respond to an event. It allows them to do this without having to re-invent the wheel.
2. What is your opinion of the new educational standards requiring all paramedic applicants to come thru an accredited program (2012 I think), and what do you think the impact will be on rural/ frontier areas? Do you have an idea on how we can assist the rural or frontier areas in this endeavor?
I realize this is a tremendous burden for many organizations. Unfortunately, there are some less than stellar paramedic programs in the United States. When there are poor paramedic programs, they are performing a disservice to people who want to enter the profession, and it lowers the standard of paramedics that ultimately enters our field. This in turn decreases our standing amongst other health care professionals.
Let us examine what has gone on with physicians. In medicine, until the release of the Flexner report, education of physicians in the United States run the gamut from extremely poor to excellent.
After the Flexner report, with the setting of standards and accreditation of medical schools, training and education improved, and so did the standard of care. If we want to do the same thing and have the same respect as all other health care providers, we need to move in this direction.
The best way to assist rural and frontier organizations is to improve delivery methods of lecture material via distributive learning (distance education). This way we could provide world class lecturers to everyone. If you have taken PHTLS and have had the opportunity and pleasure to hear Dr. McSwain, it is not only a privilege, but it is an outstanding learning experience. Using distributive learning, we can not only provide that experience to rural and frontier EMT’s and paramedics, now we can provide that knowledge to every EMT and paramedic in the United States.
Now lets expand that further: what if we took the best lecturers/educators, in every subject topic? Cardiology, Respiratory, Anatomy and Physiology? Imagine the world class education we could deliver to everyone.
There are incredible resources for education and health care in every state. If we partner with the leading academic and health care centers in each state, while I feel that there are numerous challenges, it is nothing we cannot overcome. We could then develop programs that would meet the requirements for CAAHEP accreditation.
3. What is your opinion on advanced scope medics and do you support allowing paramedics providing limited primary care in the rural and underserved areas?
I not only support this concept, I think that this is a fantastic opportunity to provide competent, caring health care providers, to improve primary health care in the community. The key to success is having a medical director for EMS who is in sync and working in partnership with the medical director for primary care services.
The positive effect of such a relationship is two fold. First patients benefit from receiving excellent primary care services from competent, skilled, and caring providers.
Second, those providers are given the opportunity to use a greater variety of skills, in a relaxed less pressured setting. They will have a greater opportunity to further refine their skills and this will benefit emergency as well as primary care patients.
Third, the EMS providers are out in the community, and this will give them a greater interaction with the residents, in a setting that is more conducive to have an exchange of information. When we are on an emergency call, there are many things I wish I could sit down and talk to patients about, but for a variety of factors, I cannot.
In a primary care setting, they can share that knowledge that they have, without having to worry that there is another assignment waiting.
Once the EMS team becomes a familiar face, you have greater buy-in when there is an emergency, hopefully there are less interpersonal conflicts, and overall with greater access to care, you will improve the health status of the more vulnerable members of the community. People will identify with the primary care paramedic, just as they used to do back in the day when the cop walked the beat in their neighborhood.
4.Would you advocate moving the association in conjunction with an organization such as the American College of Surgeons in the direction of assisting with the development of regional and local trauma infrastructure/plans in both the U.S. and abroad helping those who really need our assistance and expertise?
I would. EMS has not leveraged our relationships with other medical groups to our advantage.
EMS has had particular success with developing systems, whether they are trauma, stroke, or STEMI systems. This expertise, especially on the community level, needs to be capitalized on. This knowledge and expertise should be shared in all communities in the United States and around the world.
Raising the health status for at risk populations is a noble mission, one that we are cut out for. NAEMT has had some success with education in regards to PHTLS, but we need to take that a step further. Let us do more work in regards to trauma system development. We have demonstrated successfully that NAEMT’s educational endeavors work, let EMS show you what we can do for the development of trauma systems.
Thank you again for excellent question, stay safe,
Daniel
Dan
I appreciate your long service and accomplishments during your career. Your strong advocacy efforts in the field are well known in the Bay Area and are appreciated by many people. There are a couple of questions that I am curious to hear your take on. These are areas that I feel will have an impact on each of us as we continue to evolve as a profession in the next few decades.
1. Do you see ems as public safety or public health? why
2. What is your opinion of the new educational standards requiring all paramedic applicants to come thru an accrediated program (2012 I think), and what do you think the impact will be on rural/ frontier areas? Do you have an idea on how we can assist the rural or frontier areas in this endeavour?
3. What is your opinion on advanced scope medics and do you support allowing paramedics providing limited primary care in the rural and underserved areas?
4.Would you advocate moving the association in conjunction with an organization such as the American College of Surgeons in the direction of assisting with the development of regional and local trauma infrastructure/plans in both the U.S. and abroad helping those who really need our assistance and expertise?
Would you support a bylaw change advocating term limits for board members? why or why not
Thank you for your attention and good luck in the election
My response to Micheal:
Michael:
As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.
As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”
If you want additional information, or documentation, email me at daniel.gerard@comcast.net
Thank you Michael for your excellent comments.
To answer your question:
1. Do you see EMS as public safety or public health? Why?
I view EMS as having feet in both camps, but most importantly I think we have not paid as much attention to public health as we should have. There are 2 distinct traits of public health that interface perfectly with the mission of EMS, the first is dealing with prevention and the second is identifying at risk populations and dealing with health care issues for a given population.
The fire service has been providing fire prevention services in the community for decades. It is through these efforts that they have made fantastic strides in reducing damage to property, death, and disability over time.
If EMS applied that same model, in the context of public health, and put forth the same effort and achieved the same level of success, what would EMS be able to do in our own communities to reduce death and disability? It boggles the imagination.
If we used the public health template to develop service delivery models to target our at risk populations, we would achieve greater efficiency in service delivery, by concentrating on efforts and resources on large portions of the population.
It is also critically important to maintain a foot inside the public health arena as well, in order to provide them the resources they require for emergency response. As we deal with issues such as large scale disasters, H1 N1, bio-terrorism, health consequences related to hazardous materials exposure, public health needs to be able to have access to an emergency response capability and infrastructure. EMS allows public health to have the capability, command, communications, and control capacities that they require to respond to an event. It allows them to do this without having to re-invent the wheel.
2. What is your opinion of the new educational standards requiring all paramedic applicants to come thru an accredited program (2012 I think), and what do you think the impact will be on rural/ frontier areas? Do you have an idea on how we can assist the rural or frontier areas in this endeavor?
I realize this is a tremendous burden for many organizations. Unfortunately, there are some less than stellar paramedic programs in the United States. When there are poor paramedic programs, they are performing a disservice to people who want to enter the profession, and it lowers the standard of paramedics that ultimately enters our field. This in turn decreases our standing amongst other health care professionals.
Let us examine what has gone on with physicians. In medicine, until the release of the Flexner report, education of physicians in the United States run the gamut from extremely poor to excellent.
After the Flexner report, with the setting of standards and accreditation of medical schools, training and education improved, and so did the standard of care. If we want to do the same thing and have the same respect as all other health care providers, we need to move in this direction.
The best way to assist rural and frontier organizations is to improve delivery methods of lecture material via distributive learning (distance education). This way we could provide world class lecturers to everyone. If you have taken PHTLS and have had the opportunity and pleasure to hear Dr. McSwain, it is not only a privilege, but it is an outstanding learning experience. Using distributive learning, we can not only provide that experience to rural and frontier EMT’s and paramedics, now we can provide that knowledge to every EMT and paramedic in the United States.
Now lets expand that further: what if we took the best lecturers/educators, in every subject topic? Cardiology, Respiratory, Anatomy and Physiology? Imagine the world class education we could deliver to everyone.
There are incredible resources for education and health care in every state. If we partner with the leading academic and health care centers in each state, while I feel that there are numerous challenges, it is nothing we cannot overcome. We could then develop programs that would meet the requirements for CAAHEP accreditation.
3. What is your opinion on advanced scope medics and do you support allowing paramedics providing limited primary care in the rural and underserved areas?
I not only support this concept, I think that this is a fantastic opportunity to provide competent, caring health care providers, to improve primary health care in the community. The key to success is having a medical director for EMS who is in sync and working in partnership with the medical director for primary care services.
The positive effect of such a relationship is two fold. First patients benefit from receiving excellent primary care services from competent, skilled, and caring providers.
Second, those providers are given the opportunity to use a greater variety of skills, in a relaxed less pressured setting. They will have a greater opportunity to further refine their skills and this will benefit emergency as well as primary care patients.
Third, the EMS providers are out in the community, and this will give them a greater interaction with the residents, in a setting that is more conducive to have an exchange of information. When we are on an emergency call, there are many things I wish I could sit down and talk to patients about, but for a variety of factors, I cannot.
In a primary care setting, they can share that knowledge that they have, without having to worry that there is another assignment waiting.
Once the EMS team becomes a familiar face, you have greater buy-in when there is an emergency, hopefully there are less interpersonal conflicts, and overall with greater access to care, you will improve the health status of the more vulnerable members of the community. People will identify with the primary care paramedic, just as they used to do back in the day when the cop walked the beat in their neighborhood.
4.Would you advocate moving the association in conjunction with an organization such as the American College of Surgeons in the direction of assisting with the development of regional and local trauma infrastructure/plans in both the U.S. and abroad helping those who really need our assistance and expertise?
I would. EMS has not leveraged our relationships with other medical groups to our advantage.
EMS has had particular success with developing systems, whether they are trauma, stroke, or STEMI systems. This expertise, especially on the community level, needs to be capitalized on. This knowledge and expertise should be shared in all communities in the United States and around the world.
Raising the health status for at risk populations is a noble mission, one that we are cut out for. NAEMT has had some success with education in regards to PHTLS, but we need to take that a step further. Let us do more work in regards to trauma system development. We have demonstrated successfully that NAEMT’s educational endeavors work, let EMS show you what we can do for the development of trauma systems.
Thank you again for excellent question, stay safe,
Daniel
Saturday, September 12, 2009
Sparring with the NAEMT Treasurer
I have been going round and round now with the Treasurer for NAEMT. I am echoing my responses from the NAEMT Forum, because they stand the possibility of being edited and removed. This has already happened, and while I am not happy, I will explore all options to have this rectified. Until then...
Anyone who wants a copy of the NAEMT Treasurers Report from 2008, please contact me.
Rick Ellis has decided to ask a question. Rick is the Treasurer for NAEMT, and while I have a lot of respect for Rick, I am sorely disappointed.
Rick's Question to me on the NAEMT...Please make sure you read my follow-up response, there is very little dynamite in this, but toward the end of MY response is a shocker.
Rick Ellis:
Dan:
I would very much like to see the information you have regarding NAEMT paying for members to fly first class.
If members get an upgrade at no cost to NAEMT due to their frequent flier miles then that is something they earned and NAEMT is not being charged.
Also to let you know, if you add all travel lines in the budget (to cover instructors teaching our expo precon courses, PHTLS, AMLS, EPC committee travel, BoD travel, staff travel to support our major conference) you would be close to being correct as it accounts for 21% of the projected budget. To date we have spent only 9.8% of that budget.
As you are aware we are in the process of writing the new editions of AMLS and PHTLS textbooks. Much of this work is being done remotely but there is a need for some face to face time with publishers and authors.
If we were to look only at BoD travel, there is 7.3% of the budget projected to account for travel to meet twice a year and to attend meetings representing you the member at national forums and committees. To date we have only spent 55% of the 7.3% projected. By exerting conservative spending ideas, we only spent 50% of the projected budget item for the mid year meeting.
Travel was drastically reduced after the past Treasurer's concerns were raised in his departing report and continue to be scrutinized.
Thanks for your concern and request for information and clarification.
Richard Ellis, BSOE, NREMT-P
Treasurer
My Response to Rick:
Chief Ellis,
As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.
As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”
If you want additional information, or documentation, email me at daniel.gerard@comcast.net
To answer your question:
You stated that due to the last treasurers report, that issues relevant to travel were addressed and travel was scaled back.
What other issues in the past treasurers report were raised that you have addressed?
I am curious because previously, on this forum, another officer spoke disparagingly of that report, and now I am confused because you are stating that you have actually acted on some of those issues.
If anyone would like to see what was said previously, please email me and I will supply you a copy of what was said. My email is daniel.gerard@comcast.net
You stated Chief Ellis, and I will quote you here “I would very much like to see the information you have regarding NAEMT paying for members to fly first class.”
Sir this is very easy, as you already have them in your possession. Please refer to the Clinton Travel Agency records for the last three years, specifically the credit card receipts. Please look for the 500 Mile Upgrades purchased to be utilized for upgrades in travel.
They are all right there.
Are you also saying that we never paid for the frequent flyer club membership for any officer of the Association? NEVER?
My original question, sir, with all due respect accorded your position, I asked how much money was spent. If I wasn’t clear sir, my apologies, but I want to know a dollar amount, not what you have budgeted.
Why? You have a budget of 21%. That budgetary number is just what you have allotted, it wasn’t what you spent. You are going into the most expensive time of the year, and in past years, because the conference is in the last quarter, we have historically had a difficult time.
So that I am clear, and others understand, before we spend any other money, we have allotted 21 cents out of every dollar for travel. Out of the 79 cents left, we still have to pay salaries, benefits, of the staff in Clinton, operate and maintain the building, taxes, print and mail the newsletter, correspondence, computers, paper, and last but not least, benefits to the membership.
If we spend 21% of every dollar on travel, how much money do we spend on the members? If I am paying you my money what do I get from the Association, in dollars and as a percentage of the total budget for my dues that I paid during the last completed fiscal year?
To go back to my original question, please tell me and everyone else, what did the Association spend, in dollars and as a percentage of the total budget for travel the last 3 years?
What business was accomplished by the board of directors on this travel?
Why do I want to know this? If we are flying officers and Board members to state conferences to increase recruitment, the paid membership of the Association is between 6,000 and 7,000 members. The rest of the membership is composed of ‘free’ members who do not contribute anything in the way of dues, but have gained access for 1 year free by attending a PHTLS, AMLS, and EPC class.
Since we are not gaining a huge number of members, wouldn’t our money be better spent by keeping the officers and board of directors home, and letting local members of the Association staff the booths? This way we can kill two birds with one stone, develop local leaders, and put a real face on the organization, a member of the local EMS community who is also a member of NAEMT? What better person to explain the benefits of NAEMT than the guy or gal next door.
If the Association is growing by leaps and bounds because of the efforts of the officers of the Association, all well and good, it was worth the effort. Please provide the number of paid the members over the last 10 years (not the ‘free’ members who get their membership from AMLS, PHTLS, and EPC). Start from 1998 and show me how sending the officers to state conferences has increased membership.
I understand that travel is touchy subject, but since you brought it up Chief Ellis, have we spent any money to fly the officers or board members of the Association to a retirement affair for an officer of the Association?
I am sorry sir, regardless of how much I respect the officer in question, flying the officers and board members to retirement party is wrong. If it is wrong for AIG, Washington Mutual, and other bank executives to go to Las Vegas, it is equally as wrong to fly the officers of the Association to a retirement affair.
Our members are struggling, this isn’t responsible, it is reprehensible.
I can understand sending a couple (meaning no more than two) of the officers or members of the board for the National EMS Bike Ride. This is important for the Association and the EMS community as whole. I applaud the efforts of Jennifer for undertaking this.
I cannot and will not support flying officers to a party to have a good time on Association money, money that comes from the pockets of our members.
Previously I asked for and have yet to receive a response:
Which officers and board members traveled?
Where did they go?
What official business were they on?
How much did it cost?
Respectfully,
Daniel R. Gerard, MS, RN, NREMT-P
Anyone who wants a copy of the NAEMT Treasurers Report from 2008, please contact me.
Rick Ellis has decided to ask a question. Rick is the Treasurer for NAEMT, and while I have a lot of respect for Rick, I am sorely disappointed.
Rick's Question to me on the NAEMT...Please make sure you read my follow-up response, there is very little dynamite in this, but toward the end of MY response is a shocker.
Rick Ellis:
Dan:
I would very much like to see the information you have regarding NAEMT paying for members to fly first class.
If members get an upgrade at no cost to NAEMT due to their frequent flier miles then that is something they earned and NAEMT is not being charged.
Also to let you know, if you add all travel lines in the budget (to cover instructors teaching our expo precon courses, PHTLS, AMLS, EPC committee travel, BoD travel, staff travel to support our major conference) you would be close to being correct as it accounts for 21% of the projected budget. To date we have spent only 9.8% of that budget.
As you are aware we are in the process of writing the new editions of AMLS and PHTLS textbooks. Much of this work is being done remotely but there is a need for some face to face time with publishers and authors.
If we were to look only at BoD travel, there is 7.3% of the budget projected to account for travel to meet twice a year and to attend meetings representing you the member at national forums and committees. To date we have only spent 55% of the 7.3% projected. By exerting conservative spending ideas, we only spent 50% of the projected budget item for the mid year meeting.
Travel was drastically reduced after the past Treasurer's concerns were raised in his departing report and continue to be scrutinized.
Thanks for your concern and request for information and clarification.
Richard Ellis, BSOE, NREMT-P
Treasurer
My Response to Rick:
Chief Ellis,
As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.
As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”
If you want additional information, or documentation, email me at daniel.gerard@comcast.net
To answer your question:
You stated that due to the last treasurers report, that issues relevant to travel were addressed and travel was scaled back.
What other issues in the past treasurers report were raised that you have addressed?
I am curious because previously, on this forum, another officer spoke disparagingly of that report, and now I am confused because you are stating that you have actually acted on some of those issues.
If anyone would like to see what was said previously, please email me and I will supply you a copy of what was said. My email is daniel.gerard@comcast.net
You stated Chief Ellis, and I will quote you here “I would very much like to see the information you have regarding NAEMT paying for members to fly first class.”
Sir this is very easy, as you already have them in your possession. Please refer to the Clinton Travel Agency records for the last three years, specifically the credit card receipts. Please look for the 500 Mile Upgrades purchased to be utilized for upgrades in travel.
They are all right there.
Are you also saying that we never paid for the frequent flyer club membership for any officer of the Association? NEVER?
My original question, sir, with all due respect accorded your position, I asked how much money was spent. If I wasn’t clear sir, my apologies, but I want to know a dollar amount, not what you have budgeted.
Why? You have a budget of 21%. That budgetary number is just what you have allotted, it wasn’t what you spent. You are going into the most expensive time of the year, and in past years, because the conference is in the last quarter, we have historically had a difficult time.
So that I am clear, and others understand, before we spend any other money, we have allotted 21 cents out of every dollar for travel. Out of the 79 cents left, we still have to pay salaries, benefits, of the staff in Clinton, operate and maintain the building, taxes, print and mail the newsletter, correspondence, computers, paper, and last but not least, benefits to the membership.
If we spend 21% of every dollar on travel, how much money do we spend on the members? If I am paying you my money what do I get from the Association, in dollars and as a percentage of the total budget for my dues that I paid during the last completed fiscal year?
To go back to my original question, please tell me and everyone else, what did the Association spend, in dollars and as a percentage of the total budget for travel the last 3 years?
What business was accomplished by the board of directors on this travel?
Why do I want to know this? If we are flying officers and Board members to state conferences to increase recruitment, the paid membership of the Association is between 6,000 and 7,000 members. The rest of the membership is composed of ‘free’ members who do not contribute anything in the way of dues, but have gained access for 1 year free by attending a PHTLS, AMLS, and EPC class.
Since we are not gaining a huge number of members, wouldn’t our money be better spent by keeping the officers and board of directors home, and letting local members of the Association staff the booths? This way we can kill two birds with one stone, develop local leaders, and put a real face on the organization, a member of the local EMS community who is also a member of NAEMT? What better person to explain the benefits of NAEMT than the guy or gal next door.
If the Association is growing by leaps and bounds because of the efforts of the officers of the Association, all well and good, it was worth the effort. Please provide the number of paid the members over the last 10 years (not the ‘free’ members who get their membership from AMLS, PHTLS, and EPC). Start from 1998 and show me how sending the officers to state conferences has increased membership.
I understand that travel is touchy subject, but since you brought it up Chief Ellis, have we spent any money to fly the officers or board members of the Association to a retirement affair for an officer of the Association?
I am sorry sir, regardless of how much I respect the officer in question, flying the officers and board members to retirement party is wrong. If it is wrong for AIG, Washington Mutual, and other bank executives to go to Las Vegas, it is equally as wrong to fly the officers of the Association to a retirement affair.
Our members are struggling, this isn’t responsible, it is reprehensible.
I can understand sending a couple (meaning no more than two) of the officers or members of the board for the National EMS Bike Ride. This is important for the Association and the EMS community as whole. I applaud the efforts of Jennifer for undertaking this.
I cannot and will not support flying officers to a party to have a good time on Association money, money that comes from the pockets of our members.
Previously I asked for and have yet to receive a response:
Which officers and board members traveled?
Where did they go?
What official business were they on?
How much did it cost?
Respectfully,
Daniel R. Gerard, MS, RN, NREMT-P
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