Public Health, EMS, Emergency Management: Partners in Preparedness

The H1N1 pandemic-flu virus is already a prime topic of the day in the nation’s public-health, EMS (emergency medical services), and emergency-management communities, and is likely to be even more so in the very near future as the virus continues to spread both in the United States and throughout the world. One immediate result of the publicity given to this lethal and rapidly spreading virus has been increased collaboration and cooperation between and among those communities – which is, of course, very good for all three of those professional groups.

The steadily increasing integration of efforts, procedures, and processes not only enhances community safety and security but also creates the foundation for future such collaborative efforts that should bring the three communities even closer as they become true partnerships in preparedness. The partnerships should not and will not be limited, though, to the prevention of and/or response to pandemic flu outbreaks but will also encompass a broad spectrum of other mass-casualty incidents and events – including, but not limited to: bioterrorism attacks; chemical emergencies and other hazardous-materials incidents; salmonella outbreaks; and weather-related disasters – e.g., hurricanes, earthquakes, and tornadoes.

In short and in fact, these partnerships are and will be increasingly needed in today’s all-hazards context of emergencies, disasters, and other mass-casualty events. In the United States, most emergency-management situations come under the jurisdictional umbrella of the Department of Homeland Security (DHS) and, more specifically, that department’s Federal Emergency Management Agency (FEMA) – which works in close cooperation with and through numerous state, county, and local emergency-management departments and agencies.

A Vertical Distribution of Responsibilities

Public Health per se is under the jurisdiction of the U.S. Department of Health and Human Services (HHS) and its Atlanta-based Centers for Disease Control and Prevention (CDC) – which, like FEMA, carries out its responsibilities by working with and through state and local departments of health. The EMS distribution of responsibilities is similar: The U.S. Department of Transportation (DOT) has been assigned the national responsibilities, but it carries out most of those responsibilities through state departments of health, local – i.e., city and county – fire and police departments, and/or, in some areas, private-sector companies and organizations as well.

In short, the collaborative efforts required are generally intergovernmental, interagency, and interdisciplinary. By definition, though, the challenges involved in almost any mass-casualty event are significant and the cooperative efforts required to overcome those challenges are definitely worth the effort.

Joint planning, joint training, and joint exercises are the “magic keys” required to move the cooperative process forward. FEMA’s National Exercises Program and Homeland Security Exercise and Evaluation Program serve as excellent models for the partnerships required – and also, not incidentally, provide an ideal framework under which the numerous professionals provided by the several levels of government participating will get to know one another and test and evaluate their individual and collective plans and training. Tabletop exercises (which are essentially closely controlled seminars) allow open and free-flowing discussions that frequently lead to judicious and workable decisions and to the additional refinement of plans and training needed before these multijurisdictional partnerships can progress to the next level of preparedness.

JEMS CONNECT (a preparedness journal geared to the needs of the nation’s EMS community and its professional partners) summarizes the current situation as follows: “As many of our older generation have seen, Emergency Medical Services (EMS) has moved from a service provided by funeral homes to fixed and rotor-wing aircraft services along with advance ground services. With that transition many people have misunderstood the role which EMS has within our society. Some may see this transition as both good and bad. These views come from both non-health and healthcare-related fields alike. But how can a profession that has been around since the time of Napoleon and one that is just now entering into the mainstream of public and professional viewpoints work successfully together? Both of these fields are related to the well-being of others, yet one focuses on the well-being of a few of the population while the other looks at the well-being of the whole population.”

The Golden Examples of Two California Counties

There have been numerous notable best-practices examples observed around the nation in integration – two California jurisdictions, Ventura County and Contra Costa County, are among the very best. In each of those counties (and, of course, many other jurisdictions), there is and has been a continuing emphasis on long-term joint planning, training, and exercises, interspersed with many interim meetings and conferences, and culminating in virtually seamless operations. The constant threats in that state posed by earthquakes, out-of-control wildfires, and sometimes floods, California officials say, serve to focus the group’s, and individual participant’s, attention “like a laser.”

That is good news, of course; the bad news, though, is one heard in many other jurisdictions – state, local, and federal – throughout the county: namely, that funding is a common, persistent, and exceptionally difficult problem adversely affecting all of the departments and agencies involved, and probably will continue to be a problem for the foreseeable future.

Kay Goss
Kay C. Goss

Kay Goss has been the president of World Disaster Management since 2012. She is the former senior assistant to two state governors, coordinating fire service, emergency management, emergency medical services, public safety, and law enforcement for 12 years. She then served as the Associate Federal Emergency Management Agency (FEMA) Director for National Preparedness, Training, Higher Education, Exercises, and International Partnerships (presidential appointee, U.S. Senate confirmed unanimously). She was a private sector government contractor for 12 years at the Texas firm Electronic Data Systems as a senior emergency manager and homeland security advisor and SRA International’s director of emergency management services. She is a senior fellow at the National Academy for Public Administration and serves as a nonprofit leader on the Board of Advisors for DRONERESPONDERS International and for the Institute for Diversity and Inclusion in Emergency Management. She has also been a graduate professor of Emergency Management at the University of Nevada at Las Vegas for 16 years, İstanbul Technical University for 12 years, the MPA Programs Metropolitan College of New York for five years, and George Mason University. She has been a Certified Emergency Manager (CEM) for 25 years and a Featured International Association of Emergency Managers (IAEM) CEM Mentor for five years, and chair of the Training and Education Committee for six years, 2004-2010.



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