Federal Policy Leading the Way in Emergency Medical Services

Abstract

he most influential piece of federal legislation during my 30-year tenure with the North Carolina Office of Emergency Medical Services (NC OEMS), the last 15 as the state Emergency Medical Services (EMS) director, was creation of the EMS program at the National Highway Traffic Safety Administration (NHTSA). Since then, federal EMS legislation, programs, and agencies have profoundly impacted the evolution of EMS throughout our nation and my personal career in North Carolina. Federal EMS legislation permitted NHTSA to 1) assist states and local communities with the purchase of ambulances; 2) fund for automobile extrication courses; 3) provide national-level guidance and support to evolving EMS systems; and 4) standardize emergency medical technician (EMT) training across the nation. The NHTSA also made the term EMT a household word and created a universally recognized symbol for EMS, the blue “Star of Life.” The 1973 National EMS Systems Act helped shaped state legislation including that of North Carolina. The NHTSA state EMS assessments and reassessments program, a program supporting expert team evaluations of state EMS systems, continues to help guide the development of state EMS systems. NHTSA publications, such as the EMS Agenda for the Future and its various spin-off documents including the EMS Education Agenda for the Future: A Systems Approach, the EMS Research Agenda for the Future, and others, encouraged the nation to adopt a collaborative, consensus-based, and forward-thinking approach to EMS issues. The passage of the Emergency Medical Services Systems (EMSS) Act of 1973 brought positive changes to EMS. Health care provided in the hospital could now be extended into the community 1 and mechanisms were now available for funding the development of regional EMS systems. 2 The EMSS Act brought much needed recognition to emergency medicine as a field of medicine. 3 It also placed substantial obligations on hospitals