- The Washington Times - Thursday, September 14, 2006

The D.C. government has not provided necessary resources and adequate oversight of emergency medical services (EMS) for at least the past four years, according to a task force seeking to improve the delivery of pre-hospital care.

Among the deficiencies found were:

• A committee of mayoral appointees tasked with advising city officials on EMS issues has not been seated since 2001.

• The city’s Department of Health does not inspect the life-saving equipment on fire engines, which are the first to respond to critical medical calls in most cases.

• There is no mechanism for certifying doctors who advise field medics via telephone during emergencies.

• Certification exams for emergency medical technicians (EMTs) and paramedics are not routinely updated.

“I think we’re bearing witness as to why some of the problems we have seen are taking place,” said Paul M. Maniscalco, a past president of the National Association of Emergency Medical Technicians.

Mr. Maniscalco leads the task force created by D.C. Council member Phil Mendelson, at-large Democrat to study EMS delivery in the District.

Mr. Mendelson, chairman of the Judiciary Committee, which oversees the fire department, created the task force after an inspector general’s report issued in July found multiple errors in the handling of the emergency call for journalist David E. Rosenbaum.

Mr. Rosenbaum was attacked and beaten Jan. 6 in Northwest and died two days later from his injuries.

The disclosures about inadequate oversight of EMS were made at a task-force meeting Sept. 7 during a presentation by Beverly Pritchett, senior deputy director of the Department of Health’s Emergency Health and Medical Services Administration.

That division, created by Mayor Anthony A. Williams in 2002, is responsible for coordinating emergency preparedness and bioterrorism response, and for providing oversight of emergency medical providers and their equipment.

When questioned by task-force members, Ms. Pritchett said that her division receives $425,000 in funding from the District and that nearly 90 percent of its $8 million budget is provided by annual federal grants.

Task-force members questioned whether that is a reliable source of funding for a division with such crucial oversight responsibilities.

“The Department of Health is the oversight agency for emergency medical services. We need to give them the proper funding and authority to do their job,” said Battalion Fire Chief Brian Lee, a task-force member.

Although the division charges the fire department $400 to $600 for ambulance inspections, the fire department has not paid the bill for inspections for two years because of its own budget shortfall.

“People should be congratulating Ms. Pritchett on the level of performance she’s been able to get with the level of funding she has been provided,” Mr. Maniscalco said.

Ms. Pritchett, who has been in her job since April, said that the fire department also has been delinquent in filing quality-improvement reports.

“As far as I know, there have not been any Q.I. reports received,” she said.

In addition, the mayor’s 28-member Emergency Medical Services Advisory Committee has gone unseated since 2001, she said.

Ms. Pritchett said the committee is supposed to focus attention on and devise solutions for EMS problems, such as the lengthy waits ambulance crews must endure when they deliver patients to hospitals.

“It’s obviously important to us to have that committee be active,” she said.

Ms. Pritchett reported some improvements since she has been on the job.

Health Department officials have bolstered the integrity of the EMT and paramedic certification process by cycling out exams on a regular basis, she said, adding that health officials who administer the exams discovered that some of the tests were being reused up to three years after their initial use.

She also said she has been meeting regularly with EMS leaders in the fire department.

In addition, the Health Department will begin inspecting the medical equipment carried aboard fire engines, beginning next month.

The Washington Times reported last year that veterinary supplies had made their way on board city ambulances and that some ambulances were operating with expired inspection stickers, including the unit used by the crew that traditionally participates in presidential motorcades.

“I think it’s clear that all agencies that are tasked with health and safety must take a more involved approach toward EMS, without that, we’ll continue to be, at best, mediocre,” said Cynthiana Lightfoot, a health care activist and a member of the task force.

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