EMS advocacy: Speak the right language to the right people

By Raphael M. Barishansky, DrPH

I recently had the opportunity to publish an article for Governing magazine regarding the need for states to recognize EMS as an essential service. While attending the recently held EMS World Expo in Las Vegas, I received a lot of positive feedback on the article, but also several questions about why I chose that particular publication to highlight this topic.

To me, the reason was simple: where was the audience that needed to be reached? Most of the conversation that I have noted around that important topic has been limited to EMS-specific publications and social media. Thus, it was clear to me that to get traction on moving the issue forward, the discussion needed to be elevated to a broader audience, particularly decision-makers who have the power to influence policy. It is incumbent on EMS leaders to take their concerns about EMS sustainability to those who need to read about it and understand it.

This experience at the conference really got me thinking about the wider need for EMS leaders to communicate beyond their own groups or “echo chambers,” when addressing critical policy issues. To be clear, I’m not suggesting that all EMS leaders limit their engagement with just their peers. But if the reaction to my article is any indication, then we, collectively, must do a better job of sharing our systems’ realities with broader audiences.

Elected officials need to hear directly from EMS leaders on a range of critical issues. From operational matters, such as why response times aren’t a true EMS system performance measure; to policy issues, such as the community benefits of mobile integrated health (MIH); and even areas such as the need for across-the-board mental health programs and protections for EMS providers. Other key topics, such as designating EMS as an essential service and meaningfully addressing the paramedic workforce shortage, require that the policymakers understand the true scope of these challenges and the potential solutions and need to hear from EMS leaders.

A framework for EMS advocacy

Perhaps a framework or algorithm should be developed for EMS leaders to help guide decisions on when to step outside their own echo chambers. This could involve asking key questions such as:

• Is the issue broad-based, affecting systems across the U.S., or is it more of a localized concern?
• Have elected officials been informed of the issue by EMS subject matter experts? If so, how was this conveyed? Was the information provided with regular updates?
• What concrete steps can you propose to decision-makers to address the issue? And how can they implement these solutions – through legislation, executive orders or other actions?

The overarching advocacy strategy goes beyond simply meeting with elected officials. It also means ensuring these topics are covered at conferences you attend, on websites you frequent and in industry-specific publications you read. In short, you’ll need to do your homework to reach this cohort effectively, but it can be done.

I’ve often advised current EMS leaders – and future leaders – that they should know the name of their local, county or regional public health director and, in effect, speak the language of public health. But we need to take that a step further. EMS leaders should also know the names of all the elected officials in their area and be able to speak the language of policy and governance. These are the decision-makers, the policy writers, the budget setters – the people who need to fully understand the issues affecting EMS. And they need to hear it directly from you.

Prior to the publication of my article, I wrongly assumed that decision-makers knew that, in many states, EMS was not considered an essential service. It seems that many in governmental leadership positions are not aware of the statutory status of their emergency services. Many in leadership positions also do not understand the limitations of their specific state’s designations and the impediment it can be in trying to improve – or save – their EMS system.

Evaluate. Educate. Campaign. Improve. And stop just talking to yourselves.

| More: The Ways and Means to ensure resilient emergency medical care. Ed Racht and Matt Zavadsky recount their EMS advocacy testimony to the U.S. House Committee

ABOUT THE AUTHOR
Raphael M. Barishansky is a public health and EMS leader with more than 30 years of experience in a variety of systems and agencies. Currently an independent consultant providing his unique perspective and multi-faceted public health and EMS expertise to various organizations, his most recent position before this was as the Deputy Secretary for Health Preparedness and Community Protection at the Pennsylvania Department of Health. Prior to this position, he served as the Director of the Office of Emergency Medical Services (OEMS) at the Connecticut Department of Public Health for several years.