It has come to the IAFF’s attention that several bills are now appearing in state legislatures relating to the Mobile Integrated Healthcare (Community Paramedic) and EMS.  Some provisions in the Affordable Care Act (ACA) set up opportunities for EMS providers to participate in delivering various aspects of healthcare outside the hospital in an effort to cut overall cost of care.  For example, EMS personnel may be involved in follow-up services with patients once they have been discharged from the hospital to assure the patient is compliant with prescription regime and post wound care.

Under the ACA, key objectives are to decrease the number of uninsured while increasing quality of care.  Over the years, fire-based EMS has undergone changes that have effectively broadened the work of EMTs and paramedics to meet the needs that previously were not provided or provided in other arenas. But in today’s environment of increased responsibilities and decreasing budgets, fire department leaders must constantly evaluate and justify current systems and be prepared to propose changes to protect the quality of publicly funded fire-based EMS systems and add value to services provided to the community.

The ACA is the latest driver of these changes, causing fire departments to rethink how EMS services and perhaps mobile integrated healthcare (or community paramedic services) will be delivered and how to remain economically viable. Fire-based community paramedicine is a concept that could change existing EMS systems by coordinating with other health care providers to improve patient care, reduce expenses and be self-sustaining.

The IAFF is involved and is monitoring the political debate in state legislatures and encourages our affiliates to do the same.

For more information, read the fall 2013 edition of the Fire Fighter Quarterly’s “Answering the Call for Change” or contact the Fire/EMS Operations and GIS Department at (202) 737-8484.