Progress of EMS Services

¶ … governmental or non-governmental agency that focuses on disaster recovery. To that end, the author of this report has chosen the Federal Emergency Management Agency (FEMA). FEMA's mission as stated on their website is "to support our citizens and first responders to ensure that as a nation we work together to build, sustain and improve our capability to prepare for, protect against, respond to, recover from and mitigate all hazards" (FEMA, 2015). As already stated, the focus of this brief treatise will be on the recovery aspects of FEMA's job.

While FEMA has often been derided and been made the butt of many jokes, they serve a vital and needed role when it comes to disaster recovery. When speaking of recovery, this would reference what happens more than a month after a disaster occurs rather than the immediate response upon the event happening or even the immediate aftermath. As an example, Hurricane Katrina was a massive disaster but this report would focus on what happens after the storm has blown through and all people in immediate peril have been rescued.

One thing that FEMA did in the aftermath of Hurricane Katrina was arrange and coordinate temporary-to-permanent housing for people displaced by the storm. While New Orleans and Louisiana seemingly took the brunt of the storm, Mississippi and other states were affected as well and FEMA was on-site for all of the damage path areas (Evans-Cowley & Kitchen, 2011, pp 95-96). FEMA also works at a high level to coordinate and mandate recovery centers in each county affected by a disaster (Dekle, 2005, pp 133-134).

Access to these recovery centers and other measures that address similar needs are sometimes needed for several years after a disaster. Indeed, in November 2007, there were approximately 50,000 households that still resided in FEMA-established housing and this was two years removed from the actual storm (Shebab, Anastario & Lawry, 2008, pp 416-417). When it comes to the "crossroads" issues that emergency medical services are facing, the initial report on the issue names a few major ones including safety, effectiveness, patient-centeredness, timeliness, efficiency and equity (Warden, 2009, pp. 15-17).

Equity can be a sensitive subject even in the best of circumstances. However, this becomes even truer when speaking of an emergency situation. For example, if a hospital is not in a patient's network (knowingly or unknowingly), the patient in need of emergency services is not really going to care. However, there are obvious financial implications for both the EMS and the patient(s) involved (UMBC, 2015, p. 10). Beyond that, emergency responders are usually governed by where the emergency occurs (UMBC, 2015, p. 8). Ambulance services are often considered natural monopolies (UMBC, 2015, p. 11).

When all of this is bumped against people that are uninsured, under-insured and so forth, this can create issues. As such, equity is far from being realized. Patient-centeredness and equity are both affected by the fragmentation of the emergency services sphere that has been created by the peeling off of pediatric services as a separate segment (Kuehl, 1994, p. 22). However, the troubles with all the crossroads dimensions have seen a bit of a valley as many say that the early 1990's was a "dark" period for emergency medical services (Kuehl, 1994, p. 22).

As already intimated, at least part of the problem are the financial constraints and other issues involved (Kuehl, 1994, p. 22). This regression came after some major progress in technology and methodology that occurred through much of the 1980's. One example was the use of.