81 FR 18934 - Revision of the Emergency Medical Services Agenda for the Future; Request for Information

DEPARTMENT OF TRANSPORTATION
National Highway Traffic Safety Administration

Federal Register Volume 81, Issue 63 (April 1, 2016)

Page Range		18934-18935
FR Document		2016-06960

NHTSA, on behalf of the Federal Interagency Committee on Emergency Medical Services (FICEMS), is seeking comments from all sources (public, private, governmental, academic, professional, public interest groups, and other interested parties) on the planned revision of the 1996 Emergency Medical Services Agenda for the Future (EMS Agenda). FICEMS was created (42 U.S.C. 300d-4) by the Secretaries of Transportation, Health and Human Services and Homeland Security to, in part, ensure coordination among the Federal agencies involved with State, local, tribal or regional emergency medical services and 9-1-1 systems. FICEMS has statutory authority to identify State and local Emergency Medical Services (EMS) and 9-1-1 needs, to recommend new or expanded programs and to identify the ways in which Federal agencies can streamline their processes for support of EMS. FICEMS includes representatives from the Department of Defense (DoD) Office of the Assistant Secretary of Defense--Health Affairs, the Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR), HHS Indian Health Service (IHS), HHS Centers for Disease Control and Prevention (CDC), HHS Health Resources and Services Administration (HRSA), HHS Centers for Medicare and Medicaid Services (CMS), the Department of Homeland Security (DHS) Office of Health Affairs (OHA), DHS U.S. Fire Administration (USFA), NHTSA, the Federal Communications Commission (FCC) and a State EMS Director appointed by the Secretary of Transportation. On June 19, 2014, FICEMS unanimously approved a motion to proceed with a revision of the EMS Agenda, with a focus on data-driven approaches to future improvements. This followed an April 24, 2014 letter in which the National Emergency Medical Services Advisory Council (NEMSAC) issued recommendations to NHTSA regarding revision of the EMS Agenda. NEMSAC's recommendations were as follows: <bullet> A major revision of the EMS Agenda for the Future should be undertaken as soon as possible; <bullet> The revision process should be guided by an external entity (not NEMSAC) that will ensure a consensus- and data-driven process with broad stakeholder representation. The goal should be to replicate the process used to develop the original EMS Agenda for the Future, published in 1996; <bullet> The U.S. Department of Transportation should seek financial support and assistance from members of FICEMS to accomplish this task. The purpose of this notice is to solicit comments on the planned revision of the EMS Agenda, and to request responses to specific questions provided below. This is neither a request for proposals nor an invitation for bids.

Federal Register, Volume 81 Issue 63 (Friday, April 1, 2016)

[Federal Register Volume 81, Number 63 (Friday, April 1, 2016)]
[Notices]
[Pages 18934-18935]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-06960]


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DEPARTMENT OF TRANSPORTATION

National Highway Traffic Safety Administration

[Docket No. NHTSA-2016-0035]


Revision of the Emergency Medical Services Agenda for the Future; 
Request for Information

AGENCY: National Highway Traffic Safety Administration (NHTSA), 
Department of Transportation (DOT).

ACTION: Notice; request for information.

-----------------------------------------------------------------------

SUMMARY: NHTSA, on behalf of the Federal Interagency Committee on 
Emergency Medical Services (FICEMS), is seeking comments from all 
sources (public, private, governmental, academic, professional, public 
interest groups, and other interested parties) on the planned revision 
of the 1996 Emergency Medical Services Agenda for the Future (EMS 
Agenda).
    FICEMS was created (42 U.S.C. 300d-4) by the Secretaries of 
Transportation, Health and Human Services and Homeland Security to, in 
part, ensure coordination among the Federal agencies involved with 
State, local, tribal or regional emergency medical services and 9-1-1 
systems. FICEMS has statutory authority to identify State and local 
Emergency Medical Services (EMS) and 9-1-1 needs, to recommend new or 
expanded programs and to identify the ways in which Federal agencies 
can streamline their processes for support of EMS. FICEMS includes 
representatives from the Department of Defense (DoD) Office of the 
Assistant Secretary of Defense--Health Affairs, the Department of 
Health and Human Services (HHS) Office of the Assistant Secretary for 
Preparedness and Response (ASPR), HHS Indian Health Service (IHS), HHS 
Centers for Disease Control and Prevention (CDC), HHS Health Resources 
and Services Administration (HRSA), HHS Centers for Medicare and 
Medicaid Services (CMS), the Department of Homeland Security (DHS) 
Office of Health Affairs (OHA), DHS U.S. Fire Administration (USFA), 
NHTSA, the Federal Communications Commission (FCC) and a State EMS 
Director appointed by the Secretary of Transportation.
    On June 19, 2014, FICEMS unanimously approved a motion to proceed 
with a revision of the EMS Agenda, with a focus on data-driven 
approaches to future improvements.
    This followed an April 24, 2014 letter in which the National 
Emergency Medical Services Advisory Council (NEMSAC) issued 
recommendations to NHTSA regarding revision of the EMS Agenda. NEMSAC's 
recommendations were as follows:
     A major revision of the EMS Agenda for the Future should 
be undertaken as soon as possible;
     The revision process should be guided by an external 
entity (not NEMSAC) that will ensure a consensus- and data-driven 
process with broad stakeholder representation. The goal should be to 
replicate the process used to develop the original EMS Agenda for the 
Future, published in 1996;
     The U.S. Department of Transportation should seek 
financial support and assistance from members of FICEMS to accomplish 
this task.
    The purpose of this notice is to solicit comments on the planned 
revision of the EMS Agenda, and to request responses to specific 
questions provided below. This is neither a request for proposals nor 
an invitation for bids.

DATES: It is requested that comments on this announcement be submitted 
by June 30, 2016.

ADDRESSES: You may submit comments [identified by Docket No. NHTSA-
2016-0035] through one of the following methods:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the online instructions for submitting comments.
     Mail or Hand Delivery: Docket Management Facility, U.S. 
Department of Transportation, 1200 New Jersey Avenue SE., West 
Building, Room W12-140, Washington, DC 20590, between 9 a.m. and 5 
p.m., Monday through Friday, except on Federal holidays.

FOR FURTHER INFORMATION CONTACT: Gamunu Wijetunge, Office of Emergency 
Medical Services, (202) 493-2793, [email protected], located at 
the United States Department of Transportation; 1200 New Jersey Avenue 
SE., NPD-400, Room W44-232, Washington, DC 20590. Office hours are from 
9 a.m. to 5 p.m., Monday through Friday, except Federal holidays.

SUPPLEMENTARY INFORMATION: 

Background

    In 1996 NHTSA, in partnership with HRSA, published the EMS Agenda 
(www.ems.gov/pdf/2010/EMSAgendaWeb_7-06-10.pdf). The document created a 
vision for the future of EMS systems in the United States and led to 
EMS system improvements across the Nation. Changes envisioned by the 
EMS Agenda included the National EMS Information System (NEMSIS), the 
``EMS Education Agenda for the Future: A Systems Approach'', universal 
wireless 9-1-1, automatic crash notification, the recognition of EMS as 
a physician sub-specialty, and many others.
    The EMS Agenda included the following vision statement: ``Emergency 
medical services (EMS) of the future will be community-based health 
management that is fully integrated with the overall health care 
system. It will have the ability to identify and modify illness and 
injury risks, provide acute illness and injury care and follow-up, and 
contribute to treatment of chronic conditions and community health 
monitoring. This new entity will be developed from redistribution of 
existing health care resources and will be integrated with other health 
care providers and public health and public safety agencies. It will 
improve community health and result in more appropriate use of acute 
health care resources. EMS will remain the public's emergency medical 
safety net.''
    Furthermore, the EMS Agenda proposed development of the following 
14 EMS attributes:
     Integration of Health Services;
     EMS Research;
     Legislation and Regulation;
     System Finance;
     Human Resources;

[[Page 18935]]

     Medical Direction;
     Education Systems;
     Public Education;
     Prevention;
     Public Access;
     Communication Systems;
     Clinical Care;
     Information Systems;
     Evaluation.
    In 2014, NEMSAC recommended that NHTSA undertake a major revision 
of the EMS Agenda. NHTSA, on behalf of FICEMS, intends to work closely 
with EMS stakeholders in revising the EMS Agenda. It is anticipated the 
revised EMS Agenda will envision the evolution of EMS systems over the 
next 30 years.

Questions on the Proposed Revision of the EMS Agenda

    Responses to the following questions are requested to help plan the 
revision of the EMS Agenda. Please provide references as appropriate.
    1. What are the most critical issues facing EMS systems that should 
be addressed in the revision of the EMS Agenda? Please be as specific 
as possible.
    2. What progress has been made in implementing the EMS Agenda since 
its publication in 1996?
    3. How have you used the EMS Agenda? Please provide specific 
examples.
    4. As an EMS stakeholder, how might the revised EMS Agenda be most 
useful to you?
    5. What significant changes have occurred in EMS systems at the 
national, State and local levels since 1996?
    6. What significant changes will impact EMS systems over the next 
30 years?
    7. How might the revised EMS Agenda support the following FICEMS 
Strategic Plan goals:
    a. Coordinated, regionalized, and accountable EMS and 9-1-1 systems 
that provide safe, high-quality care;
    b. data-driven and evidence-based EMS systems that promote improved 
patient care quality;
    c. EMS systems fully integrated into State, territorial, local, 
tribal, regional, and Federal preparedness planning, response, and 
recovery;
    d. EMS systems that are sustainable, forward looking, and 
integrated with the evolving health care system;
    e. an EMS culture in which safety considerations for patients, 
providers, and the community permeate the full spectrum of activities; 
and
    f. a well-educated and uniformly credentialed EMS workforce.
    8. How could the revised EMS Agenda contribute to enhanced 
emergency medical services for children?
    9. How could the revised EMS Agenda address the future of EMS data 
collection and information sharing?
    10. How could the revised EMS Agenda support data-driven and 
evidence-based improvements in EMS systems?
    11. How could the revised EMS Agenda enhance collaboration among 
EMS systems, health care providers, hospitals, public safety answering 
points, public health, insurers, palliative care and others?
    12. How will innovative patient care delivery and finance models 
impact EMS systems over the next 30 years?
    13. How could the revised EMS Agenda promote community preparedness 
and resilience?
    14. How could the revised EMS Agenda contribute to improved 
coordination for mass casualty incident preparedness and response?
    15. How could the revised EMS Agenda enhance the exchange of 
evidence based practices between military and civilian medicine?
    16. How could the revised EMS Agenda support the seamless and 
unimpeded transfer of military EMS personnel to roles as civilian EMS 
providers?
    17. How could the revised EMS Agenda support interstate 
credentialing of EMS personnel?
    18. How could the revised EMS Agenda support improved patient 
outcomes in rural and frontier communities?
    19. How could the revised EMS Agenda contribute to improved EMS 
education systems at the local, State, and national levels?
    20. How could the revised EMS Agenda lead to improved EMS systems 
in tribal communities?
    21. How could the revised EMS Agenda promote a culture of safety 
among EMS personnel, agencies and organizations?
    22. Are there additional EMS attributes that should be included in 
the revised EMS Agenda? If so, please provide an explanation for why 
these additional EMS attributes should be included.
    23. Are there EMS attributes in the EMS Agenda that should be 
eliminated from the revised edition? If so, please provide an 
explanation for why these EMS attributes should be eliminated.
    24. What are your suggestions for the process that should be used 
in revising the EMS Agenda?
    25. What specific agencies/organizations/entities are essential to 
involve, in a revision of the EMS Agenda?
    26. Do you have any additional comments regarding the revision of 
the EMS Agenda?

    Issued on: March 22, 2016.
Jeffrey P. Michael,
Associate Administrator, Research and Program Development.
[FR Doc. 2016-06960 Filed 3-31-16; 8:45 am]
 BILLING CODE 4910-59-P

18934 Federal Register / Vol. 81, No. 63 / Friday, April 1, 2016 / Notices

Drinking Water Act (42 U.S.C. 300); services and 9–1–1 systems. FICEMS • Federal eRulemaking Portal: http://
Rivers and Harbors Act of 1899 (33 has statutory authority to identify State www.regulations.gov. Follow the online
U.S.C. 401–406); and the National Flood and local Emergency Medical Services instructions for submitting comments.
Insurance Act of 1968 and Flood (EMS) and 9–1–1 needs, to recommend • Mail or Hand Delivery: Docket
Disaster Protection Act (42 U.S.C. new or expanded programs and to Management Facility, U.S. Department
4012a, 4106); identify the ways in which Federal of Transportation, 1200 New Jersey
9. Executive Orders (E.O.): E.O. agencies can streamline their processes Avenue SE., West Building, Room W12–
11990, Protection of Wetlands; E.O. for support of EMS. FICEMS includes 140, Washington, DC 20590, between 9
11988, Floodplain Management; E.O. representatives from the Department of a.m. and 5 p.m., Monday through
12898, Federal Actions to Address Defense (DoD) Office of the Assistant Friday, except on Federal holidays.
Environmental Justice in Minority Secretary of Defense—Health Affairs, FOR FURTHER INFORMATION CONTACT:
Populations and Low Income the Department of Health and Human Gamunu Wijetunge, Office of
Populations; E.O. 11593, Protection and Services (HHS) Office of the Assistant Emergency Medical Services, (202) 493–
Enhancement of Cultural Resources; Secretary for Preparedness and 2793, gamunu.wijetunge@dot.gov,
E.O. 13007, Indian Sacred Sites; E.O. Response (ASPR), HHS Indian Health located at the United States Department
13175, Consultation and Coordination Service (IHS), HHS Centers for Disease of Transportation; 1200 New Jersey
with Indian Tribal Governments; E.O. Control and Prevention (CDC), HHS Avenue SE., NPD–400, Room W44–232,
11514, Protection and Enhancement of Health Resources and Services Washington, DC 20590. Office hours are
Environmental Quality; and E.O. 13112, Administration (HRSA), HHS Centers from 9 a.m. to 5 p.m., Monday through
Invasive Species. for Medicare and Medicaid Services Friday, except Federal holidays.
(Catalog of Federal Domestic Assistance (CMS), the Department of Homeland SUPPLEMENTARY INFORMATION:
Program Number 20.205, Highway Planning Security (DHS) Office of Health Affairs
and Construction. The regulations (OHA), DHS U.S. Fire Administration Background
implementing E.O.12372 regarding (USFA), NHTSA, the Federal In 1996 NHTSA, in partnership with
intergovernmental consultation on Federal Communications Commission (FCC) HRSA, published the EMS Agenda
programs and activities apply to this and a State EMS Director appointed by
program.)
(www.ems.gov/pdf/2010/
the Secretary of Transportation. EMSAgendaWeb_7-06-10.pdf). The
Authority: 23 U.S.C. 139 (l)(1). On June 19, 2014, FICEMS document created a vision for the future
Issued on: March 25, 2016.
unanimously approved a motion to of EMS systems in the United States and
proceed with a revision of the EMS led to EMS system improvements across
Peter J. Hartman,
Agenda, with a focus on data-driven the Nation. Changes envisioned by the
FHWA Idaho Division Administrator, Boise, approaches to future improvements.
Idaho. EMS Agenda included the National
This followed an April 24, 2014 letter EMS Information System (NEMSIS), the
[FR Doc. 2016–07412 Filed 3–31–16; 8:45 am]
in which the National Emergency ‘‘EMS Education Agenda for the Future:
BILLING CODE 4910–RY–P
Medical Services Advisory Council A Systems Approach’’, universal
(NEMSAC) issued recommendations to wireless 9–1–1, automatic crash
DEPARTMENT OF TRANSPORTATION NHTSA regarding revision of the EMS notification, the recognition of EMS as
Agenda. NEMSAC’s recommendations a physician sub-specialty, and many
National Highway Traffic Safety were as follows: others.
Administration • A major revision of the EMS The EMS Agenda included the
Agenda for the Future should be following vision statement: ‘‘Emergency
[Docket No. NHTSA–2016–0035] medical services (EMS) of the future
undertaken as soon as possible;
Revision of the Emergency Medical • The revision process should be will be community-based health
Services Agenda for the Future; guided by an external entity (not management that is fully integrated with
Request for Information NEMSAC) that will ensure a consensus- the overall health care system. It will
and data-driven process with broad have the ability to identify and modify
AGENCY: National Highway Traffic stakeholder representation. The goal illness and injury risks, provide acute
Safety Administration (NHTSA), should be to replicate the process used illness and injury care and follow-up,
Department of Transportation (DOT). to develop the original EMS Agenda for and contribute to treatment of chronic
ACTION: Notice; request for information. the Future, published in 1996; conditions and community health
• The U.S. Department of monitoring. This new entity will be
SUMMARY: NHTSA, on behalf of the Transportation should seek financial developed from redistribution of
Federal Interagency Committee on support and assistance from members of existing health care resources and will
Emergency Medical Services (FICEMS), FICEMS to accomplish this task. be integrated with other health care
is seeking comments from all sources The purpose of this notice is to solicit providers and public health and public
(public, private, governmental, comments on the planned revision of safety agencies. It will improve
academic, professional, public interest the EMS Agenda, and to request community health and result in more
groups, and other interested parties) on responses to specific questions provided appropriate use of acute health care
the planned revision of the 1996 below. This is neither a request for resources. EMS will remain the public’s
Emergency Medical Services Agenda for emergency medical safety net.’’
asabaliauskas on DSK3SPTVN1PROD with NOTICES

proposals nor an invitation for bids.
the Future (EMS Agenda). Furthermore, the EMS Agenda
FICEMS was created (42 U.S.C. 300d– DATES: It is requested that comments on proposed development of the following
4) by the Secretaries of Transportation, this announcement be submitted by 14 EMS attributes:
Health and Human Services and June 30, 2016. • Integration of Health Services;
Homeland Security to, in part, ensure ADDRESSES: You may submit comments • EMS Research;
coordination among the Federal [identified by Docket No. NHTSA– • Legislation and Regulation;
agencies involved with State, local, 2016–0035] through one of the • System Finance;
tribal or regional emergency medical following methods: • Human Resources;

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Federal Register / Vol. 81, No. 63 / Friday, April 1, 2016 / Notices 18935

• Medical Direction; emergency medical services for 26. Do you have any additional
• Education Systems; children? comments regarding the revision of the
• Public Education; 9. How could the revised EMS EMS Agenda?
• Prevention; Agenda address the future of EMS data Issued on: March 22, 2016.
• Public Access; collection and information sharing?
Jeffrey P. Michael,
• Communication Systems; 10. How could the revised EMS
Associate Administrator, Research and
• Clinical Care; Agenda support data-driven and
Program Development.
• Information Systems; evidence-based improvements in EMS
• Evaluation. systems? [FR Doc. 2016–06960 Filed 3–31–16; 8:45 am]
In 2014, NEMSAC recommended that 11. How could the revised EMS BILLING CODE 4910–59–P

NHTSA undertake a major revision of Agenda enhance collaboration among
the EMS Agenda. NHTSA, on behalf of EMS systems, health care providers,
FICEMS, intends to work closely with hospitals, public safety answering DEPARTMENT OF TRANSPORTATION
EMS stakeholders in revising the EMS points, public health, insurers, National Highway Traffic Safety
Agenda. It is anticipated the revised palliative care and others? Administration
EMS Agenda will envision the evolution 12. How will innovative patient care
of EMS systems over the next 30 years. delivery and finance models impact [Docket No. NHTSA–2016–0040]
EMS systems over the next 30 years?
Questions on the Proposed Revision of 13. How could the revised EMS Request for Public Comments on
the EMS Agenda Agenda promote community NHTSA Enforcement Guidance Bulletin
Responses to the following questions preparedness and resilience? 2016–02: Safety-Related Defects and
are requested to help plan the revision 14. How could the revised EMS Emerging Automotive Technologies
of the EMS Agenda. Please provide Agenda contribute to improved AGENCY: National Highway Traffic
references as appropriate. coordination for mass casualty incident Safety Administration (NHTSA),
1. What are the most critical issues preparedness and response? Department of Transportation.
facing EMS systems that should be 15. How could the revised EMS
Agenda enhance the exchange of ACTION: Request for public comments.
addressed in the revision of the EMS
Agenda? Please be as specific as evidence based practices between SUMMARY: Automotive technology is at a
possible. military and civilian medicine? moment of rapid change and may evolve
2. What progress has been made in 16. How could the revised EMS farther in the next decade than in the
implementing the EMS Agenda since its Agenda support the seamless and previous 45-plus year history of the
publication in 1996? unimpeded transfer of military EMS Agency. As the world moves toward
3. How have you used the EMS personnel to roles as civilian EMS autonomous vehicles and innovative
Agenda? Please provide specific providers? mobility solutions, NHTSA is interested
17. How could the revised EMS in facilitating the rapid advance of
examples.
Agenda support interstate credentialing technologies that will promote safety.
4. As an EMS stakeholder, how might
of EMS personnel? NHTSA is commanded by Congress to
the revised EMS Agenda be most useful 18. How could the revised EMS
to you? protect the safety of the driving public
Agenda support improved patient
5. What significant changes have against unreasonable risks of harm that
outcomes in rural and frontier
occurred in EMS systems at the may occur because of the design,
communities?
national, State and local levels since 19. How could the revised EMS construction, or performance of a motor
1996? Agenda contribute to improved EMS vehicle or motor vehicle equipment, and
6. What significant changes will education systems at the local, State, mitigate risks of harm, including risks
impact EMS systems over the next 30 and national levels? that may be emerging or contingent. As
years? 20. How could the revised EMS NHTSA always has done when
7. How might the revised EMS Agenda lead to improved EMS systems evaluating new technologies and
Agenda support the following FICEMS in tribal communities? solutions, we will be guided by our
Strategic Plan goals: 21. How could the revised EMS statutory mission, the laws we are
a. Coordinated, regionalized, and Agenda promote a culture of safety obligated to enforce, and the benefits of
accountable EMS and 9–1–1 systems among EMS personnel, agencies and the emerging technologies appearing on
that provide safe, high-quality care; organizations? America’s roadways.
b. data-driven and evidence-based 22. Are there additional EMS NHTSA has broad enforcement
EMS systems that promote improved attributes that should be included in the authority, under existing statutes and
patient care quality; revised EMS Agenda? If so, please regulations, to address existing and
c. EMS systems fully integrated into provide an explanation for why these emerging automotive technologies. This
State, territorial, local, tribal, regional, additional EMS attributes should be proposed Enforcement Guidance
and Federal preparedness planning, included. Bulletin sets forth NHTSA’s current
response, and recovery; 23. Are there EMS attributes in the views on emerging automotive
d. EMS systems that are sustainable, EMS Agenda that should be eliminated technologies—including its view that
forward looking, and integrated with the from the revised edition? If so, please when vulnerabilities of such technology
evolving health care system; or equipment pose an unreasonable risk
asabaliauskas on DSK3SPTVN1PROD with NOTICES

provide an explanation for why these
e. an EMS culture in which safety EMS attributes should be eliminated. to safety, those vulnerabilities constitute
considerations for patients, providers, 24. What are your suggestions for the a safety-related defect—and suggests
and the community permeate the full process that should be used in revising guiding principles and best practices for
spectrum of activities; and the EMS Agenda? motor vehicle and equipment
f. a well-educated and uniformly 25. What specific agencies/ manufacturers in this context. This
credentialed EMS workforce. organizations/entities are essential to notice solicits comments from the
8. How could the revised EMS involve, in a revision of the EMS public, motor vehicle and equipment
Agenda contribute to enhanced Agenda? manufacturers, and other interested

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Document Created: 2016-04-06 00:08:48
Document Modified: 2016-04-06 00:08:48

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice; request for information.
Dates		It is requested that comments on this announcement be submitted by June 30, 2016.
Contact		Gamunu Wijetunge, Office of Emergency Medical Services, (202) 493-2793, [email protected], located at the United States Department of Transportation; 1200 New Jersey Avenue SE., NPD-400, Room W44-232, Washington, DC 20590. Office hours are from 9 a.m. to 5 p.m., Monday through Friday, except Federal holidays.
FR Citation		81 FR 18934

81 FR 18934 - Revision of the Emergency Medical Services Agenda for the Future; Request for Information

DEPARTMENT OF TRANSPORTATIONNational Highway Traffic Safety Administration

Federal Register Volume 81, Issue 63 (April 1, 2016)

DEPARTMENT OF TRANSPORTATION
National Highway Traffic Safety Administration