EMS agencies must prepare for a shift away from fee-for-service reimbursement toward fee-for-quality and value-based purchasing.
Austin-Travis County Emergency Medical Services has a rep as one of the best services in the country. But after years of structural problems – highlighted by recent suicides – its own personnel might call it the worst.
In 2008, the average fire in Lawrence caused $18,936 in property damage compared to a state average of $8,435.
Healthcare and social service workers face significant risks of job-related violence and it is OSHA’s mission to help employers address these serious hazards. This publication updates OSHA’s 1996 and 2004 voluntary guidelines for preventing workplace violence for healthcare and social service workers. OSHA’s violence prevention guidelines are based on industry best practices and feedback from stakeholders, and provide recommendations for developing policies and procedures to eliminate or reduce workplace violence in a range of healthcare and social service settings.
These guidelines reflect the variations that exist in different settings and incorporate the latest and most effective ways to reduce the risk of violence in the workplace. Workplace setting determines not only the types of hazards that exist, but also the measures that will be available and appropriate to reduce or eliminate workplace violence hazards.
For the purpose of these guidelines, we have identified five different settings:
■ Hospital settings represent large institutional medical facilities;
■ Residential Treatment settings include institutional facilities such as nursing homes, and other long-term care facilities;
■ Non-residential Treatment/Service settings include small neighborhood clinics and mental health centers;
■ Community Care settings include community-based residential facilities and group homes; and
■ Field work settings include home healthcare workers or social workers who make home visits.
Indeed, these guidelines are intended to cover a broad spectrum of workers, including those in: psychiatric facilities, hospital emergency departments, community mental health clinics, drug abuse treatment centers, pharmacies, community-care centers, and long-term care facilities. Healthcare and social service workers covered by these guidelines include: registered nurses, nurses’ aides, therapists, technicians, home healthcare workers, social workers, emergency medical care personnel, physicians, pharmacists, physicians’ assistants, nurse practitioners, and other support staff who come in contact with clients with known histories of violence. Employers should use these guidelines to develop appropriate workplace violence prevention programs, engaging workers to ensure their perspective is recognized and their needs are incorporated into the program….
Source: Bruce J. Perlman, State and Local Government Review, Vol. 47 no. 1, March 2015
Taken together, the two articles in this issue of the State and Local Government Review’s (SLGR) Governance Matters (GM) section might be said to be as much about the management of emergence as they are about emergency management. Although both articles focus on the administrative practice of emergency management in state and local governments, they do so without focusing on suddenly developing crisis events or predetermined, agency-based reaction to them. Rather, they emphasize slowly developing, less specific (yet potentially as disastrous in the long run) occurrences like climate change as well as broad-based, decentralized (although likely as sound) possibilities for developing responses. They combine the ideas of emergency and emergence in a unique way….
Local Governments and Climate Change in the United States: Assessing Administrators’ Perspectives on Hazard Management Challenges and Responses
Source: Brian J. Gerber, State and Local Government Review, Vol. 47 no. 1, March 2015
From the abstract:
Local governments in the United States have become central actors in addressing climate change as a hazard management challenge. Using evidence from a purposive sample of 10 U.S. cities, this article examines how local government officials view climate change in hazard vulnerability terms, what motivates local efforts in this area, and how officials initiate internal collaboration and external stakeholder outreach. The findings suggest level of hazard risk does influence a city’s efforts to address climate change, as does resource availability. In contrast, geographic location and associated hazard type (drought vs. flooding) does not appear to be a key driver of a municipality’s actions in this domain. Further, the results point to how addressing the climate hazard and improving commitment to emergency management is relevant to increasing community resilience for future emergencies and disasters.
Embracing Crowdsourcing: A Strategy for State and Local Governments Approaching “Whole Community” Emergency Planning
Source: Jesse A. Sievers, State and Local Government Review, Vol. 47 no. 1, March 2015
From the abstract:
Over the last century, state and local governments have been challenged to keep proactive, emergency planning efforts ahead of the after-the-disaster, response efforts. After moving from decentralized to centralized planning efforts, the most recent policy has returned to the philosophy that a decentralized planning approach is the most effective way to plan for a disaster. In fact, under the Obama administration, a policy of using the “whole community” approach to emergency planning has been adopted. This approach, however, creates an obvious problem for state and local government practitioners already under pressure for funding, time, and the continuous need for higher and broader expertise—the problem of how to actually incorporate the whole community into emergency planning efforts. This article suggests one such approach, crowdsourcing, as an option for local governments. The crowdsourcer-problem-crowd-platform-solution (CPCPS) model is suggested as an initial framework for practitioners seeking a practical application and basic comprehension. The model, discussion, and additional examples in this essay provide a skeletal framework for state and local governments wishing to reach the whole community while under the constraints of time, budget, and technical expertise.
From the summary:
The Outbreaks: Protecting Americans from Infectious Diseases report finds that the Ebola outbreak exposes serious underlying gaps in the nation’s ability to manage severe infectious disease threats.
Half of states and Washington, D.C. scored five or lower out of 10 key indicators related to preventing, detecting, diagnosing and responding to outbreaks. Maryland, Massachusetts, Tennessee, Vermont and Virginia tied for the top score – achieving eight out of 10 indicators. Arkansas has the lowest score at two out of 10.
Source: David M. Newman, American Journal of Industrial Medicine, Volume 57, Issue 11, November 2014
From the abstract:
Despite incremental lessons learned since 9/11, responder and community health remain at unnecessary risk during responses to catastrophic disasters, as evidenced during the BP Deepwater Horizon spill and Hurricanes Katrina, Rita, and Sandy. Much of the health harm that occurs during disaster response, as distinct from during the disaster event itself, is avoidable. Protection of public health should be an integral component of disaster response, which should “do no additional harm.” This commentary examines how challenges and gaps the World Trade Center response resulted in preventable occupational and environmental health harm. It proposes changes in disaster response policies to better protect the health of rescue and recovery workers, volunteers, and impacted worker and residential communities.
…These women want to join the tiny sisterhood Srisakul is part of: the women of the FDNY, who make up less than one-half of 1 percent of the department’s active-duty firefighters. There are 37 female firefighters in the department, alongside some 10,500 men. No two women work in the same firehouse. The most women who ever served in the department at one time is 41.
That was 30 years ago….
Source: Katharine H. Parker, Employee Relations Law Journal, Vol. 39 no. 4, Spring 2014
While the personal and societal impact of natural disasters and other tragedies are the first and foremost concern, these events also highlight for business the importance of having a plan in place before disaster strikes. The authors of this article reviews employers’ legal obligation to employees during these events.
From an ICMA article:
ICMA’s Police and Fire Personnel and Expenditures Survey provides an overview of trends in staffing and expenditures across the country. As local governments have wrestled with budgets for the last six years, police and fire departments have not been immune, although they may have been among the last departments to be affected by reduced budgets. Staffing and expenditures are always a topic of discussion as budgets are prepared.
– The average entrance salaries are $45,664 for police officers and $40,887 for fire fighters.
– The average maximum salaries for police officers and fire fighters are $64,897 and $57,091, respectively.
– Both police and fire show average overtime expenditures of approximately $500,000.
The survey also covers staffing shifts and workweeks, which have been a focus of recent questions in the Knowledge Network related to police departments.
Results from ICMA’s 2013 Police and Fire survey show that
– Over 70% of local governments report a 40-hour workweek for police officers.
– Slightly more than 50% report 10/12-hour shifts for police officers.
Other highlights from the 2013 survey include:
– For firefighters, a plurality of local governments reports a 56-hour workweek.
– Approximately 75% of local governments report that firefighters work 24-hour shifts.
– The average number of police officers for responding local governments is 105 and 72 for firefighters, but population size, density, and other factors influence the staffing in each locality.
– For both police and fire the average per capita number of officers has decreased since 2012.
The survey summary also includes minimum and maximum salaries for an additional 12 police and fire department officer positions.