Report looks at organization of medical services in states | 06.21.2006 | 09:30:54 | Views: 5990 | ID: June 21 '06: A report released by the RAND Corporation which was compiled for the US Department of Health and Human Services found that response to a medical emergency stemming from a natural disaster or a biological, chemical, nuclear or other terrorist attack would "largely depend" on the existing medical response structure and that, depending on how those responder and public agencies are organized, would affect the response. The report, compiled in 2004 and 2005, was prepared for the Office of Public Health Emergency Preparedness and was released this year. Already, existing structures are in place for medical and first responder rescue and recovery using the National Information Management System which works to coordinate command and response organizations. NIMS "was developed so responders from different jurisdictions and disciplines can work together better to respond" to national or natural emergencies. NIMS was to comply and work into the National Response Plan, that would help the federal, state, tribal and local levels incorporate "best practices and procedures from incident management disciplines - homeland security, emergency management, law enforcement, firefighting, public works, public health, responder and recovery worker health and safety, emergency medical services, and the private sector." In the RAND report however, the coordination necessitated by NIMS through the NRP would find a varying public health system that is uneven and unregulated so that "In some states, the public health agency is a freestanding agency, functioning on its own; in other states, public health is a part of a health and human services department." A similar report released by the Institute of Medicine found that federal oversight of the US medical emergency services was "scattered". Additionally, there were no nationwide standards "for the training and certification of EMS personnel" and EMS agencies "do not communicate effectively with public safety agencies and public health departments - they often operate on different radio frequencies and lack common procedures for emergencies." Relationships between the state and local health agencies also are not formalized in the US. The RAND report found that some states "have a centralized organizational structure, in which the state agency has direct control over local public health services." The organization of states and their health departments and emergency response services also means that a survey of county and city health officials found that 13 states have centralized systems, 26 states are decentralized and 11 states have mixed organizations.
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