Emergency Medical Services for Children

Authorizing Legislation - Section 1910 of the Public Health Service Act.

Program Description and Accomplishments
The Emergency Medical Services for Children (EMSC) Program began in 1984 and was designed to ensure state-of-the-art emergency medical care for ill or injured children and adolescents. It covered the entire spectrum of emergency medical care. The EMSC program provided grants to States to improve existing Emergency Medical Services (EMS) systems and to schools of medicine to develop and evaluate improved procedures and protocols for treating children.

In FY 2007, the EMSC Program awarded 54 Grants to States and Territories which focused on ensuring operational capacity to provide pediatric emergency care through: (1) building capacity for pediatric components of statewide EMS data collection efforts; (2) adopting requirements for pediatric emergency education for the recertification of paramedics; (3) establishing permanence of EMSC in the State/Territory EMS system and; (4) incorporating pediatric EMS issues into preparedness for mass casualty disasters and terrorism. State’s progress toward achieving these outcomes was tracked using EMSC Program performance measures. The EMSC Program supported the National EMSC Data Analysis Resource Center in order to help State EMS Offices and medical schools developed their own capabilities to collect, analyze, and utilize EMS and other healthcare data to improve the quality of care in State EMS systems.

The EMSC Program also funded 16 Targeted Issues grants to States and medical schools. These grants were demonstration projects that focused on a wide array of emerging and critical topics including: improving emergency department management of children with head trauma, seizures, and diabetic ketoacidosis; increasing patient safety; improving pre-hospital pain management in children; developing a computer-based emergency department screening process for adolescent depression; enhancing coordination between EMS and primary care for injured adolescents and alcohol problems and post-traumatic stress disorder; and improving the quality of prehospital care of pediatric patients through more accurate assessment by paramedic providers. The EMSC Program also funded the Network Development Demonstration Project in order to conduct meaningful and rigorous multi-institutional studies in the management of acute illness and injury in children across the continuum of emergency medicine. The EMSC Program collaborated with the Department of Transportation’s National Highway Traffic Safety Administration since its inception and was a partner in the implementation of the National EMS Information System. The EMSC Program collaborated with the Indian Health Service (IHS) in order to ensure the availability of pediatric specific training initiatives tailored to the needs of tribal EMS and IHS medical facility professionals.

The program supported the development of improved emergency procedures and protocols for children. In FY 2006, 20 State EMS systems demonstrated the operational capacity to provide pediatric emergency care. In 2006, 21 States adapted requirements for pediatric emergency education for the re-certification of paramedics.

The EMSC program was reviewed in 2004 using the Program Assessment Rating Tool (PART). and was given a score of Results Not Demonstrated. The review cited that the program has a clear purpose, but had not developed performance measures that reflected the purpose of the program. Since that time, the program has developed a long-term health outcome measure and annual measures. As part of the review the program was directed to conduct an independent evaluation of the EMSC program. The Institute of Medicine (IOM) completed a study of the Nation’s emergency care system entitled “The Future of Emergency Care in the U.S. Health System”in 2006 which met the requirement for the evalaution. The study included an examination of the unique challenges associated with the provision of emergency services to children and adolescents.

Funding includes costs associated with grant reviews, processing of grants through the Grants Administration Tracking and Evaluation System (GATES) and HRSA’s electronic handbook, and follow-up performance reviews.

Funding History

Budget Request
The FY 2009 request provides no funding for this program rated as results not demonstrated through the PART process. These activities may be more addressed through the MCH Block Grant.

See Table