Resilience

First-Responder Accreditation: The Pros and Cons

by Ashley Moore

By Ashley Moore, amoore@domprep.com

Anteon Corp. CBRNE Technical Director

"Never, never, never believe any war will be smooth and easy, or that anyone who embarks on the strange voyage can measure the tides and hurricanes he will encounter. The statesman who yields to war fever must realize that, once the signal is given, he is no longer the master of policy, but the slave of unforeseeable and uncontrollable events." ~ Sir Winston Churchill (1874 - 1965)

For the past several years, members of Congress and Bush Administration officials have debated the need for establishing a comprehensive set of national standards to regulate state and local terrorism preparedness programs. Proponents say that a set of recognized and federally supported standards could significantly improve the capabilities of the nation’s first-responder community to counter a terrorist attack involving chemical, biological, radiological, nuclear, and/or improvised high-yield explosive (CBRNE) weapons. Amy Smithson of the Henry L. Stimson Center remarked, for example, during a House Committee on Government Reform hearing in October 2001, that “The prerequisite for institutionalization is standards, and all of the response disciplines … [have] expressed an abundance of frustration over the absence of standards and protocols to guide them. Standards command the attention of rescue and healthcare personnel because they are the backbone of accountability.”

By now Congress, the Government Accountability Office, and the White House’s own preparedness officials should be able to assure the public that first responders nationwide can handle an adversary’s attack with at least some reasonable level of competency. As noted in Defeating the Jihadists: A Blueprint for Action, by Richard A. Clarke, America’s local and state emergency responders are on the front line when it comes to homeland security. However, although certain first-responder standards are now required in most areas of the country, these standards are not yet universal. Evenly applied, though, nationwide standards could be of critical importance, given the central role likely to be played by first responders in managing the immediate response to a terrorist attack and the probability that their efforts in the initial minutes following such an attack might well determine how many lives will be saved and how quickly order is likely to be restored.

The nation’s emergency responders, like military field medics, have been asked to place themselves in harm’s way to defend and rescue the wounded on the most likely battlefields of the 21st century. However, since the Defense Against Weapons of Mass Destruction Act of 1996, billions of dollars have been invested in preparedness programs, and national, state, and local counterterrorism training exercises have been carried out for many years, and have been thoroughly documented. But there still is no comprehensive readiness assessment available that can be used to validate the effectiveness of specific programs or exercises.

Is First-Responder Accreditation Really Needed? In a 1 October 2002 DHS (Department of Homeland Security) press release on Grants and Funding for Fiscal Year 2004, the department acknowledged the need for a national first-responders training accreditation program. The same press release noted that the DHS Homeland Security Science and Technology division would be allocated $39 million to develop a database of homeland security-related training as well as the performance standards offered by private-sector organizations within the first-responder community that have focused on the development of standards.

There is little if any agreement on what agency, or private-sector organization, should be assigned the responsibility for developing – and evaluating – first-responder accreditation standards. Currently, private educational accrediting associations, both regional and national, usually develop and promulgate evaluation criteria and then conduct peer evaluations to assess whether or not a specific institution should be permitted to offer its programs to the public. It seems reasonable to suggest that institutions that develop CBRNE responder programs – arguably a much more important responsibility – also should be evaluated by a government agency and should meet the preferably rigorous preparedness criteria set by that agency.

The same process should be used to evaluate organizations and institutions at all levels – state, local, and federal – of government, including the Department of Homeland Security itself, as well as contractors and consulting firms working in the preparedness field. As an interesting side note, it should be noted that even the U.S. Department of Education does not accredit educational institutions and/or programs.

The Office of Domestic Preparedness, the Department of Health and Human Services, the Department of Justice, and the Federal Emergency Management Agency (FEMA) all develop and maintain various sets of responder-training and/or terrorism-preparedness criteria, and have participated in a broad spectrum of standards development programs – none of which, however, have been nationally accredited.

On the other hand, educational institutions, such as colleges and universities, can and have adopted programs similar to those mentioned above and offer credit for training completed. The fact that this credit is an option is due primarily to the influence of such respected organizations as the National Association of Emergency Managers, the International Association of Fire Chiefs, and the Commission of Accreditation on Ambulance Services (CAAS). CAAS and other accreditation standards might be useful as a template to use by the agency or organization eventually responsible for the accreditation of first responders.

Why Is Accreditation Important? Accreditation, it is generally agreed, is the key – in any professional field – to assessing the quality of institutions, programs, and services, measuring them against agreed-on standards, and determining whether specific institutions, and/or individuals, meet those standards. Because there are two types of accreditation, institutional and programmatic (or specialized), the accreditation standards should fit a definitive baseline:

  • Institutional accreditation reassures potential students that an institution is both credible and competent, and that its administrative body, training resources, employees, and services have met certain minimum standards.
  • Programmatic, or specialized, accreditation scrutinizes particular schools and/or programs within a larger educational institution – e.g., law schools, medical schools, and nursing programs that are affiliated with a major university. There are standards by which the types of programs offered are measured; in general, such programs are developed by professionals involved in each branch of learning and reflect what an individual must know and be capable of performing successfully within the specialized profession.

An excellent example of what might be required for counterterrorism programs is the Hazardous Waste Operations and Emergency Response standard, inelegantly called HAZWOPER, which was put into effect in March 1990. HAZWOPER training addresses several elements of hazardous materials response, including some specifically relevant to CBRNE incidents. For example, itentifies the necessary elements – e.g., lines of authority, site security, and evacuation procedures – of an acceptable emergency-response plan. It also establishes standards for different levels of training competency – e.g., the increasing levels of capability required to be qualified as a technician, a specialist, and/or an incident commander. Reasonable but well-monitored regulations specify the gradually increasing knowledge, skills, and abilities the responder must possess at each level. HAZWOPER also sets standards for personal protective equipment, decontamination gear, refresher training, and the medical surveillance of first responders.

There already are several nongovernmental organizations that have the responsibility of accrediting public safety agencies. Among them are the Commission on Fire Accreditation International (CFAI), the Commission on Accreditation of Law Enforcement Agencies (CALEA), and the Joint Commission on Accreditation of Health Organizations (JCAHO). Even though these organizations develop preparedness standards, their focus in the past was on general improvement of the agencies they monitor. They now also evaluate the facility emergency management and terrorism preparedness programs of those agencies.

State and local officials throughout the United States are divided on the issue of requiring accreditation for emergency-service providers. Advocates believe that achieving accreditation validates the need for standard processes that define emergency-services capabilities and ensures that reasonable levels of both quality and uniformity are met. However, opponents commonly criticize the process as too time-consuming and costly, and claim that accreditation is not a viable way to measure readiness. Regardless of the arguments for and against, the establishment of a reasonable set of standards, coupled with periodic organizational-compliance assessments, should at least upgrade the level of capability required and at the same time improve the odds of saving more lives in the wake of any terrorist attack or other catastrophic event.

Cruel Facts, and a Possible Solution At the heart of most national terrorism preparedness proposals, the most important task is almost always to define the minimum essential capabilities that should be expected of emergency responders, rather than create another bureaucracy for accreditation of first-responder training programs. The cruel fact is, though, that there now are no clearly defined national standards for determining the essential capabilities required of first responders, and no way to assess past and/or current progress toward domestic preparedness at the federal, state, or local levels.

However, the Homeland Security Grant Enhancement Act of 2005 offers a possible resolution to the quandary. The Act creates a “Homeland Security Information Clearinghouse (HSIC),” under the purview of the Office of State and Local Government Coordination (OSLGC), that would, among other things, collect and disseminate information on voluntary standards that might be adopted for preparedness training, equipment, and exercises. The Clearinghouse also would provide information to state and local governments about homeland security grants, the technical assistance available, best practiceseas, and how federal funds might be used for facility emergency management and terrorism preparedness training programs. The logical next step might be, therefore, to assign the development of standardized accredited first-responder training programs to the same agency. These programs could use one of three processes (outlined in Executive Order 12866, U.S. Congress, Office of Technology Assessment, Global Standards: Building Blocks for the Future, and P.L. 104-113, sec 12(d)(1); 110 Stat. 783) to develop the standards needed – the de facto process, a voluntary consensus process, or a regulatory process (the latter would require approval and monitoring by OSLGC/HSIC). Following is a brief summary of each process:

  • De Facto Process. Sometimes first responders will gradually adapt the way they operate to fit the best practices learned through experience and interaction with other responders. Although de facto standards allow states and localities greater discretion in developing and implementing the standards that best meet their individual needs, an inconsistent or untimely approach could result in incompatibilities with national standards, ultimately minimizing efficiencies in time and cost.
  • Voluntary Consensus Process. The National Technology Transfer Advancement Act of 1995 states that, “To the extent practicable,” all federal agencies and departments “shall use, for procurement and regulatory applications, standards that are developed or adopted by voluntary consensus standards bodies.” Many nongovernmental organizations, such as the National Fire Protection Association (NFPA), influence the development of preparedness standards through the Voluntary Consensus Process.
  • Regulatory Process. In situations wherein standards are not being developed and/or implemented in a timely manner, or when existing standards are inadequate, federal, state, and/or local governments can require that a mandatory regulatory process be established to resolve the situation.

Proponents argue that adopting voluntary consensus standards for regulatory purposes could and should lead to greater acceptance and implementation. On the other hand, a number of circumstances can render the process ineffective, including a dominating regulatory agency, stakeholders who are unsatisfied with their level of representation, and/or cumbersome administrative processes. Moreover, regulatory standards must be updated from time to time – t o keep pace with advances in technology, for example – if they are to retain their legitimacy.

Robert Kupperman and Darrell Trent, the authors of Terrorism: Threat, Reality, Response, point out that the conflict between terrorists and governments is not a zero-sum game. It is, rather, a much more complex contest, rich with mixed strategies. When faced with the credible prospect of a mass-destruction attack, every concessionary move made by a government is not only tactical but also potentially strategic.eally, of course, in the event of an actual threat, there will be enough time to locate and disarm the specific instrument of destruction – and, as in many popular books and television programs, also capture the terrorists.

In the real world, the final result might be considerably different.