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pediatric equipment and training. They may also lead to congressional funding
for the Emergency Medical Services for Children (EMSC) program to ensure that
states and territories meet targets and achieve progress in the EMSC performance
measures and to support research and development.
As a result of this report, eligibility guidelines for Centers for Medicare and
Medicaid Services reimbursement may require first response and emergency medi-
cal response vehicles to acquire and maintain pediatric equipment and supplies in
accordance with the national guidelines for equipment for Basic Life Support and
Advanced Life Support vehicles. In addition, HHS and DHS may establish more
stringent pediatric EMS performance measures within relevant federal emergency
preparedness grant programs.
Disaster Case Management
The NCCD report recommends appropriate resourcing of disaster case manage-
ment programs and standards for consistent holistic services that achieve tangible,
positive outcomes for children and families affected by the disaster. Aside from
the federal funding implications and desire to provide broad based case manage-
ment, it is possible that clearer definitions for transition from federal to state-led
disaster case management programs will be developed. Development of voluntary
consensus standards regarding essential elements and method of case management
are also likely. Standards may include precredentialing of case managers and train-
ing that includes focused attention to the needs of children and families. These
enhancements to the national strategy for disaster case management should mini-
mize reunification issues and lead to faster, more complete recovery for families.
Child Care and Early Education
Regarding child care and early education, the report addresses three primary
recommendations:
Improve disaster preparedness capabilities for child care.
Improve capacity to provide child care services in the immediate aftermath of
and recovery from a disaster.
Require disaster preparedness capabilities for Head Start Centers and basic
disaster mental health training for staff.
Although these recommendations are directed primarily at HHS, they have sub-
stantial local and state impact. It is likely that states will be required, at some point
in the future, to develop statewide child care disaster plans in coordination with
state and local emergency managers, public health, state child care administrators
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