Policy is one of the strongest tools in the public health toolbox. It often arises to address a problem that ideally has been identified through data collection and analysis. Once enacted, policy addresses the problem by prompting change. The FIRST Center recognizes the fundamental interconnectedness of policy, data, and change. When it comes to the fire and rescue service, policy research and implementation is lacking. Therefore, FIRST works in collaboration with the fire and rescue service to develop model policies and conduct research on what policy interventions can be effective for making substantial change within the fire service.

SAVER Model Policies

Our systematic literature review of workplace violence against EMS responders led to the Stress and Violence to fire-based EMS Responders (SAVER) project, the first FEMA-funded grant to look at the EMS side of fire. In 2019, we convened over 40 fire and EMS thought leaders from 27 organizations for the SAVER Systems Checklist Consensus Conference (SC³). For two days, we asked attendees to modify and revise the Checklist to ensure it would meet the needs of first responders. Then, in 2020, fire and EMS leadership, frontline workers, dispatchers, and labor union representatives from three metropolitan fire departments re-convened to take these 80 checklist items and codify them into 8 domains to form the SAVER Model Policies. This family of policies express to members that there is a strong commitment to their safety, zero tolerance for violence against them, and that remedies to address job stress are being codified in policy. Departments can weave these off-the-shelf policies into their own SOPs and SOGs to prompt concrete action that protects their EMS providers from workplace violence and its mental and physical sequelae.

Workers' Compensation Policies

Workers' compensation laws specify the types of support for physical injuries and traumatic events on the job. The FIRST Center conducted a comprehensive review of sate workers' compensation laws in the United States to evaluate how these laws support first responders suffering from psychological conditions. Findings show that the number of states that have presumption of causation laws for diseases associated with firefighting and EMS work (e.g., heart disease, respiratory disease, infectious disease, etc.) far outweighs the number of states that have mental health presumption laws. To bridge these gaps in policy, states could implement presumptive coverage for first responder mental illness as a statute with a built-in "sunset" clause, or termination date. This models the pattern states utilized during the COVID-19 pandemic for presumption of causation related to contracting COVID-19 on the job. Fire departments and their advocates should urge their state legislatures to adopt these presumptive measures as a means of easing the process for receiving workers' compensation coverage for mental injuries received in the line of duty.