tire region plans for and responds to MCIs with the same strategies, expectations, and language plan. Inclusive pre-planning and practice exercises, engaging representatives of local 9-1-1 services to state administrators, are the only way to achieve this type of cooperation, says Spears-Dean. Policy interoperability should strive to be comprehensive, encompassing issues of technology, resource dispersion, and the dedication of funding in the context of an entire region’s or state’s ability to respond to an MCI.

The strategies offered by those in attendance, detailed below, aim to resolve challenges of inconsistent communications coverage and available technological expertise through creatively leveraging new and existing technology, and increasing policy interoperability with a leadership role for the states and federal government.

Inconsistencies in Cell Phone Service

Emergency medical services (EMS) awareness that an incident has occurred is the first link in the response chain, and for rural America, it is one of the most challenging obstacles to future improvement. The importance of cell phone service to emergency response is undisputed: one-third to one-half of all 9-1-1 calls are made from a wireless phone. Yet, noted Booz Allen Hamilton lead associate John Chiaramonte, there are about 125 counties across the United States, primarily in the frontier areas, that do not currently provide enhanced 9-1-1 (E911) services. In these areas only basic 9-1-1 service is available, without location or caller phone number information; in some cases no 9-1-1 service is available. This issue of inadequate or unavailable 9-1-1 services is compounded by the absence of redundant communications systems. Often, even where redundancies exist, they are confined to the same physical space as the primary system, like primary and backup phone trucks located along the same stretch of highway. Limited effectiveness of the backup results from the fact that both primary and secondary systems can be inactivated simultaneously.

Wireless coverage is concentrated in populated areas. About 90 percent of the 3,135 counties in the United States have some sort of phase II wireless, which has the ability to locate a wireless caller using either handset-based global positioning system (GPS) information, or network-based triangulation services using cell phones, tower locations, and wireless signal strength.

There are about 6,100 9-1-1 centers or public safety answering points (PSAPs), across the United States. All of these centers are facing at least some issues associated with coverage, access, technology, funding, recruiting and retaining qualified staff, and the ability to provide emergency medical dispatch. Chiaramonte noted that in rural areas these issues are magnified.

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