EMS Administration, Plans, Boards & Commissions
State EMS Office
State EMS offices regulate a variety of services across emergency medical dispatch, community paramedicine, non-ambulance transport, air medical services, ground specialty care, 911 care without transport and 9-1-1 care with transport. This search term captures the establishment and any changes made to state EMS offices.
Quality management programs ensure patients receive the best medical care possible. Some states require quality improvement plans from local EMS agencies. The federal National EMS Quality Measures Set developed in 2019 provides a framework for identifying measures that are meaningful to patient populations and improve performance and patient care. This term captures quality assurance legislation such as programs, protections and data collection.
EMS as an Essential Service
An essential service is a service that the government is required, by law, to provide to its citizens. States have the authority to determine which services are “essential.” EMS may be considered an essential service for its role ensuring the health and safety of the population.
EMS Funding and Appropriations
Reimbursement for Providers/Services
Reimbursement processes for EMS vary across states. Some provide increased reimbursement rates under the state Medicaid program or supplemental payments for uncompensated costs. These funds may come from state general funds, grants, billing or other sources.
State funding sources for EMS may include general fund, dedicated fund, agency licensure fees, professional licensing fees, traffic tickets and motor vehicle related fees, private grants and donations, state grants or contracts and other special state funds. Revenue may be paid directly to EMS providers, districts, municipalities or other entities.
Fees, Service Fees and Surcharges
States may charge special fees to support reimbursement or supplemental payments for EMS providers, or they may grant authority to EMS providers or districts to establish fees and charges for EMS services.
EMS Rules and Regulations
Good Samaritan Laws
Good Samaritan laws generally provide protections from arrest and liability under certain circumstances. This search term captures legislation covering the provision of bystander or medical care, such as EMS services, under Good Samaritan laws.
Emergency Medical Services for Children (EMSC) Activities
Emergency Medical Services for Children (EMSC) includes preventative, pre-hospital, hospital, rehabilitative and other post-hospital care for children. EMSC is a federal program administered by the Health Resources and Services Administration and Maternal & Child Health Bureau providing grants, technical assistance and research to states. To ensure all children and adolescents receive appropriate care in a health emergency, states have created EMSC advisory committees, increased the availability of pediatric equipment on ambulances, increased EMS pediatric training requirements, developed interfacility pediatric transfer guidelines and agreements and recognized pediatric facilities.
Progress/impacts to the National Emergency Medical Services Information System (NEMSIS)
The National Emergency Medical Services Information System (NEMSIS) is a national effort to standardize data collection by EMS agencies. This search term includes state legislation to adopt newer versions of NEMSIS, collection of new data, comply with new processes or meet new reporting requirements.
Aeromedical services, also referred to as air medical services or air ambulances, involves the transport of patients from one location to another by a fixed-wing (airplane) or rotary wing aircraft (helicopter). This term includes legislation regulating aeromedical services.
EMS Systems of Care
A trauma system is an organized, coordinated effort in a defined geographic area that delivers a full range of care to injured patients and is integrated within the local public health system. Trauma systems aim to provide seamless and effective care to meet the medical needs of the community.
An acute ST-elevation myocardial infarction (STEMI) is a very serious type of heart attack in which one of the heart’s major arteries is blocked. A STEMI system of care may include EMS providers, community hospitals, tertiary centers and others. Coordinated systems aim to improve the quality of services and outcomes for STEMI patients.
Stroke systems of care coordinate and promote timely patient access to stroke prevention, treatment and rehabilitation. Systems treat patients throughout the health care journey, including the first symptoms of strokes, EMS transport, hospital care and outpatient follow-up services. This search term includes statewide standards for the formal designation of stroke facilities, the development of transport protocols, creation of stroke care data registries, and standardized prehospital and EMS stroke practices and treatment protocols.
Licensure of EMS Professionals
Licensure is issued by a state board and serves as an assurance to the public that a health professional has met predetermined education, training and certification requirements. This search term includes the creation or alteration of formal licensure processes, as well as education, training or certification requirements.
Classification of EMS and 911 Providers
States define, by statute, the tasks and functions (or scope of practice) of a profession. These tasks may only be performed by licensed professionals. There are several levels of practice within the EMS profession, including emergency medical responder (EMR), emergency medical technician (EMT), advanced emergency medical technician (AEMT) and paramedic. Each provider type is allowed to provide different EMS services. This search term includes legislation to define—or set the responsibility to define—the scope of practice for these roles.
The EMS Compact authorizes state EMS offices to legally recognize EMS personnel licensed from any member state. States must enact legislation to join the EMS Compact. This term includes legislation authorizing states to join the EMS Compact for interstate licensure.