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State System Assessments

State EMS officials often have the most insight into what their State EMS system is doing well and where there's room for improvement. Making the case for change without third-party validation, however, can be a challenge.

Since 1988, NHTSA has supported comprehensive expert evaluations of State emergency medical and trauma systems. These State EMS assessments help States recognize and build on strengths, identify gaps in policy and programming, and improve the effectiveness of EMS care. They also provide State officials an opportunity to discuss these issues with technical experts and share best practices.

States following an EMS assessment have addressed the enactment of comprehensive EMS and trauma system legislation, the addition of full-time positions to help with program implementation and data analysis, and the development of statewide EMS plans.

What an Assessment Entails

To conduct an assessment, NHTSA assembles a team of five to six individuals with broad experience in EMS development. While NHTSA funds the effort, the team is composed of experts who serve at the State and local level, typically including at least one emergency physician, one trauma surgeon, one State EMS director and one State official with legal expertise.

The group spends several days on-site with the State EMS officials who requested the assessment, receiving briefings about their programs and results. They then spend one to two days creating and presenting a report that includes specific recommendations for improving the EMS program.

The reports evaluate 11 specific components of a State’s EMS system:

  • 1

    Regulation and Policy

  • 2

    Resource Management

  • 3

    Human Resources and Training

  • 4


  • 5


  • 6


  • 7

    Public Information and Education

  • 8

    Medical Direction

  • 9

    Trauma Systems

  • 10


  • 11


Requesting a State EMS Assessment

Since the program’s inception, 48 States, two U.S. Territories and two Federal agencies have received at least one assessment of their EMS systems, with several undergoing periodic reassessments as well. To request a NHTSA State EMS Assessment, State officials apply through their State Highway Safety Office to the appropriate regional office.

In addition to EMS system assessments, NHTSA supports assessments of several other State programs, including 911 systems. The NHTSA Safety Program Assessment provides support to State Highway Safety Offices, State EMS offices and other State agencies. State EMS officials with questions about the NHTSA State EMS Assessment program should contact Dave Bryson, Emergency Medical Services Specialist at the NHTSA Office of EMS. Read about New Hampshire’s State EMS assessment in the Winter 2020 issue of the “EMS Update” newsletter.

Last Updated: 11/28/2022