State Flex Program Rural EMS Assessment Strategies (FMT Policy Brief #46)


This brief provides an overview of the EMS assessment projects and tools implemented by five State Flex Programs (Arizona, California, Minnesota, Nebraska, and Wisconsin), including the strategies and tools used to conduct their assessments and their dissemination plans. Based on State Flex Program grant applications, progress reports, assessment tools, and interviews with key informants, this brief provides insight into state EMS assessments, factors that contributed to their successes and challenges, and their plans for disseminating results. The brief concludes by highlighting lessons learned to inform the efforts of others interested in conducting their own rural EMS assessments.


  • Flex funding was an important resource that helped leverage in-kind support from EMS stakeholders.
  • The scope of state EMS assessments varied from comprehensive assessments covering all EMS providers to more targeted assessments focused on rural EMS.
  • State EMS assessments varied in their degree of alignment with Flex performance measures.
  • States that pursued comprehensive EMS assessments were delayed in completing the assessment, limiting their ability to use assessment results in the Flex program’s EMS planning. A two-stage assessment process could potentially overcome this problem.
  • Collaboration with key state and regional Emergency Medical Services (EMS) stakeholders was essential to conducting a robust assessment and encouraging participation of local agencies and services.
  • Strong communications plans implemented at the start of and conducted throughout the assessment process increased awareness among potential respondents and increased response rates.


Community Impact EMS (Emergency Medical Services)