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Oklahoma City, OK
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NASEMSO Monographs

NASEMSO engages in periodic data collection from state EMS offices to determine how each state's programs compare in terms of structure, services, and regulations. The documented results are very useful to anyone who is interested in national, state, and local EMS policy development.

Download a flyer that includes a full list of available NASEMSO Monographs.

Click the title of each monograph below to download free of charge.

Status of State Trauma System Planning and Development: Utilization of the HRSA Model Trauma System Planning and Evaluation Document - Monograph (Sept 2016)

In this monograph, NASEMSO examines the general status of formal trauma system development in the states, and particularly the utilization of system development tools produced by the Health Resources and Services Administration (HRSA) and the National Highway Traffic Safety Administration (NHTSA.) The assessment population consisted of trauma system managers or the state EMS director in May 2015. Of the potential pool of 50 states and 6 US territories, 41 full or partial responses were collected for an overall return rate of 82%. To the extent it was possible, findings were compared to data collected in 2010. Key data include:

  • 82% of respondents indicated their state has enabling legislation or rules to designate trauma centers.
  • 23% of respondents, only 16 percent of all states, have legislative authority to limit the number of trauma centers.
  • 46% of respondents did not receive federal or outside funding for state trauma program administration.
  • In spite of a 16% net loss in the Level I category, there has been a 27 percent increase in trauma centers overall since 2010.
  • The largest increase in trauma center recognition is occurring at the level III (12%), IV (63%), and V (117%) levels.

Personnel Licensing Policies, Practices and Procedures of State EMS Offices (and Variances for Military EMS Personnel) (Nov 2015)

This monograph describes contemporary state EMS licensing authority practices and requirements for the licensure of EMS personnel. It also discusses variations in practices and requirements that may exist for military-related EMS personnel (those separating from the military, members of guard or reserve units, and military spouses). The monograph is based on data collected from state EMS agency websites, state EMS agency staff interviews, and other sources during the Fall and Winter of 2014 with verification of the data reported by virtually all state EMS agencies in July 2015, just prior to publication. The monograph provides summaries of licensing practices and requirements in chart, map, and table summary formats as well as specific discussion.


The Incorporation of EMS Patient Care Data in State Data Linkage Programs (Sept 2012)

The "Incorporation of EMS Patient Care Data in State Data Linkage Programs" was produced by NASEMSO with support from the U.S. Department of Transportation, National Highway Transportation Safety Administration. This monograph reports the results of a survey of state EMS offices to assess the extent to which emergency medical services patient care records are linked with other record systems in the states, the history and near-future plans for data linkage efforts, the perceived issues that may impede data linkage efforts, steps that would likely reduce those impediments, and how those data are used by the states.

The National EMS Pandemic Influenza Preparedness Index (Nov 2010)

"The National EMS Pandemic Influenza Preparedness Index" was produced by NASEMSO with support from the U.S. Department of Transportation, National Highway Traffic Safety Administration. This report examines the levels of pan flu preparedness reported by state/territory EMS offices. The magnitude and complexity of a pandemic disease outbreak requires the concerted and coordinated efforts of the whole nation’s healthcare system. Emergency medical services are the front line of the healthcare system. Complete integration of EMS into the nation’s pandemic influenza planning and response is essential to assuring the health and safety of the public.

The Status of State Trauma System Planning and Development and Utilization of the HRSA Model Trauma System Planning and Evaluation Documents (July 2010)

"The Status of State Trauma System Planning and Development and Utilization of the HRSA Model Trauma System Planning and Evaluation Documents” was produced by NASEMSO with support from the U.S. Department of Transportation, National Highway Traffic Safety Administration, with thanks to the members of the NASEMSO Trauma Managers Council for their expertise. In this study, NASEMSO surveyed the status of state trauma systems by specifically examining the access and use of the Health Resources and Services Administration’s “Model Trauma System Planning and Evaluation Guide” and its companion self-assessment tools. The monograph represents a snapshot in time of the status of U.S. state trauma systems. This monograph can be used to identify strengths of our state trauma systems and can also be utilized to identify opportunities for improvement.

The Status of State Emergency Medical Services Office Funding and Utilization of Section 402 and 408 Highway Safety Funding (Nov 2009)

"The Status of State Emergency Medical Services Office Funding and Utilization of Section 402 and 408 Highway Safety Funding" was produced by NASEMSO with support from the U.S. Department of Transportation, National Highway Traffic Safety Administration, with thanks to the members of the NASEMSO Highway Incident & Transportation Systems (HITS) Committee for their expertise. This monograph represents the third comprehensive examination of state EMS funding. To the extent that funding equals resources, the level and trends associated with state EMS funding represent an important area of interest relating to a component of the healthcare system charged with a critical safety-net function. In this study, NASEMSO examined the levels and sources of all funding to support state EMS offices for Fiscal Year 2009 and compared those data with comparable information from previous studies. NASEMSO also specifically examined the access and use of Section 402 and Section 408 Highway Safety Funding currently experienced by state EMS offices. This monograph represents extensive work over the past year in instrument design, information gathering and data analysis.

The Status of State EMS Office Involvement in EMS Communications (Dec 2008)

NASEMSO conducted a nationwide survey of state EMS directors to ascertain the status of EMS communications capabilities, oversight and development. Communication technologies are central to the efficient coordination and delivery of emergency medical services in everyday operation and in mass casualty and domestic preparedness endeavors. We believe an understanding of the current status of these systems is essential to effective planning and better understanding of both the challenges and opportunities facing EMS. This monograph represents extensive work over the past year in instrument design, information gathering and data analysis. We are pleased that 50 of the eligible 56 jurisdictions participated in this project. This translates to an overall response rate of 89%. Because of this high response rate, our confidence in the findings is also high. We hope you will find the monograph useful in furthering the ongoing development of emergency medical services systems locally and nationally.

Depletion of Experience in State EMS Systems Leadership Positions (June 2008)

"Depletion of Experience in State EMS Systems Leadership Positions" was produced by NASEMSO with support from the U.S. Dept. of Transportation, National Highway Traffic Safety Administration. In the United States and its territories, there are 56 EMS Director positions. The specific responsibilities of these positions differ with locality, but generally encompass the highest level of administrative responsibility for the oversight of the emergency medical services system at the state or territorial government level. This is the first effort we know of to attempt to identify both the quantity and reasons for the turnover in these positions. The job of a state EMS Director is complex with a long learning curve, no matter the education or background experience of the person at the helm. Fifty of the eligible 56 jurisdictions participated in this project; this is a response rate of approximately 89%. The jurisdictions that did not respond to the survey are: California, Hawaii, Kentucky, American Samoa, Puerto Rico, and the U.S Virgin Islands. With respect to the analysis of the membership roster, tenure information is included on all 56 eligible states and territories.

Training and Certification of EMS Personnel (Apr 2007)

"The Training and Certification of Emergency Medical Services Personnel" was produced by NASEMSO with support from the U.S. Dept. of Transportation, National Highway Traffic Safety Administration. Since EMS systems have evolved differently in each of the 56 states and territories according to the resources, advocacy, political climate, case law and governing experiences of each jurisdiction, the training and certification of emergency medical services personnel also varies between states. Fifty-three of the eligible 56 jurisdictions participated in this project, including all 50 states and the District of Columbia.

"The Status of State EMS Funding" (Dec 2006)

"The Status of State EMS Funding" was produced by NASEMSO with support from the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Response (DIR) as part of CDC's TIIDE Project (Terrorism Injuries: Information, Dissemination and Exchange). In 2003, NASEMSO undertook a study of the status of state EMS funding. The study included an examination of several key indicators of state and territorial EMS system status. One of these key indicators was state EMS office funding sources and levels. Program funding is but one of several measures of preparedness; but it is an important one. After all, programs can only do what they are authorized and funded to do. "The Status of State EMS Funding" revisits the issue of how each of these offices is currently funded, and compares findings to our study in 2003 of the same subject to ascertain whether funding is increasing or decreasing generally and specifically to the sources of revenue. The survey instrument was designed to elicit information as to the amount and source of revenues that support state EMS office operations, services and products. The survey population consisted of the EMS directors of the states, territories and the District of Columbia. Of the potential pool of 56 directors, 47 surveys were returned, for an 84% rate of return. BONUS: This monograph also includes a complimentary copy of the NASEMSO April 2003 study on the status of state EMS funding.

EMS Office Structure and Function (Dec 2005)

"The Organization, Staffing and Function of State and Territorial EMS Offices" was produced by NASEMSO with support from the U.S. Dept. of Transportation, National Highway Traffic Safety Administration. Since EMS has evolved differently in each of the 56 U.S. states and territories, this project examined the current status of the systems to contribute to a better understanding of the challenges and opportunities facing EMS in the United States. Fifty-three of the 56 eligible jurisdictions participated, including all 50 states and the District of Columbia. The monograph includes organization and staffing of each EMS office; the specific areas in which EMS offices have definitive authority; exemptions, deemed status and waivers; cost, complexity and criticality of function; and state and territorial EMS office profiles. Respondents also reported on trends in net EMS staffing levels over the last five years.

Any questions about NASEMSO Monographs should be directed to:

Sharon Kelly
NASEMSO Membership Director

Phone: 703.538.1799
Fax: 703.241.5603
Email: info@nasemso.org