The History and Funding of EMS

EMS has its roots in the Department of Transportation (DOT) when Congress enacted the Highway Safety Act of 1966. Through its Office of EMS (OEMS), the DOT's National Highway Traffic Safety Administration (NHTSA) reduces death and disability by providing leadership and coordination to the EMS community in assessing, planning, developing, and promoting comprehensive, evidence-based emergency medical services. 

Since its inception, the goal of EMS has been to render emergency medical care to sick or injured citizens in emergency situations, and to provide transportation to a hospital. During the past 50 years, the role of EMS has continuously evolved. Modern EMS developed out of simultaneous advances in the science of cardiac resuscitation, combined with the recognition of accidental death and disability as a neglected epidemic. 

Today, EMS has expanded to provide care for all types of emergencies. In many areas of the country, EMS serves as a healthcare safety net, especially for the uninsured and underinsured. Public health authorities have also turned to EMS to assist in prevention activities, to promote community health and to assist in the identification of new or significant outbreaks of illness or injury.

Natural and man-made disasters have further changed the role of EMS, with an increased need to respond to a growing list of hazards and care for large numbers of patients. Advances in medicine and technology continue to generate changes in operations and the protocols for emergency care provided by EMS. Learn more about the development of modern EMS at NHTSA’s Office of EMS website.

Funding EMS

EMS care is funded mainly at the local level. Some states have adopted a more centralized EMS infrastructure, while others allow local jurisdictions to retain greater authority to develop, fund, and implement their EMS systems. Common sources of local government revenue include taxes (primarily property and sales taxes), user fees/fines, and bonds. Special districts are also frequently used to help fund these services. As an essential and safety net service, EMS must be funded by a variety of revenue streams that match its quad-pronged missions of public safety, health care, public health and disaster response and mitigation to make EMS a sustainable essential service and safety net provider. 

Today, EMS leaders across the country are working with EMS agencies, government agencies, the Centers for Medicare & Medicaid Services and insurance companies to address the EMS funding challenges. 

Grants from the 2021 Bipartisan Infrastructure Law

The 2021 bipartisan infrastructure law includes nearly 14 billion dollars in new funding to be invested directly into improving roadway safety. Approximately 6 billion dollars is authorized for the Safe Streets and Roads for All (SS4A) program, which supports local initiatives through grants to prevent death and serious injury on our roadways. It’s not too late for EMS agencies to take advantage of Planning and Demonstration Grants. Deadline #3 for these grants is August 29, 2024, 5 p.m. (EDT). 

Watch this informative webinar to learn how EMS agencies are taking advantage of grant funding opportunities to improve EMS response to roadside crashes. In addition to securing new grants, it’s a good idea to investigate grants that have already been awarded in your area to see how your agency can benefit and get involved.