State EMS Offices

It is critical that an EMS office exist within each state to both regulate EMS functions and provide technical assistance to the EMS system. The lead agency for EMS within a state's government structure varies among states, but ideally the director of the lead agency should have cabinet‐level access to the governor. Each state EMS director should have access to a state EMS medical director, EMS medical committee, and EMS advisory or authority committee. The regulation of EMS systems by states includes defining levels of licensed EMS practitioners, setting a scope of practice for each level of practitioner, licensing agencies and practitioners, and establishing standards for education, certification, and reciprocity for EMS practitioners. State EMS offices can play a crucial role in collaboratives that regionalize care for time‐sensitive illnesses and recognizing specialty receiving centers. State EMS offices may also be responsible for establishing equipment requirements, medication formularies, and protocols or guidelines for patient care. State EMS offices serve as resources for EMS agencies and practitioners within the state by assisting with planning, gap analyses, funding, and other support for the provision of day‐to‐day EMS care and health care at large‐scale events and disasters.