Funding and Blood Transfusions Take Center Stage at November 2026 NEMSAC Meeting

Federal funding for post-crash care and an ambitious plan to expand prehospital blood transfusions dominated the National Emergency Medical Services Advisory Council's (NEMSAC) Nov. 4, 2026, virtual meeting.

Council members discussed more than $1 billion in newly announced federal roadway-safety grants, including approximately $335 million for projects emphasizing post-crash care, as well as a draft national strategy aimed at dramatically increasing EMS access to blood transfusions by 2028.

The meeting also highlighted the challenges of putting that strategy into practice, including the cost of blood products, sustainable reimbursement, clinical decision-making, and the data needed to evaluate patient outcomes.

Federal Investments in Post-Crash Care

Discussing the Safe Streets and Roads for All (SS4A) grant program, Gamunu "Gam" Wijetunge, Director of the National Highway Traffic Safety Administration’s Office of EMS, reported that "Secretary Duffy announced the FY26 SS4A awards representing roughly $1.01 billion in SS4A grants awarded to 297 projects in all 50 states, Puerto Rico and several tribal lands."

Wijetunge highlighted the importance of the funding for EMS, noting that approximately $335 million supports projects focused primarily on post-crash care and trauma response, including improvements to prehospital blood transfusion capabilities.

FICEMS Strategic Plan and Prehospital Blood Expansion

Wijetunge formally presented a letter from the Federal Interagency Committee on EMS (FICEMS) requesting NEMSAC's advice on its draft strategic plan for nationwide implementation of prehospital blood transfusions.

“Evidence demonstrates that prompt prehospital blood transfusion can save an estimated 37% of severe bleeding trauma patients, and every minute of delay increases mortality risk by 11%,” he said. “The draft of FICEMS' strategic plan sets an aim of preventing 10,000 deaths annually and achieving a 5% reduction in overall trauma mortality by 2028. FICEMS is soliciting NEMSAC's advice on national implementation targets across three core pillars in integrated informatics, increasing 9-1-1 pre-arrival shock instructions for pediatric and overall crash victims to 25% by 2028.”

On the topic of blood transfusions, Dr. Dustin Calhoun, the Emergency Management Officials representative who serves as the Medical Director for the Cincinnati Fire Department, suggested that EMS agencies need to make their blood product choices and resource allocation decisions carefully.

“We do have, at EMS, a tendency towards what is crassly referred to as ‘shiny object syndrome,’" he said. “We jump on new things and push forward. And the most recent excellent example of that is prehospital cooling. So, we pushed forward, everybody jumped onto it, we thought we were helping patients. And then further research demonstrated that not only were we not, we were actually harming patients.”

Dr. Nicholas Cozzi, the EMS Physicians representative and EMS & Disaster Medicine Medical Director at Rush University Medical Center, stated, "prehospital blood transfusion has to be data driven" first and foremost. He stressed that the EMS industry must "find a fundable, secured way that goes from year to year to actually provide the funding long term for this.”

Pediatric Emergency Physicians representative Dr. Shea Duerring, an Associate Professor of Pediatric Emergency Medicine at UAB, added, "Trauma is the number one thing that kills kids in our country" and urged the council to remember that pediatric patients "are uniquely positioned to really benefit” from prehospital blood transfusions.

Subcommittees Establish Early Frameworks

NEMSAC’s newly established subcommittees provided their inaugural updates to the full council. EMS Researchers representative Dr. Angela P. Cornelius, Associate System Medical Director for MedStar and Chair of the Clinical Excellence Subcommittee, said that her subcommittee is working to refine upcoming advisories. She cautioned that "we really need a good framework for all of these things" because "we all know that EMS data is dirty data".

State EMS Officials representative Steve McCoy, the Division Director for Emergency Preparedness and Community Support at the Florida Department of Health and Chair of the Systems Innovation Subcommittee, reported that his subcommittee had "a great discussion about how to expand those blood programs" and that "a significant portion of the meeting was really around what's the process for developing the advisories".

Hospital Administration representative William "Bill" Leggio, Administrator for Emergency Departments at Mayo Clinic Health System and Chair of the Integrated Informatics Subcommittee, shared that his subcommittee will partner with Systems Innovation. Together, "our action items next really are to focus on that joint subcommittee meeting to learn about Next Generation 9-1-1,” he said.

Federal and Public Updates

Federal partners also shared operational updates. U.S. Fire Administration representative Chief Richard Patrick announced that his agency is "currently letting a contract for a specific fire-based EMS whole blood program administration guide".

During the public comment period, Leah Mendelsohn Stone, Vice President of Public Policy and Advocacy at the Association for the Advancement of Blood & Biotherapies, recommended that CMS "create a separate add-on payment" for field transfusions and noted that "expanded adoption of prehospital transfusion programs depends on collaboration among the blood collectors, hospitals, and EMS agencies."

Finally, Donnie Woodyard, executive director of the United States EMS Compact, reported that the Compact's database contained 476,901 active EMS licenses. He said the system can also identify individual clinicians holding licenses in multiple states, providing a de-duplicated workforce count for the 27 states where the Compact is operational.

Looking Ahead

The next NEMSAC public meeting is scheduled to be held virtually on Feb. 3, 2027. Learn more at www.ems.gov/resources/national-ems-advisory-council-nemsac.