Highlights from the May 20, 2026 NEMSAC Meeting

The first National EMS Advisory Council (NEMSAC) meeting of 2026 took place virtually on May 20, 2026. This was the first meeting of the advisory council since the terms of its previous members were terminated Aug. 13, 2025. All NEMSAC functions were reportedly suspended after the inauguration of President Donald Trump, after which applications were taken for new NEMSAC members.

According to EMS.gov, “The National EMS Advisory Council was established in April 2007 as a nationally recognized council of EMS representatives and consumers to provide advice and recommendations regarding EMS to National Highway Traffic Safety Administration (NHTSA), part of the Department of Transportation, and to the members of the Federal Interagency Committee on EMS (FICEMS). NEMSAC provides a forum for the development, consideration and communication of information from a knowledgeable and independent perspective. NEMSAC does not exercise program management or regulatory development responsibilities and makes no decisions directly affecting the programs for which it provides advice.”

Here are some highlights from the May 20, 2026 virtual meeting.

Elevating 9-1-1 and Post-Crash Care

Gamunu "Gam" Wijetunge, Director of the Office of EMS at the National Highway Traffic Safety Administration (NHTSA), spoke about the life-saving impact of 9-1-1 pre-arrival instructions and post-crash care. "If we don't start off on a good foot for these critical patients, it's hard to recover," he said.

To make his point about the importance of early intervention, Wijetunge shared a story about an eight-year-old boy struck by a car. Because the local EMS agency had advanced capabilities, they were "able to provide him a blood transfusion within seven minutes and he was discharged alive from the hospital two weeks later," he said. Such timely interventions are "making not only a lasting difference on the patients, but clearly a lasting difference on everyone involved."

To track these vital initiatives nationwide, Wijetunge highlighted the role of the National EMS Information System (NEMSIS). He stressed that "the importance of accurate documentation cannot be understated," as it forms the backbone of all EMS research. He then issued an urgent reminder about the Safe Streets and Roads for All (SS4A) grant program. With nearly $1 billion in available funding, Wijetunge urged agencies to apply, pointing out that the Department of Transportation explicitly places "a priority on public safety infrastructure for post-crash care, emergency response coordination and pre-hospital blood transfusion activities."

Laying the Ground Rules: NEMSAC's Mission and Ethical Mandates

Clary Mole, Emergency Medical Services Specialist at the NHTSA Office of EMS (OEMS), discussed NEMSAC’s history, operations, and strict ethical framework. Established as the "single identified body to serve as that defined mechanism for giving feedback to the federal government," he said, NEMSAC operates under the Federal Advisory Committee Act (FACA) to ensure transparency and balanced public access.

Mole clearly defined the limits of the council’s authority to prevent misunderstandings among new members and the public. "One thing that's not in NEMSAC's authority is the ability to create policy or to pass regulations," he warned. "You're only here to provide advice to the government; that's a common misconception."

Mole added that members are appointed to represent specific EMS sectors—such as state offices, physicians, or educators—and must serve as a voice for those groups rather than pushing personal or employer agendas.

"We don't want you to represent yourself, your employer, [or] an organizational affiliation," he said. "Don't exert inappropriate influence. Essentially don't be a bully about your opinions."

Finally, Mole detailed the formal proposal process for drafting and approving advisories, explaining that proposals require majority approval to ensure they address systemic gaps and target agencies that possess the statutory authority to implement the recommended changes.

Structuring Subcommittees and Electing Leaders

Wijetunge covered the administrative mechanics of NEMSAC, focusing heavily on federal transparency rules and the election of council leadership. Relying on DOT Order 1120.3E, he explained that "subcommittees are strictly regulated to ensure they remain subordinate to the parent advisory committee and do not bypass federal transparency requirements."

Wijetunge then emphasized that subcommittees lack independent authority; their work is "not considered final or official until it has been deliberated and voted upon by the parent council."

The agenda then shifted to the nominations for chairperson and vice chairperson. Candidates were required to give statements reflecting their commitment to the council's 2026 priorities, such as post-crash care and prehospital blood transfusions. After various members made their cases for these positions, this process was suspended. The formal voting process will be worked out with the Secretary of Transportation prior to the next meeting.

Brainstorming the Future: Tackling Wall Times, Funding, and Provider Safety

With the administrative tasks concluded, the floor was opened to allow the newly appointed council members to brainstorm future advisory topics and subcommittee focuses. The discussion generated an enthusiastic and wide-ranging list of systemic challenges facing modern EMS, reflecting the diverse expertise of the council.

Financial sustainability and evolving care models dominated the conversation. Dr. Angela P. Cornelius, Associate System Medical Director for the Metropolitan Area EMS Authority (MedStar) in Fort Worth, Texas, stressed that "we really need to be looking at it from a treatment in place type area," advocating for EMS to be recognized and funded as an essential service.

Dr. Nicholas P. Cozzi, EMS & Disaster Medicine Medical Director at Rush University Medical Center, echoed this, warning that the current mismatch between the advanced clinical care EMS provides and the transport-based payment model "threatens access, patient care, sustainability and readiness."

Operational bottlenecks and provider well-being were also raised during this discussion. Multiple members raised alarms over hospital wall times, with Crystal Shelnutt, Regional Trauma System Development Manager for the Georgia Trauma Commission, noting how interfacility transport barriers contribute to the problem, especially in rural communities.

Steve McCoy, Division Director for Emergency Preparedness and Community Support at the Florida Department of Health, brought a crucial human element to the discussion, firmly stating, "I think we can't get through this thing without addressing the mental health and wellness of our EMTs and paramedics." He pointed out the alarming rates of suicide and the rising physical attacks on providers, intertwining these issues with broader workforce retention struggles.

Passing the Torch: Final Advice and Public Appeals

During the meeting, the council received unexpected guidance from Brendan Hayden, the immediate past chair of NEMSAC. Dialing in while driving through Boston traffic, Hayden urged the new members to lean on returning members and staff to navigate complex government structures, and to protect the integrity of the council's mission.

"In every meeting I was part of, at no time did politics play a role in anything that we did," Hayden emphasized. "While we currently live in a very politically charged world, that world must remain outside of NEMSAC's work."

Following his remarks, Mole moved to the formal public comment period. He read a letter from the American College of Paramedics, which argued that "the default practice model must change" and requested permanent federal reimbursement pathways for community paramedicine and treatment-in-place programs. Mole also shared a poignant comment from a rare disease advocate, pleading for expanded EMS protocols to allow first responders to administer lifesaving, patient-carried medications—a gap in current rules that has tragically cost lives.

The next NEMSAC meeting is scheduled for August 2026.