UNITED STATES OF AMERICA
DEPARTMENT OF TRANSPORTATION
NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION
COOPERATIVE AGREEMENT AWARD

I. STATEMENT OF AUTHORITY

This Cooperative Agreement between the National Highway Traffic Safety Administration (NHTSA), hereinafter referred to as “NHTSA”, and the National Association of State EMS Directors (NASEMSD), hereinafter referred to as “the Grantee” is hereby entered into under the authority of the Highway Safety Act of 1966, as amended (23 U.S.C. Chapter 4). This Cooperative Agreement provides for the limited exchanges of personnel, equipment, facilities and funds to achieve the following purpose(s).

II. STATEMENT OF BACKGROUND AND PURPOSE

NHTSA’s influence in the EMS education arena has been significant and longstanding. NHTSA develops and updates the National Standard Curriculum (NSC) for the initial training of Emergency Medical Technicians (EMT), but recently this task has become a very expensive and politically charged venture. One of the primary reasons this process has become so difficult is because the overall domain of EMS knowledge and skills is not defined. Each time curricula are revised, this issue is revisited, causing extensive discussion and considerable frustration. To improve the way in which the NSC is developed and revised, NHTSA and the EMS community came together and developed the EMS Education Agenda for the Future: A Systems Approach. This vision describes a structured EMS education system with five integrated primary components: National EMS Core Content; National EMS Scope of Practice Model; National EMS Education Standards; National EMS Education Program Accreditation; and, National EMS Certification.

A central benefit of this systems approach is improvement in the consistency of instructional quality among EMS education programs, achieved by coordinating the functions of the National EMS Education Standards, National EMS Education Program Accreditation and National EMS Certification. For paramedic education, this strategy for ensuring consistency allows the use of less prescriptive National EMS Education Standards in place of the current National Standard Curricula. With less dependence on a prescriptive National Standard Curriculum, instructors will have greater flexibility for targeting instruction to specific audiences, resulting in enhanced comprehension and improved student competence. And, by linking education standards with program accreditation and provider certification, the consistency of instructional quality can be enhanced while allowing local flexibility.

NHTSA and MCHB need to facilitate this vision and will continue to do so by supporting the efforts of the National Association of State EMS Directors (NASEMSD), who will be the grantee and lead organization for this project, and the National Council of State EMS Training Coordinators (NCSEMSTC), who will assist NASEMSD with this project. Together these organizations will develop the second piece of the vision, the National EMS Scope of Practice Model.

III. OBJECTIVE

NHTSA will enter into a Cooperative Agreement with NASEMSD to develop a National EMS Scope of Practice Model that will replace the 1993 EMS Education and Practice Blueprint. The Model Scope of Practice will define the national levels of EMS provider and include their entry-level skills and knowledge as defined within the National EMS Core Content. In addition, a schedule and method for updating the National EMS Scope of Practice Model will be established. A National EMS Scope of Practice Model will obviate the need to revisit the medical appropriateness of each procedure or cognitive domain when education standards are revised. With this essential framework, the architects of the remaining system components can focus on their specific area of responsibility, rather than on defining and redefining the scope of practice for EMS providers.

This project will also require involvement from other national EMS organizations to ensure its success. It is essential that the Scope of Practice Model, and each of the remaining soon-to-be-developed vision components, be developed in the spirit of teamwork, with the appropriate involvement of those partners and customers in the national, state and regional EMS community who have a stake in its outcome. Effective communication with appropriate facets of the EMS community is essential for project understanding and acceptance.

This project will require three operational teams and a national review team. The Administrative Team will carry out the management, supervisory and administrative requirements; the Technical Advisory Group will develop the first drafts; the Scope of Practice Task Force, comprised of members of national EMS organizations, will develop the National EMS Scope of Practice Model; and, a National Review Team will provide final review and input.

Administrative Team
The Grantee will assemble an Administrative Team that includes at a minimum, a project director(s), a principal investigator(s) and administrative support. This team is responsible for the supervision of the various teams or committees, logistical planning and scheduling, financial management, media relations, writing, technical expertise and coordination with NHTSA, MCHB, NASEMSD, and NCSEMSTC. The staff selected must have the ability to commit their time to the project so that this project can be completed on schedule. Letters of support and agreement to designated time commitment may be required for all staff. Employees of organizations who commit significant time must have support from their sponsoring organization.

Technical Advisory Group
The Grantee will assemble a group of NASEMSD and NCSEMSTC members to develop a straw man document to lead the development of the National EMS Scope of Practice Model. This group will also assist the Grantee with logistical and technical issues, such as, writing, research, and meeting agenda planning.

Scope of Practice Content Task Force
The Grantee will assemble an expert panel of subject matter experts that represent the expertise required to develop the Scope of Practice. This panel, brought together and facilitated by the Administrative Team, must demonstrate expertise in the particular subject matter area, commitment and availability. Employer commitment and support may be required as well. A formal process must be developed for the project that the Task Force can utilize when developing the Scope of Practice.

The task force should be made up of, but not limited to, the following national organizations:

• National Association of State EMS Directors
• National Council of State EMS Training Coordinators
• National Association of EMS Physicians
• American College of Emergency Physicians
• American College of Surgeons
• American Ambulance Association
• National Registry of EMTs
• National Association of EMTs
• National Association of EMS Educators
• International Association of Fire Chiefs
• International Association of Fire Fighters

The Task Force is expected to meet at least four times face-to-face; however, if in-process communication is kept up between all of the groups involved throughout the process, the number of face-to-face meetings may be reduced. The fourth meeting will be in conjunction with the National Review Team meeting.

National Review Team
NHTSA and the Grantee will identify appropriate members of the NRT and provide justification for the members selected. This group will provide the final level of review before the Grantee finalizes the document for submission to NHTSA.

The NRT should be made up of, but not limited to, the following national organizations:

• National Association of State EMS Directors
• National Council of State EMS Training Coordinators
• National Association of EMS Physicians
• American College of Emergency Physicians
• American College of Surgeons
• American Ambulance Association
• International Association of Fire Chiefs (EMS Committee)
• International Association of Firefighters (EMS Division)
• National Volunteer Fire Council
• National Registry of EMTs
• National Association of EMTs
• National Association of EMS Educators

IV. SCOPE OF WORK

For the period as hereinafter set forth, NHTSA and the grantee shall cooperatively furnish the necessary personnel, equipment and facilities and otherwise perform all things necessary for or incident to the performance of work (the accomplishment of objectives) as set forth below:

1. Specifically, NHTSA will:
1. Provide a Contracting Officer’s Technical Representative (COTR) to participate in the planning and management of this Cooperative Agreement and to coordinate activities between the grantee and NHTSA.
2. Provide information and technical assistance from available government resources as determined appropriate by the COTR.
3. Provide liaison with other government/private agencies as appropriate; and,
4. Stimulate the exchange of ideas and information among recipients of related projects through periodic meetings.
2. Specifically, the Grantee will:
   Perform the work outlined below to accomplish the objectives of this project:
1. TASK 1 - Start-up Teleconference (07/15/02)
   Within ten (10) working days after the award of this Cooperative Agreement, the grantee shall confer by telephone with the COTR and other appropriate NHTSA staff persons to review the objectives of this Agreement and the approach to reach these objectives.
2. TASK 2 - Formalize Administrative Team (8/02-9/15/02)
   The list of participants for the Administrative Team (A-Team) will be finalized and letters of support and commitment shall be submitted for review and acceptance.
3. TASK 3 – First Administrative Team Conference Call (9/25/02)
   The Administrative Team will conduct their first conference call to discuss the direction of the project and potential Technical Advisory Group (TAG) members.
4. TASK 4 - Formalize Technical Advisory Group (9/02-11/30/02)
   The grantee will formalize and invite selected NASEMSD and NCSEMSTC members to be part of the TAG.
5. TASK 5 – Second Administrative Conference Call (12/15/02)
   The A-Team and the TAG will have a conference call to plan for the first A-Team and TAG face-to-face meeting.
6. TASK 6 - First A-Team and TAG Meeting (2/24/03)
   The grantee will conduct the first joint meeting between the A-Team and TAG. The purpose of this meeting is to begin the process of developing the Straw Man document as the first step for the eventual development of the National EMS Scope of Practice Model.
7. TASK 7 - Develop the Straw Man Document (3/03-6/15/03)
   The grantee will develop the first straw man document and circulate it to the A-Team and TAG for further development electronically.
8. TASK 8 - Second A-Team and TAG (7/15/03)
   The grantee will again bring together the A-Team and TAG to further develop the straw man document and begin formalizing the Scope of Practice Task Force.
9. TASK 9 - Develop second draft of Straw Man and Formalize Task Force (8/03-10/03)
   The grantee will develop the second draft of the straw man and invite representatives of the national EMS community to participate in the process as members of the Task Force.
10. TASK 10 - First Task Force meeting (11/03)
    The grantee will bring together the members of the A-Team, TAG, and Task Force to convert the straw man document into the first draft of the National EMS Scope of Practice Model.
11. TASK 11 - Develop First Draft of the Scope of Practice Model (12/03-2/04)
    The grantee will develop the first draft of the Scope of Practice Model based upon input from the 1st Task Force meeting.
12. TASK 12 – Second Task Force meeting (3/04)
    The grantee will once again bring together the members of the A-Team, TAG, and Task Force to discuss the second draft of the Scope of Practice Model.
13. TASK 13- Develop Second Draft of the Scope of Practice Model (4/04-6/04)
    The grantee will develop the second draft of the Scope of Practice Model based upon input from the 2nd Task Force meeting.
14. TASK 14 – Third Task Force meeting (7/04)
    The grantee will again bring together the members of the A-Team, TAG, and Task Force to discuss the third draft of the Scope of Practice Model.
15. TASK 15- Develop Third Draft of the Scope of Practice Model (8/04-11/04)
    The grantee will develop the third draft of the Scope of Practice Model based upon input from the 3rd Task Force meeting and the Fall EMS conferences.
16. TASK 16 – National Review Team Meeting (12/04)
    The grantee will invite the A-Team, TAG, Task Force, and additional national EMS organization representatives to do a final review of the Scope of Practice Model.
17. TASK 17 - Develop Final DRAFT of the Scope of Practice Model (1/05-3/05)
    The grantee will develop the final DRAFT of the Scope of Practice Model.
18. TASK 18 – Submit final DRAFT to NHTSA COTR (4/05)
    The grantee will submit the final DRAFT to the NHTSA COTR for NHTSA internal review.
19. TASK 19 – NHTSA Internal Review (5/05-6/05)
    The NHTSA COTR will circulate the final DRAFT through the NHTSA internal review process. Any edits and comments will be forwarded to the grantee to address when they finalize the document.
20. TASK 20 – Finalize the Scope of Practice Model (7/05-8/05)
    The grantee will finalize the document for submission to NHTSA. The grantee will address any comments forwarded by the NHTSA COTR.
21. TASK 21 – Submit Final National EMS Scope of Practice Model to NHTSA (9/05)
    The grantee will submit the camera-ready copies of the document to the NHTSA COTR and meet the requirements as stated in the deliverables section of the Cooperative Agreement.
3. Deliverables
1. Delivery Schedule:
   The following items shall be delivered under this Cooperative Agreement:

V. REPORTING REQUIREMENTS:

Monthly Progress Reports
The grantee shall furnish two copies of a monthly progress report, one to the COTR and one to the Contracting Officer, by the 15th of each month being reported. The report shall include:

1. Accomplishments made during the reporting period.
2. Funding expended during reporting period.
3. What is planned for accomplishment during next reporting period.
4. Problems and/or delays grantee has encountered in conduct of services.
5. Specific actions that grantee would like NHTSA to undertake to solve problem.

VI. PERFORMANCE PERIOD
All work required herein including preparation, submission, and acceptance of the National EMS Scope of Practice Model shall be completed within 36 months after effective date of this Cooperative Agreement.

VIII. PROJECT OFFICERS

A. NHTSA: (Contracting Officer's Technical Representative)
David Bryson
DOT/NHTSA
400 7th Street, SW (NTS14)
Washington DC 20590
(202) 366-4302

B. The Grantee:
Beth Armstrong
NASEMSD
111 Park Place
Falls Church, VA 22046
(703) 538-1799

IX. SPECIAL PROVISIONS

Seat Belt Use Policies and Programs

In accordance with Executive Order 13043, the recipient of this award is encouraged to adopt and enforce on-the-job seat belt use policies and programs for its employees when operating company-owned, rented or personally owned vehicles. The National Highway Traffic Safety Administration (NHTSA) is responsible for providing leadership and guidance in support of this presidential initiative.

Information on how to implement such a program or statistics on the potential benefits and cost-savings to companies or organizations, can be found in the Buckle Up America section on NHTSA=s website at www.nhtsa.dot.gov. Additional resources are available from the Network of Employers for Traffic Safety (NETS), a public-private partnership headquartered in Washington DC dedicated to improving the traffic safety practices of employers and employees. NETS is prepared to help with technical assistance, a simple, user-friendly program kit and an award for achieving the goal of 85 percent seat belt use. NETS can be contacted at 1 (888) 221-0045 or visit its website at www.trafficsafety.org.

X. GENERAL PROVISIONS
The NHTSA General Provisions for Assistance Agreements, dated 7/95, as attached, shall be applicable to this Cooperative Agreement.

XI. MODIFICATIONS
Modifications to this Grant may be proposed at any time during the period of performance by either party, and shall become effective upon approval by both parties.