This notice announces the opportunity to apply for funding under the Medicare Rural Hospital Flexibility Program (Flex Program), Emergency Medical Services (EMS) Competing Supplement (EMS Supplement).

Throughout this NOFO, the term Flex Program will refer to the larger, primary program while EMS

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Supplement will refer to the supplemental projects that are the focus of this NOFO.

The purpose of the EMS Supplement is to enable states to establish or expand programs for the provision of rural EMS by strengthening the EMS workforce in rural areas through recruitment, retention, and financial and operational strategies.

This includes, but is not limited to, activities such as:
• Establishing career advancement programs for EMS staff as part of the hiring process; • Working with local schools and community colleges to recruit students interested in EMS; • Educating community leaders on the need for volunteers and/or paid staff • Training on EMS billing; • Updating billing software; • Establishing cost-sharing agreements for billing services with other agencies; • Assisting with travel costs for training/certification; • Assisting with training/certification costs; • Addressing fatigue and the mental health toll of EMS work; The EMS Supplement intends to address and improve EMS workforce challenges in rural areas by offering support and resources to communities struggling with workforce shortages and inconsistent billing practices.