In FY19, the Federal Office of Rural Health Policy (FORHP) presented State Flex Programs (SFPs) with an opportunity to receive $250,000 per year in funding over a three-year span to further the implementation of pilot rural Emergency Medical Services (EMS) models and quality measures for rural EMS agencies. The Flex Monitoring Team developed a multi-year plan to evaluate the SFP activities in the eight states that received funding, with goals to:

1. Monitor and collect information on projects during Year One of supplemental funding through SFP proposals, reports, and calls with program coordinators and stakeholders while clarifying which measures to use for assessing progress;
2. Provide rapid cycle data and analyses to guide participating states and inform FORHP;
3. Identify implementation challenges and the perceived impact on rural EMS services and communities;
4. Build on Year One data collection by assessing short-term outcome measures for each demonstration project.