Since the first full year of Flex Program funding, the number and range of EMS improvement activities proposed by participating facilities has increased substantially. This report describes the EMS-related projects that states proposed to conduct in fiscal year 2004-2005.

Overall, in the 2004-2005 fiscal year few states proposed newly designed activities. Rather, it appears that many Flex coordinators proposed using Flex funding to support ongoing activities aimed at improving EMS in rural areas. The use of Flex grant funds for EMS mini-grants also appears to be very popular among states. In general, Flex funding was used in diverse ways to improve EMS, consistent with the “flexibility” of the grant program. States largely chose to use Flex grant funds to focus on three EMS challenges: promoting integration of health services, addressing human resource challenges, and improving EMS education systems.